Objective:To determine the correlation of tumor volume and weight with biochemical parameters in patients with parathyroid adenoma (PA) .Methods:A prospective electronic database collected clinical data on 208 patients with PA treated for the first time by surgery at department of general surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College.The relationship between biochemical parameters and tumor volume and weight was analyzed with Spearman’s correlation.Results:Tumor volume and weight were positively correlated with parathyroid hormone (PTH) ( r=0.33, P<0.001; r=0.39, P<0.001), calcium ( r=0.16, P=0.018; r=0.18, P=0.007) and alkaline phosphatase levels ( r=0.24, P<0.001; r=0.27, P<0.001), respectively. Clinical correlates affecting serum PTH were age, serum calcium and tumor weight ( F=30.325, P<0.001) . Conclusions:Tumor burden in patients with PA correlates with some laboratory biochemical parameters. Age and cystic lesions of the tumor may influence the actual serum PTH levels.

Oral and maxillofacial space infection(OMSI)as a mostly mixed infection,often requires the combination of anti-aerobe and an-ti-anaerobe antibiotics.The use of third-generation quinolones,such as levofloxacin,is limited in OMSI due to the tendon rupture and other serious adverse drug reactions(ADR).In the treatment of a case with OMSI and anaphilactic shock induced by levofloxacin,the association evaluation method of ADR and literature review method participated by clinical pharmacists were used.Suggestions on rational drug use and ADR treatment were gained,the patient was timely rescued from anaphylactic and cured of OMSI.

BACKGROUND: Syringomyelia is a progressive chronic disease that leads to nerve pain, sensory dissociation, and dyskinesia. Symptoms often do not improve after surgery. Stem cells have been widely explored for the treatment of nervous system diseases due to their immunoregulatory and neural replacement abilities. METHODS: In this study, we used a rat model of syringomyelia characterized by focal dilatation of the central canal to explore an effective transplantation scheme and evaluate the effect of mesenchymal stem cells and induced neural stem cells for the treatment of syringomyelia. RESULTS: The results showed that cell transplantation could not only promote syrinx shrinkage but also stimulate the proliferation of ependymal cells, and the effect of this result was related to the transplantation location. These reactions appeared only when the cells were transplanted into the cavity. Additionally, we discovered that cell transplantation transformed activated microglia into the M2 phenotype. IGF1-expressing M2 microglia may play a significant role in the repair of nerve pain. CONCLUSION Cell transplantation can promote cavity shrinkage and regulate the local inflammatory environment.Moreover, the proliferation of ependymal cells may indicate the activation of endogenous stem cells, which is important for the regeneration and repair of spinal cord injury.

Endometrial cancer (EC) is a common malignant tumor within the female reproductive system,and its incidence is increasing. The prognosis for patients with early EC is good,but the prognosis for patients with advanced and recurrent EC is extremely poor. In recent years,immune checkpoint inhibitors have shown significant promise in tumor therapy,including therapy for patients with advanced and re-current EC. Some of these patients experience disease progression during immunotherapy,and the mechanism of tumor immune escape is not thoroughly understood. Indoleamine 2,3-dioxyfenase-1 (IDO1) catalyzes the conversion of tryptophan to kynurenine,which is the first and rate-limiting step in the major pathway of tryptophan catabolism. IDO1 overexpression in a tumor microenvironment results in trypto-phan depletion and kynurenine metabolites overproduction,facilitating cancer immune escape. We review the primary mechanisms by which the IDO1 pathway facilitates immune escape in EC,and describe research progress into EC therapy targeting the IDO1 pathway.

Endometrial cancer (EC) is a common malignant tumor within the female reproductive system,and its incidence is increasing. The prognosis for patients with early EC is good,but the prognosis for patients with advanced and recurrent EC is extremely poor. In recent years,immune checkpoint inhibitors have shown significant promise in tumor therapy,including therapy for patients with advanced and re-current EC. Some of these patients experience disease progression during immunotherapy,and the mechanism of tumor immune escape is not thoroughly understood. Indoleamine 2,3-dioxyfenase-1 (IDO1) catalyzes the conversion of tryptophan to kynurenine,which is the first and rate-limiting step in the major pathway of tryptophan catabolism. IDO1 overexpression in a tumor microenvironment results in trypto-phan depletion and kynurenine metabolites overproduction,facilitating cancer immune escape. We review the primary mechanisms by which the IDO1 pathway facilitates immune escape in EC,and describe research progress into EC therapy targeting the IDO1 pathway.

Objective To compare the function recovery of multiple injuries combined with floating knee joint injury and simple knee joint injury,and to analyze the risk factors.Methods A retrospective case control study was conducted to analyze the clinical data of 41 patients with multiple injuries combined with Blake and McBryde Ⅱ A floating knee injury admitted to Xijing Hospital of Air Force Medical University from June 2011 to June 2017.There were 26 males and 15 females,aged 18-76 years,with an average of 34.5 years.There were 25 patients with simple knee joint injury and and 16 patients with multi-joint combined injury involving knee joint and ipsilateral hip joint or ankle joint injury.Surgical fixation was performed in different parts by external fixation,intramedullary nail and plate screw fixation.According to the Kalstr(o)m and Olerud functional evaluation criteria,the excellent and good rate of postoperative functional recovery was compared between the two groups.The surgical fixation methods of the two groups were compared.Logistic regression analysis was performed on the influencing factors of functional recovery.Results The patients were followed up for 1-7 years,with an average of 3 years.The excellent and good rate of overall functional recovery in the two groups was 68％,and the rate was 84％ in simple knee injury group and 44％ in multi-joint combined injury group (P ＜ 0.01).There was no significant difference in the ratio of intramedullary nail and plate screw fixation between the two groups (P ＞ 0.05),while the proportion of the external fixation in the multi-joint combined injury group [31％ (5/16)] was significantly higher than that in the simple knee joint injury group [16％ (4/25)] (P ＜ 0.05).Logistic regression analysis showed that the rate of external fixation was an independent factor affecting the postoperative function (OR =0.15,P ＜ 0.01).Conclusions The postoperative function in multi-joint injury patients is poorer than in the single joint injury patients.The higher rate of using external fixation in multi-joint injury patients is a risk factor.For Blake and McBryde Ⅱ A floating knee injury combined with multi-joint injury,less external fixation should be used,so as to improve the postoperative function.

Objective: To find out the present pediatrician allocation and the burden of diagnosis and treatment in Beijing, so as to provide evidence for effective allocation of pediatricians. Methods: Data and indicators were selected from Beijing Health Comprehensive Statistical Information Platform, including Manpower Basic Information Survey of Beijing Health Institutions, Annual Report of Medical Institutions, Beijing Statistical Data on Health Work(Compendium), as well as Beijing Health and Family Planning Statistical Yearbook. The study dynamically analyzed the number of pediatricians, that of pediatricians per 1 000 children, that of outpatients and emergency patients per pediatrician and the number of discharges per pediatrician from 2013 to 2017. Descriptive analysis was carried out on the data. Results: In 2017, the proportion of pediatricians accounted for 2.78% of the total number of doctors in the city, the number of pediatric emergencies accounted for 6.47% of the total outpatients and emergencies in the city, and the number of hospitalizations accounted for 5.70% of the total discharge in the city.From 2013 to 2017, the number of outpatients and emergency patients per pediatrician increased by 40.58%, and the number of discharged patients increased by 36.70%. The proportion of hospitalization at tertiary hospitals increased from 80.2% to 85.1%, and that in primary institutions decreased from 6.3% to 1.7%. Conclusions The study found such setbacks in the allocation of pediatric medical resources in Beijing, as insufficient pediatricians, unreasonable allocation and excessive burden on pediatricians. We should strengthen the planning and construction of pediatric human resources, improve the training mode of pediatricians, improve the salary level of pediatricians, and ease the burden on pediatricians, so as to provide high-quality medical services for children.

Objective To investigate the effect of silencing Notch1 gene by RNA interference on the proliferation,apoptosis and Akt/mTOR signaling pathway in clear renal cell carcinoma.Methods The optimal segment targeting Notch1 gene was designed and transfected into 786-O cells by Lipofectamine TM2000.The Notch1 mRNA and protein were detected by RT-PCR and Western blot.The proliferation rate of 786-O cells was evaluated by MTT and the variation of apoptosis was measured by TUNEL.The protein expression level of apoptosis-related protein Bcl-2,caspase-3,caspase-9,and signaling pathway protein Akt,p-Akt,p-mTOR,p-P70S6K were detected by Western blott.Results Notchl mRNA and protein was markedly suppressed by the siRNA targeting Notch1.Treated with 0,40,60,80,100 and 120 nmol/L of Notch1 siRNA for 24 hours,cell proliferation rates were (98.51 ± 1.33) ％,(87.34 ± 2.26) ％,(64.72 ± 3.24)％,(57.68 ±3.32)％,(31.91 ± 1.85)％ and (19.27 ±2.73)％,and the difference was statistically significant (P ＜ 0.01).Treated with 0,40,80,and 120 nmol/L of Notchl siRNA for 24 hours,apoptosis rates were (7.6 ± 3.8) ％,(21.5 ± 4.8) ％,(32.3 ± 3.5) ％,and (46.3 ± 4.7％),the difference was statistically significant (P ＜ 0.05).Decreased expression of Akt signaling pathway proteins p-Akt,p-mTOR,p-70S6K and apoptosis-related protein Bcl-2,procaspase-3 was detected,but no change in the total protein of Akt.Conclusions Depletion of Notch1 gene could inhibit cell growth and induce apoptosis in 786-O cell line.It inhibits Akt/mTOR signaling pathway by dephosphorylated.

Objective To compare the effectiveness of expandable intramedullary nail(EIMN) versus locked compression plate (LCP) in the treatment of humeral shaft fractures of AO types A and B.Methods The clinical data were retrospectively analyzed and compared of the 44 humeral shaft fractures which had been treated between May 2012 and February 2016.There were 26 men and 18 women,from 23 to 66 years of age (average,41.5 years).By AO classification,22 cases were type 12-A and 22 type 12-B.EINM was used in 22 patients with an average age of 41.3 ± 1 1.7 years and LCP in 22 ones with an average age of 41.6 ± 10.3 years.The 2 groups were compared in terms of intraoperative blood loss,operative time,hospital stay,union time,union rate,Constant and Mayo scores at the final follow-ups,and complications as well.Results The 2 groups were compatible without significant differences in the preoperative demographic data (P ＞ 0.05).All the 44 patients were followed up for 10 to 18 months (average,12 months).The intraoperative blood loss (76.4 ± 18.66 mL),operative time (69.1 ± 13.2 min),incision length (5.8 ± 1.5 cm) and union time (13.2 ± 8.4 w) in the EIMN group were significantly better than those in the LCP group (138.6 ± 39.4 mL,96.4 ± 14.2 min,8.5 ± 1.4 cm and 18.4 ± 6.6 w,respectively) (P ＜ 0.05).There was also a significant difference between the 2 groups in the total complication rate[18.2％ (4/22) versus 50.0％ (11/22)] (P ＜0.05).No deep infection or should pain was observed in either group.Conclusions Inthe treatment of humeral shaft fractures of AO types 42-A and 42-B,compared with LCP,EIMN may have advantages of less intraoperative blood loss,operative time,union time and complications.The 2 methods are similar in hospital stay and final functional recovery of the should joint.