【Objective】 To explore the effectiveness and safety of polyglycolic acid (PGA) and hydroxypropyl methylcellulose (HPMC) composite materials in distal pancreatectomy postoperative suturing. 【Methods】 We selected 36 healthy adult beagles and divided them randomly into observation group and control group, with 18 distal pancreatectomy surgeries in each group. The observation group used PGA+HPMC composite materials for incision reinforcement while the control group used NEOVEIL for incision reinforcement. 3 days before surgery, 3 days after surgery, and before dissection, blood routine tests were performed on each group of experimental dogs. Observation periods of 2-week, 4-week and 8-week were set, and six animals at each observation point were evaluated for histological examination of heart, liver, spleen, lung, and kidney tissues, hard tissue slice pathological diagnosis, and safety evaluation. 【Results】 There was no significant difference between the observation group and the control group in the preoperative blood routine test. Repeated measures ANOVA results showed differences in the mean values of white blood cell count (WBC) ( F=14.875, P=0.001), mean corpuscular hemoglobin concentration (MCHC) (F=5.049,P=0.009), neutrophil percentage (Neu%) (F=4.794, P=0.011), red blood cell count (RBC) (F=6.591, P=0.002), hemoglobin (HGB) (F=8.154, P=0.001), hematocrit (HCT) (F=5.281, P=0.007), platelet count (PLT) (F=6.560, P=0.014), red blood cell distribution width coefficient of variation (RDW-CV) (F=33.950, P=0.039), or lymphocyte percentage (Lym%) (F=3.299, P=0.043) at different time points. However, the observation group and the control group did not differ, and the interaction between time and group had no significant effect on the above indicators, suggesting that both groups of dogs had inflammatory response or surgical stress. For the 8-week postoperative hard tissue pathological section score, there was no significant difference between the observation group and the control group in the inflammation and necrosis related score, fibrosis, repair or other related scores and total score (P>0.05). In the dissection at 8 weeks after surgery, no obvious damage to the heart, liver, spleen, lung, kidney, or other organs was found in both groups, nor was there any residual suture material, pancreatic fistula, or pancreatitis, indicating that the suture materials in both groups had been completely absorbed and metabolized, and the incision healed well without causing adverse effects on the visceral organs. 【Conclusion】 PGA and HPMC are effective and safe postoperative suture materials, with good biodegradability, biocompatibility, suture strength, and wound healing quality. They can be comparable to traditional absorbable reinforcement materials in distal pancreatectomy postoperative suturing, thus providing scientific basis for their clinical application.

Objective To summarize the clinical effect and adverse reactions of avatrombopag combined with tacrolimus in the treatment of elderly patient with refractory severe aplastic anemia. Methods An elderly patient with refractory severe aplastic anemia was treated with avatrombopag and tacrolimus, and the literature review on the mechanism of action and safety of avatrombopag and tacrolimus was conducted. Results The patient was treated with a combination of cyclosporine, testosterone undecanoate, and itraconazole for 6 months without success, and developed liver and kidney dysfunction. The medication was discontinued, and the patient was treated with a combination of avatrombopag (20 mg, once per day) and tacrolimus (1 mg, twice per day). After 9 months of treatment, the patient's platelet count increased to 54×10⁹/L, the hemoglobin increased to 124 g/L, the white blood cells increased to 8.23×10⁹/L, liver and kidney function also returned to normal level, and no other adverse reactions such as thrombotic events were observed. After treatment, CD4/CD8 decreased, CD8⁺ T cells increased, and the proportion of Treg cells increased as well. Conclusion The combination of avatrombopag and tacrolimus is effective and well tolerated in the treatment of elderly patient with refractory aplastic anemia, but the long-term follow-up observation and continued accumulation of cases are still needed in the future.

Nearly a decade of curriculum update in American medical colleges and universities are summarized in this paper. This paper introduces the situation of sampling survey of colleges and universities. The results show the diversity of medical curriculum integration, reflecting the concept of multi-disciplinary integration of basic disciplines, clinical disciplines and public health and social sciences, and giving experiences such as early clinical practice, providing personalized talent cultivation approaches, and designing competency-oriented curriculum system. Combined with the current situation of medical education curriculum reform in China, it's suggested to explore the construction of medical curriculum system with Chinese characteristics, so as to contribute to the cultivation of excellent physicians for implementing Healthy China Initiative.

Spinal tuberculosis (ST) is the tuberculosis caused by Mycobacterium tuberculosis (Mtb) infections in spinal curds. Isoliquiritigenin 4,2′,4′-trihydroxychalcone, ISL) is an anti-inflammatory flavonoid derived from licorice (Glycyrrhiza uralensis), a Chinese traditional medicine. In this study, we evaluated the potential of ISL in treating ST in New Zealand white rabbit models. In the model, rabbits (n=40) were infected with Mtb strain H37Rv or not in their 6th lumbar vertebral bodies. Since the day of infection, rabbits were treated with 20 mg/kg and 100 mg/kg of ISL respectively. After 10 weeks of treatments, the adjacent vertebral bone tissues of rabbits were analyzed through Hematoxylin-Eosin staining. The relative expression of Monocyte chemoattractant protein-1 (MCP-1/CCL2), transcription factor κB (NF-κB) p65 in lymphocytes were verified through reverse transcription quantitative real-time PCR (RT-qPCR), western blotting and enzyme-linked immunosorbent assays (ELISA). The serum level of interleukin (IL)-2, IL-4, IL-10 and interferon γ (IFN-γ) were evaluated through ELISA. The effects of ISL on the phosphorylation of IκBα, IKKα/β and p65 in NF-κB signaling pathways were assessed through western blotting. In the results, ISL has been shown to effectively attenuate the granulation inside adjacent vertebral tissues. The relative level of MCP-1, p65 and IL-4 and IL-10 were retrieved. NF-κB signaling was inhibited, in which the phosphorylation of p65, IκBα and IKKα/β were suppressed whereas the level of IκBα were elevated. In conclusion, ISL might be an effective drug that inhibited the formation of granulomas through downregulating MCP-1, NF-κB, IL-4 and IL-10 in treating ST.
Blotting, Western ; Bone and Bones ; Chemokine CCL2 ; Enzyme-Linked Immunosorbent Assay ; Glycyrrhiza ; Granuloma ; Interferons ; Interleukin-10 ; Interleukin-4 ; Interleukins ; Lymphocytes ; Medicine, Chinese Traditional ; Mycobacterium tuberculosis ; New Zealand* ; Phosphorylation ; Rabbits ; Real-Time Polymerase Chain Reaction ; Reverse Transcription ; Transcription Factors ; Tuberculosis ; Tuberculosis, Spinal*

Objective:To explore the influence of ulinastatin combined with thymosinα1 on the immune function of patients with a-cute brain injury. Methods:Sixty-eight cases of patients with acute brain injury were divided into the control group and the observation group randomly with thirty-four ones in each. The control group was given the routine treatment, and the observation group was given ulinastatin combined with thymosinα1 additionally. After the 1-day, 3-day, 7-day and 14-day treatment, transforming growth factor-β1 (TGF-β1), interleukin-6(IL-6), interleukin-10 (IL-10), tumor necrosis factor-α (TNF-α) and the other serum inflammatory cyto-kine levels, and CD4 +, CD8 +, CD4 + /CD8 +, HLA-DR and cellular immune index levels were detected in the two groups. The prog-nosis effects were evaluated by the prognostic classification of brain injury, and the adverse reactions were analyzed in the two groups as well. Results:After the 1-day treatment, there were no significant differences in the serum inflammatory cytokines and immune param-eters between the groups (P>0. 05). After the 3-day, 7-day and 14-day treatment, serum TGF-β1, IL-6, IL-10 and TNF- α levels were higher than those on the first day after the treatment, and TGF-β1 showed an increasing trend with time extension, while IL-6, IL-10, TNF-α and CD4 + and CD4 + /CD8 +rose first and then decreased. After the 3-day, 7-day and 14-day treatment, serum IL-10 and CD4 +levels in the observation group were significantly higher than those in the control group, and IL-6 and TNF-αlevels were signifi-cantly lower than those in the control group (P<0. 05). After the 3-day and 14-day treatment, CD4 + and CD8 + levels in the observa-tion were significantly higher than those in the control group, and after the 7-day and 14-day treatment, HLA-DR levels were signifi-cantly higher than those in the control group (P<0. 05). The prognosis effect of the observation group was better than that of the con-trol group with statistically significant difference (P<0. 05). Conclusion:Ulinastatin combined with thymosin α1 is used to treat the patients with acute brain injury with better cellular immune function improvement and prognosis effect, which is worthy of clinical popu-larization and application.

Objective To investigate the therapeutic effects of cFLIP-siRNA tail venous injection on acute necrotizing pancre.atitis (ANP) rats,and explore the related mechanism.Methods Three pairs of cFLIP siRNAs (cFLIP-siRNA) and negative control(siRNA-NC) were designed and synthesized.The most effective siRNA to inhibit the expression of cFLIP gene was selected for the experiment.Thirty SD rats were treated with retrograde pancreaticobiliary duct injection of 5％ taurocholic acid sodium salt solution to establish ANP rat model.They were randomly divided into ANP group,siRNA-NC group and cFLIP-siRNA group with l0 rats in each group using random number method.The same volume of normal saline,siRNA-NC and cFLIP-siRNA were injected into tail vein,respectively.The rats were sacrificed after 24 h and the blood samples were colelcted.The levels of serum amylase and endotoxin were measured.The pancreatic tissues were collected and routine pathological examination was performed.The expressions of cFLIP-S and caspase-8 protein in pancreatic tissues were detected by immunohistochemistry and Western blotting.Results The levels of serum amylase in ANP group,siRNA-NC group and cFLIP-siRNA group were (1 286 ± 209),(1 297 ± 305) and (552± 256)U/L,the level of serum endotoxin were (136± 32),(128± 56) and (46± 23)ng/L,respectively.The pancreatic pathological scores were (4.97 ± 1.16),(4.92 ± 2.03) and (1.67 ± 1.98).The expression level of cFLIP-S protein were (8.56 ± 2.72),(9.12 ± 2.45) and (3.82 ± 1.46),respectively,which were significantly lower in cFLIP-siRNA group than in ANP group and siRNA-NC group (P ＜ 0.05),and the difference was statistically significant (P ＜ 0.05).The expression level of caspase-8 protein in the three groups were (2.25 ± 1.24),(2.41 ± 1.14) and (5.56 ± 1.79),respectively,which were significantly higher in cFLIP-siRNA group than in ANP group and siRNA-NC group,and the difference was statistically significant (P ＜0.05).However,there was no significant difference between ANP group and siRNA-NC group.Conclusions Inhibition of cFLIP gene expression can reduce pancreatic injury in ANP rats.The possible mechanism was that the up-regulation of caspase-8 can inhibit pancreatic cell necrosis and promote apoptosis.

Objective To investigate the level of the red blood cell (RBC) distribution width and other related indicators to predict the prognosis in patients with chronic heart failure elderly.Methods Retrospective analysis was performed in the patients with chronic heart failure elderly which died in our hospital (experimental group) and 100 patients were selected randomly that with heart failure elderly being improved by treatment (control group).The difference was compared in the level of the RBC distribution width (RDW),high-sensitivity C-reactive protein (hs-CRP),homocysteine (Hcy),D-dimer (DD),and amino-terminal pro-brain natriuretic peptide (NT-proBNP) in two groups.Results The level of RDW,hsCRP,Hcy,DD,and NT-proBNP in experimental group were significantly higher than that in control group (P ＜0.01).Conclusions Chronic heart failure was common clinical critically ill in the elderly.There were important clinical significance and important predictors to detect the levels of RDW,hs-CRP,Hcy,DD,and NT-proBNP in predicting prognosis and evaluating the effect of treatment.

OBJECTIVE: To explore the effect on proliferation and invasion of human papillary thyroid carcinoma K1 cells by application of small hairpin RNA (shRNA) silencing TFF3 gene expression. METHOD: Using liposome transfection method, TFF3-shRNA targeting of TFF3 gene will be transient transfected to papillary thyroid carcinama K1 cells, inducing the corresponding gene silencing. The experiment set up blank control group (Con group), negative control group (ConNC group) and interference group (TFF3-shRNA group). The TFF3 protein and mRNA expression were evaluated by RT-PCR, Real time-PCR, immunocytochemistry and Western blot in K1 cells after TFF3-shRNA transfected. CCK-8 method and Scratch test were used to detect the change of proliferation ability and invasion ability respectively. RESULT: (1) The recombinant plasmid Ca # HSH018037-4-HIVmU6 carrying TFF3-shRNA transfected K1 cells successfully. (2) RT-PCR and Real time-PCR detected the expression of TFF3 mRNA, which was 0.38 ± 0.11 times as many as the blank control group (P < 0.01) after TFF3 gene silenced. But the negative control group was 1.082 times of blank control group (P > 0.05). (3) Western blot show that after TFF3 gene silence induced TFF3 protein expression levels have decreased 59.5% (P < 0.01), The difference was statistically significant compared with the blank control group. (4) Cell scratch detects K1 cell invasion ability. The invasion ability of K1 cells in interference group (TFF3-shRNA group) reduced. The scratch width significantly decreased 57.1% than blank control group (P < 0.01). (5) CCK-8 kit detect cell proliferation ability. K1 cells grow significantly slower in the interference group (TFF3-shRNA group) than the blank control group through the analysis of the growth curve (P < 0.01). In the interference group (TFF3-shRNA group) proliferation inhibition rate of K1 cells at 6 h, 12 h, 24 h and 36 h, 48 h are 16.6%, 26.6%, 33.6%, 33.8%, 35.0% respectively. Compared with negative control group, proliferation ability of K1 cell decreased significantly. CONCLUSION Silenced TFF3 gene can cause the degradation of mRNA, reduce the protein translation , and inhibit the invasion and proliferation ability of K1 cell.
Carcinoma ; genetics ; pathology ; Carcinoma, Papillary ; Cell Line, Tumor ; Cell Proliferation ; Humans ; Peptides ; genetics ; Plasmids ; RNA Interference ; RNA, Messenger ; genetics ; RNA, Small Interfering ; genetics ; Real-Time Polymerase Chain Reaction ; Thyroid Cancer, Papillary ; Thyroid Neoplasms ; genetics ; pathology ; Transfection ; Trefoil Factor-3

Objective To explore the value of magnetic resonance imaging (MRI)different planes in the diagnosis of uterine sep-tum.Methods The MR images of 28 cases with hysteroscopy surgery proved congenital uterine septum were analyzed retrospective-ly.The MRI findings in different planes of uterine septum were compared.Results 28 cases of congenital uterine septum malforma-tion were shown by magnetic resonance imaging in different planes.The sensitivity of oblique coronal for the uterine septum was not only higher than the conventional axial and oblique axial,but also higher than normal coronal (P <0.05).The oblique coronal was the most sensitive MRI imaging position for diagnosis of uterine septum,especially for complete uterine septum malformation.The uterine septum morphology and signal characteristics was fully visualized and accurately measured by the oblique coronal T2 WI.The oblique axial T2 WI displayed a continuous cross-sectional image of uterine septum and played a complementary role on the diagnosis of uterine septum.In contrast,a poor display was observed for uterine septum on sagittal plane.Conclusion Congenital uterine sep-tum can be clearly demonstrated by MRI oblique coronal and oblique axial joint application.

Objective To observe the morphological changes of pancreatic tissue of thoracic duct ligated rats in fine and ultrastructural levels, and to determine whether lymph block animal model can affect pancreatic islet amyloid polypeptide(PIAP)deposit in rat pancreas. Methods At the 6th month after the operation, some pancreatic tissue sections of 16-month-old experimental rats were embedded in paraffin wax and stained with HE and Congo red;immunohistochemical staining was performed on some frozen sections, which were then observed with light microscope;transmission electron microscope (TEM) specimen preparation and observation were performed on other samples. Results HE and Congo red stained sections showed that the pancreatic glandular lobule space was widened, with significant connective tissue hyperplasia, and fat accumulation when the islet was stained indistinctly or vermeil and tissue space was broadened. The sections with immunohistochemical staining displayed the pancreatic islet as well as the tissues around it were stained into dark brown being positive with PIAP antigen. TEM observation showed the pancreatic glandular interlobule space was widened, while blood vessels and enlarged lymphatic vessels were visible;within widened pancreatic islet interstitial space, a great quantity of lipid droplets and some collagen fibril structures could be seen.Conclusion The ligation of thoracic duct can contribute to pancreatic lymph draining block, lymphagiectasis, connective tissue space and interstitial space widening, fat accumulation, and PIAP deposit in rat pancreas. These structural changes may affect the function of pancreatic islets.