Objective:To characterize the histopathological subtypes and their clinicopathological parameters of gender and onset age by common, rare and sparse primary esophageal malignant tumors (PEMT).Methods:A total of 272 437 patients with PEMT were enrolled in this study, and all of the patients were received radical surgery. The clinicopathological information of the patients was obtained from the database established by the State Key Laboratory of Esophageal Cancer Prevention & Treatment from September 1973 to December 2020, which included the clinical treatment, pathological diagnosis and follow-up information of esophagus and gastric cardia cancers. All patients were diagnosed and classified by the criteria of esophageal tumor histopathological diagnosis and classification (2019) of the World Health Organization (WHO). The esophageal tumors, which were not included in the WHO classification, were analyzed separately according to the postoperative pathological diagnosis. The χ 2 test was performed by the SPSS 25.0 software on count data, and the test standard α=0.05. Results:A total of 32 histopathological types were identified in the enrolled PEMT patients, of which 10 subtypes were not included in the WHO classification. According to the frequency, PEMT were divided into common (esophageal squamous cell carcinoma, ESCC, accounting for 97.1%), rare (esophageal adenocarcinoma, EAC, accounting for 2.3%) and sparse (mainly esophageal small cell carcinoma, malignant melanoma, etc., accounting for 0.6%). All the common, rare, and sparse types occurred predominantly in male patients, and the gender difference of rare type was most significant (EAC, male∶ female, 2.67∶1), followed with common type (ESCC, male∶ female, 1.78∶1) and sparse type (male∶ female, 1.71∶1). The common type (ESCC) mainly occurred in the middle thoracic segment (65.2%), while the rare type (EAC) mainly occurred in the lower thoracic segment (56.8%). Among the sparse type, malignant melanoma and malignant fibrous histiocytoma were both predominantly located in the lower thoracic segment (51.7%, 66.7%), and the others were mainly in the middle thoracic segment.Conclusion:ESCC is the most common type among the 32 histopathological types of PEMT, followed by EAC as the rare type, and esophageal small cell carcinoma and malignant melanoma as the major sparse type, and all of which are mainly occur in male patients. The common type of ESCC mainly occur in the middle thoracic segment, while the rare type of EAC mainly in the lower thoracic segment. The mainly sparse type of malignant melanoma and malignant fibrous histiocytoma predominately occur in the lower thoracic segment, and the remaining sparse types mainly occur in the middle thoracic segment.

OBJECTIVE：To study t he effects of bro mophenylcurcumin（GL63）on the apoptosis ，migration and invasion of human cholangiocarcinoma RBE cells ，and to investigate its mechanism based on JAK/STAT signaling pathway. METHODS ：MTT assay was used to detect the effects of different concentrations of GL 63 [0（blank control ，similarly hereinafter ），1.25，2.5，5，10， 20，40 μ mol/L] on the proliferation of RBE cells after 48 h treatment ；the IC 50 was calculated. The effects of different concentrations of GL 63（0，5，10，20 μmol/L）on colony formation were detected by crystal violet staining after 48 h treatment. Flow cytometry ，Hoechst 33342 staining，cell scratch test and Transwell chamber invasion test were used to detect the effects of different concentrations of GL 63（0，5，10，20 μmol/L）on cell cycle distribution ，apoptosis，migration and invasion ability after 24 h treatment. Western blotting assay was adopted to detect the effects of different concentration of GL 63（0，5，10，20 μmol/L） on the expression of JAK 2/STAT3 signal pathway associated proteins. RESULTS ：The proliferation inhibition rates of RBE cells in different concentrations of GL 63 groups（1.25-40 μmol/L）were significantly increase d，compared with blank control group （P＜ 0.01），and showed a dose-dependent trend ，with IC 50 of （8.46±1.30）μmol/L. Compared with blank control group， 85917439。E-mail：zhaoji-an-88@163.com inhibition rates of RBE cell colony formation were significantly decreased in different concentrations （5，10，20 μmol/L）of GL 63 groups（P＜0.01）. The percentage of RBE cells at G 0/G1 phase increased significantly ，while that at S phase decreased significantly （P＜0.01）. The apoptotic rate increased significantly（P＜0.01），and the nucleus showed dense pyknosis and apoptotic bodies. The rate of cell migration and healing was significantly decreased （P＜0.01），and the number of invasive cells through basement membrane was significantly decreased （P＜ 0.01）. The protein expression of p-JAK 2， p-STAT3， Bcl-2， MMP-2， MMP-9， Pro-caspase-9 and P ro-caspase-3 were down-regulated significantly while the expression of Bax ，Cyt-c，Cleaved-caspase-9 and Cleaved-caspase- 3 were up-regulated significantly（P＜0.01）. CONCLUSIONS ：GL63 may inhibit the proliferation ，migration and invasion of RBE cells and promote its apoptosis by inhibiting JAK 2/STAT3 signal pathway.

Objective:To explore the effect of problem-based learning (PBL) combined with case teaching method in the three-year probationary teaching of clinical urology in three-year higher vocational colleges.Methods:A total of 45 students from Class 1, Grade 2015, and 37 students from Class 2, Grade 2016 of Ningxia Medical University were selected as study subjects. They were divided into experimental group and control group. Forty-two students in experimental group were taught with PBL combined with case teaching method. 40 students in control group were taught with traditional clinical probation teaching method. Besides, a questionnaire survey was conducted among two groups of students in the Department of urology.Results:There was no significant difference in the scores of theoretical examination between the experimental group and the control group ( P>0.05). The scores of medical history collection, physical examination, practical skills and total scores were much higher in the experimental group than in the control group. The results of the questionnaire survey showed that the teaching of the experimental group could significantly motivate students' enthusiasm and participation, as well as enhance ability of self-study, information acquisition, innovation, analysis and problem-solving and team consciousness ( P<0.05). Conclusion:The new model of PBL combined with case teaching is helpful in improving students' academic performance, probation effect and comprehensive practical ability in urology internship teaching, which is worth being popularized in clinical teaching.

Objective:To explore the clinical strategies for preservation of the exposed implant in chronic wounds and wound repair.Methods:From January 2016 to January 2019, totally 8 patients (4 males and 4 females, aged 10 to 73 years) sustaining postoperative chronic wounds with exposed implants were admitted to the Fourth Medical Center of PLA General Hospital. There were 2 cases of abdominal patch exposure after abdominal trauma surgery, 2 cases of titanium plate exposure post craniocerebral surgery, 3 cases of internal fixator exposure post orthopedic surgery, and 1 case of cerebrospinal fluid drainage tube exposure after craniocerebral surgery. The wound exudate was collected for bacterial culture on admission. On the basis of glycemic control and correction of anemia and hypoproteinemia, thorough wound debridement was performed as soon as possible and the wound area after debridement ranged from 2.0 cm×0.5 cm to 6.0 cm×5.0 cm. The wounds of 4 patients were immediately closed after debridement, including 1 case by primary closure, 1 case by primary closure after local filling of platelet rich plasma gel, and 2 cases by local flap transplantation, with flap size of 10.0 cm×8.0 cm and 12.0 cm×8.0 cm, respectively. The donor sites of flaps were sutured directly and all the incisions were treated with continuous vacuum sealing drainage (VSD) after surgery. The other 4 patients were treated with continuous VSD after debridement to improve the wound bed. The wound of 1 case healed gradually, 1 case received direct wound suturing, and the wounds of 2 cases were repaired with thin split-thickness skin grafts from the thigh or the head. The results of bacterial culture of wound exudate on admission, wound healing post surgery, and follow-up were observed and recorded.Results:The bacterial culture of wound exudate on admission was positive in 6 patients, and 10 strains of bacteria were isolated with Staphylococcus epidermidis as the main pathogen. All the skin grafts or flaps of patients survived post surgery, with the incisions and wounds healed and all the implants preserved. After 1 to 3 years of follow-up, no recurrence of wound was found in any patient. Conclusions:The postoperative chronic wounds with exposed implants can be closed in primary stage by direct suturing or flap transplantation if it is clean enough on the basis of thorough debridement. The wounds with large defects or serious infection can be treated with continuous VSD firstly and then closed with direct suturing or skin grafting for delayed wound closure, thereby to reach the treatment goal of preserving the implants and repairing the wounds simultaneously.

Objective To summarize analysis in elderly patients with type 2 diabetes mellitus with cerebral microvascular lesion with diabetes pill in combination with metformin on patients after treatment the blood viscosity, the effects of cognitive dysfunction.Methods Our hospital during the period of July 2014 to September 2016 received 100 cases of elderly patients with type 2 diabetes mellitus with cerebral microvascular lesions, according to the random allocation method divided into observation group(50 cases) and control group(50 cases) and control group using metformin treatment, the observation group USES the diabetes pill metformin treatment, treatment effect of two groups of patients and related indicators for comparative analysis.Results After treatment the cognitive function score and blood viscosity related indicators, statistically significant differences between observation group and control group.Conclusion Elderly patients with type 2 diabetes mellitus with cerebral microvascular lesions in clinical application in diabetes, pill metformin, help to improve the patient's cognitive dysfunction, improve the patient's blood viscosity, promote the prognosis of patients, is worthy of popularization and application.

Objective:To explore the effect of chitosan hydrogel on the serum levels of tumor necrosis factor (TNF-α),interleukin (IL-10) and intercellular adhesion molecule (ICAM-1) of patients with burns.Methods:96 cases with second degree burns who were treated in our hospital from June 2015 to November 2016 were selected and randomly divided into two groups,with 48 cases in each group.The patients in the observation group were treated with chitosan hydrogel,while the patients in the control group were treated with conventional vaseline gauze wound.Then the wound healing,the serum levels of tumor necrosis factor (TNF-α),interleukin (IL-10) and intercellular adhesion molecule (ICAM-1) and the incidence of adverse reactions were observed and compared between the two groups before and after the treatment.Results:The healing rate of superficial burns at the 7th day in the observation group was significantly higher than that of the control group (P＜0.01).The healing rate of deep burns at the 15th day and 25th day were significantly higher than those of the control group (P＜0.05).The healing time of the superficial burns and deep bums in the observation group were significantly shorter than those of the control group,and the SI score was significantly lower (P＜0.01).After treatment,the serum levels of TNF-α,IL-10 and ICAM-1 of patients with superficial burns significantly decreased in the two groups,and the observation group was lower than that of the control group (P＜0.05).The serum levels of TNF-α,IL-10 and ICAM-1 of patients with deep burns were significantly lower than before,and the observation group was lower than that of the control group (P＜0.01).The incidence of wound infection in the observation group was lower than that of the control group (P＜0.05).Conclusion:Chitosan wound repair membrane gel could accelerate the wound healing,prevent the wound infection,and reduce the inflammation with high safety.

OBJECTIVETo observe the curative effects of platelet-rich plasma (PRP) combined with negative-pressure wound therapy (NPWT) on patients with sternal osteomyelitis and sinus tract after thoracotomy.

METHODSSixty-two patients with sternal osteomyelitis and sinus tract after thoracotomy, hospitalized from March 2011 to June 2015, were retrospectively analyzed. Based on whether receiving PRP or not, patients were divided into two groups, group NPWT ( 22 patients hospitalized from March 2011 to December 2012) and combination treatment group (CT, 40 patients hospitalized from January 2013 to June 2015). After debridement, patients in group NPWT were treated with continuous NPWT (negative pressure values from -15.96 to -13.30 kPa), while those in group CT were treated with PRP gel (blood platelet counts in PRP ranged from 1 450×10(9)/L to 1 800×10(9)/L, with 10-15 mL in each dosage) made on the surgery day to fill the sinus tract and wound, followed by NPWT. Negative pressure materials were changed every 5 days until 20 days after surgery in patients of both groups. PRP gel was replenished before changing of negative pressure materials in patients of group CT. The sinus tract sealing time, wound healing time, number of patients who had secondary repair surgery, number of patients who had recurrence of sinus tract within three months after wound healing, and length of hospital stay were recorded. Data were processed with t test, Fisher's exact test, and chi-square test.

RESULTSThe sinus tract sealing time, wound healing time, and length of hospital stay in patients of group CT were (16±8), (27±13), and (43±13) d respectively, which were all significantly shorter than those in group NPWT [(29±14), (41±17), and (60±20) d, with t values from 3.88 to 4.67, P values below 0.01]. The number of patients who had secondary repair surgery in group CT was less than that in group NPWT (P<0.01). There was no statistically significant difference in the number of patients who had recurrence of sinus tract between two groups (P>0.05).

CONCLUSIONSCompared with NPWT only, PRP combined with NPWT has great curative effects on patients with sternal osteomyelitis and sinus tract after thoracotomy, for it shortens sinus tract sealing time, wound healing time, and length of hospital stay, and avoids the secondary repair surgery. This method is simple and safe with little injury.

Debridement ; Humans ; Length of Stay ; Negative-Pressure Wound Therapy ; Osteomyelitis ; surgery ; therapy ; Paranasal Sinuses ; pathology ; Platelet-Rich Plasma ; Retrospective Studies ; Sternum ; surgery ; Thoracotomy ; Wound Healing

Purpose To determine the effect of RNase MC2 purified from momordica charantia on cell growth of hepatocellular carcino-ma ( HCC) and its underlying mechanism. Methods MTT, colony formation and nude mice model were used to examine the activity of RNase MC2 in cell proliferation. Cell cycle analysis was done by flow cytometry. Autophagy induced by RNase MC2 treatment was observed via transmission electron microscope. Western blot was performed to detect the RNase MC2-mediated changes of proteins. Re-sults In vitro and in vivo data showed that RNase MC2 markedly inhibited HCC cell proliferation, arrested cells at G2/M phase by in-creasing expression of p53 and p21, induced autophagy via upregulating Beclin-1 and LC3-Ⅱ. Furthermore, combination of RNase MC2 and Sorafenib exerted enhanced lethal effect on HCC cells. Conclusion RNase MC2 manifests significant antitumor activities and enhances the killing effect of Sorafenib in HCC via inducing cell cycle arrest and autophagy.

Adult ; Arrhythmias, Cardiac ; diagnosis ; physiopathology ; Brugada Syndrome ; Cardiac Conduction System Disease ; Electrocardiography ; Female ; Heart Conduction System ; abnormalities ; physiopathology ; Humans ; Young Adult

Objective To explore the mechanism of Didang Qigui Recipe on preventing diabetes. Methods Ten female rats were set randomly as normal group, and others 70 were injected with STZ (60 mg/kg) to establish the diabetic model. After the model was established, 50 model rats were randomly divided into five groups:the model group, Didang Qigui Recipe group, the gliclazide group, Didang Qigui Recipe high-dose group, Didang Qigui Recipe and gliclazide group, with 10 rats in each group. All groups were given a gavage with related medicine. With treatment being given respectively, eight weeks later, contents of IL-1βand IL–2 in serum were detected by ELISA and structure of pancreatic β cells was observed by immunohistochemistry and microscope. Results Compared with the model group, the contents of IL-1βand IL-2 in serum of rats decreased in treatment groups, especially in Didang Qigui Recipe group and Didang Qigui and gliclazide group (P<0.05). The degree of apoptosis in pancreaticβcells, especially in the above two groups, has been less affected than other groups (P<0.05). Conclusion Didang Qigui Recipe has preventive and therapeutic effects on diabetes by inhibition of inflammatory response and protection structure of pancreaticβcells.