The saphenous vein has been one of the most commonly used vascular materials for coronary artery bypass grafting(CABG), but the low long-term patency of the vein grafts limits the surgical benefits of CABG. The traditional method of saphenous vein harvesting is more damaging to the venous structures, which has led to the development of no-touch saphenous vein harvesting techniques. In this paper, we review the clinical progress of no-touch saphenous vein in CABG and the potential mechanisms of this technique, to improve the patency of vein grafts by analyzing the latest literature and research progress at the domestic and international level.

Objective:To establish a mortality risk prediction model of severe bacterial infection in children and compare it with the pediatric early warning score (PEWS), pediatric critical illness score (PCIS) and pediatric risk of mortality score Ⅲ (PRISM Ⅲ).Methods:A total of 178 critically ill children were selected from the PICU of the Children's Hospital of Nanjing Medical University from May 2017 to June 2022. After obtaining the informed consent of the parents/guardians, basic information such as sex, age, height and weight, as well as indicators such as heart rate, systolic blood pressure and respiratory rate were collected from all children. A standard questionnaire was used to score the child 24 h after admission to the PICU. The children were divided into the survival and death groups according to their survival status at 28 d after admission. A mortality risk prediction model was constructed and nomogram was drawn. The value of the mortality risk prediction model, PEWS, PCIS and PRISM in predicting the risk of death was assessed and compared using the receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC).Results:Among the 178 critically ill children, 11 cases were excluded due to severe data deficiencies and hospitalization not exceeding 24 h. A total of 167 children were included in the analysis, including 134 in the survival group and 33 in the death group. A mortality risk prediction model for children with severe bacterial infection was constructed using pupillary changes, state of consciousness, skin color, mechanical ventilation, total cholesterol and prothrombin time. ROC curve analysis showed that the AUCs of mortality risk prediction model was 0.888 ( P<0.05). The AUCs of PEWS, PCIS and PRISM Ⅲ in predicting death in children with severe bacterial infection were 0.769 ( P< 0.05), 0.575 ( P< 0.05) and 0.759 ( P< 0.05), respectively. Hosmer-Lemeshow goodness-of-fit test showed the best agreement between risk of death and PEWS predicted morbidity and mortality and actual morbidity and mortality (χ 2 = 5.180, P = 0.738; χ 2 = 4.939, P = 0.764), and the PCIS and PRISM Ⅲ predicted mortality rates fitted reasonably well with actual mortality rates (χ 2= 9.110, P= 0333; χ 2 = 8.943, P= 0.347). Conclusions:The mortality risk prediction model for predicting the death risk has better prognostic value than PEWS, PCIS and PRISM Ⅲ for children with severe bacterial infection.

Objective:The changes of serum inflammatory factors in patients with chronic obstructive pulmonary disease (COPD) with different traditional Chinese medicine (TCM) syndrome types were compared, and the characteristics and significance of inflammatory factors in COPD were discussed from the perspective of traditional Chinese and western medicine.Methods:A total of 100 patients with COPD who met the inclusion criteria and were admitted to Dongzhimen Hospital of Beijing University of Chinese Medicine from September 2021 to September 2022 were selected and divided into phlegm turbation obstructing lung group ( n=50) and lung and kidney qi deficiency group ( n=50) according to TCM syndrome types. Twenty healthy subjects in the same period were selected as control group. Serum levels of monocyte chemoattractant protein-1 (MCP-1), macrophage inflammatory protein-1α (MIP-1α), interleukin-6 (IL-6), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and other inflammatory factors were compared in each group. Results:The MCP-1, IL-6, ESR, CRP, white blood cell count (WBC) and procalcitonin (PCT) of COPD patients in phlegm turbation obstructing lung group were significantly higher than those in lung and kidney qi deficiency group (all P<0.05). The WBC, MCP-1, MIP-1α, IL-6, ESR and CRP of COPD patients in the lung and kidney qi deficiency group were significantly higher than those in the control group (all P<0.05). In the phlegm turbation obstructing lung group, the MIP-1α, MCP-1, IL-6, ESR, CRP, WBC, and PCT were significantly higher than those in the control group (all P<0.05). Conclusions:Patients with COPD have inflammatory reactions, and the inflammatory reactions of patients with phlegm turbation obstructing lung syndrome are more obvious than those with lung and kidney qi deficiency syndrome. The inflammatory factors MCP-1, MIP-1α, IL-6, ESR, CRP, WBC, PCT and other indicators could be used to judge the degree of COPD inflammation, which had certain clinical guiding significance for different syndrome types of COPD patients.

Ma-huang Lian-yao Chi-xiao-dou Tang is one of the three formulas for typhoid jaundice.But it has not received much attention,and the source of Lian-yao in the formula is unknown and the status and role are difficult to identify.In this paper,we first analyzed the functions of Ephedra and the symptoms of the whole formula.The formula was mainly used to"clear damp-heat"in order to remove jaundice.On this basis,it is proved that Lian-yao is the root of Forsythia,not"Qiao-gen".Today,the use of Forsythia instead of Lian-yao has the same effect.Then,the indispensable and important position of Forsythia in the formula was analyzed.It also pointed out some valuable directions for the medicinal use and research and development of Forsythia based on its wide range of effects but the lack of main symptoms.This paper provides insights for in-depth theoretical and practical research on Forsythiae Fructus.

Objective:To investigate the effects of curcumin on apoptosis and radiosensitivity of human chordoma cell line CM-319 and its mechanism.Methods:CM-319 cells were cultured in vitro and divided into curcumin 0 μmol/L group, curcumin 5 μmol/L group, curcumin 10 μmol/L group, curcumin 20 μmol/L group, si-NC group, si-UHRF1 group, curcumin+pcDNA group, curcumin+pcDNA-UHRF1 group.Flow cytometry was usedtodetect cell apoptosis, Western Blot was used to detectthe protein expression of Bcl-2, Bax, Cleaved Caspase-3 and UHRF1, qRT-PCR was used to detect the expression of UHRF1 mRNA, and clone formationexperiment was used to detect the sensitivity of CM-319 cells to radiation.Results:Compared with the curcumin 0 μmol/L group, the apoptosis rate of CM-319 cellsinthe curcumin 5 μmol/L group, curcumin 10 μmol/L group and curcumin 20 μmol/L groupincreased 12.61%±1.57%, 18.42%±1.54%, 29.37%±2.65% vs 7.24%±0.73% ( t=9.305, 19.680, 24.153; all P<0.05), and the protein expression of Bcl-2 decreased 0.62±0.06, 0.51±0.05, 0.33±0.03 vs 0.76±0.07 ( t=4.556, 8.719, 16.939; all P<0.05), while the protein expression of Bax 0.41±0.04, 0.55±0.05, 0.69±0.06 vs 0.26±0.03 ( t=9.000, 14.920, 19.230; all P<0.05) and Cleaved Caspase-3 0.37±0.04, 0.49±0.05, 0.62±0.06 vs 0.24±0.03 ( t=7.800, 12.862, 16.994; all P<0.05) increased, and the expression of UHRF1 mRNA decreased 0.82±0.08, 0.67±0.07, 0.42±0.04 vs 1.01±0.09 ( t=4.734, 8.946, 17.972; all P<0.05), the protein expression of UHRF1 decreased 0.61±0.06, 0.48±0.05, 0.31±0.03 vs 0.83±0.08 ( t=6.600, 11.130, 18.258; all P<0.05), and were dose-dependent, and the sensitization ratios were 1.433, 1.708, and 2.183, respectively. Compared with the si-NC group, the protein expression of UHRF1in CM-319 cells in the si-UHRF1 group decreased 0.35±0.04 vs 0.79±0.08 ( t=14.758, P<0.05), the apoptosis rate of CM-319 cells increased 21.49%±2.11% vs 8.24%±0.83% ( t=17.531, P<0.05), the protein expression of Bcl-2 decreased 0.34±0.03 vs 0.71±0.07 ( t=14.575, P<0.05), while the protein expression of Bax 0.62±0.06 vs 0.25±0.03 ( t=16.547, P<0.05) and Cleaved Caspase-3 0.58±0.05 vs 0.23±0.03 ( t=18.007, P<0.05) increased, and the sensitization ratio was 1.727. Compared with the curcumin+pcDNA group, the apoptosis rate of CM-319 cells in the curcumin+pcDNA-UHRF1 groupreduced 13.59%±1.25% vs 28.31%±3.01% ( t=13.549, P<0.05), the protein expression of Bcl-2 increased 0.63±0.06 vs 0.31±0.03 ( t=14.311, P<0.05), while the protein expression of Bax 0.42±0.04 vs 0.71±0.07 ( t=10.791, P<0.05) and Cleaved Caspase-3 0.38±0.04 vs 0.65±0.05 ( t=12.650, P<0.05) decreased, and the sensitization ratio was 0.539. Conclusion:Curcumin can induce apoptosis of CM-319 cells and enhance the radiosensitivity of CM-319 cells, , and the mechanism is related to the down-regulation of UHRF1 expression.

Objective:To evaluate the personalized 3D printed guide template used in the osteotomy for malunion of tibial fracture.Methods:A retrospective analysis was conducted of the 30 patients who had been treated for malunion of tibial fracture at Department of Orthopaedics, The First Affiliated Hospital to Zhengzhou University from January 2010 to January 2018. Of them, 15 used a personalized 3D printed guide template in the osteotomy (3D printing group). They were 9 males and 6 females, with an age of 46.3 year±8.2 years. The fracture malunion was located in the upper and middle tibia in 11 cases, in the lower tibia in 4 cases, on the left side in 6 cases and on the right side in 9 ones. There were 8 cases of varus deformity and 7 ones of valgus deformity. Their preoperative fracture deformity angle was 24.3°±5.5°. The other 15 patients were treated with conventional surgery (conventional group). They were 10 males and 5 females, with an age of 47.1 years±6.0 years. The fracture was located in the upper and middle tibia in 12 cases, in the lower tibia in 3 cases, on the left side in 5 cases and on right side in 10 cases. There were 7 cases of varus deformity and 8 ones of valgus deformity. Their preoperative fracture deformity angle was 22.5°±5.4°. The 2 groups were compared in terms of preoperative baseline data, operation time, intraoperative blood loss and postoperative recovery of the alignment of lower limb.Results:There were no significant differences in the preoperative baseline data between the 2 groups, showing comparability ( P>0.05). The 3D printing group was followed up for an average of 12 months while the conventional group for an average of 10 months. The operation time for the 3D printing group was significantly shorter than that for the conventional group(102.2 min±13.0 min versus 137.9 min ±10.5 min), the intraoperative blood loss for the former significantly less than that for the latter (77.3 mL ± 39.7 mL versus 163.3 mL ± 35.2 mL), and the postoperative malunion angle in the former significantly smaller than that in the latter (1.9°±0.4° versus 3.2°±0.9°) (all P< 0.05). The last follow-ups revealed no implant failure or re-malunion but fine healing of the osteotomy sites and good recovery of the alignment of lower limb in the 2 groups. Conclusion:A personalized 3D printed guide template used in the osteotomy for malunion of tibial fracture is an effective aid because it can facilitate precise osteotomy, reduce operation time and intraoperative blood loss and help correct the alignment of lower limb, leading to good short-term surgical outcomes.

Objective:To investigate the effects of lncRNA cytoskeleton regulator (CYTOR) on proliferation, migration, invasion and radiosensitivity in chordoma CM-319 and U-CH1cells and uncover the underlying mechanism.Methods:The expression of CYTOR and miR-24-3p in chordoma and nucleus pulposus tissues were detected by qRT-PCR. Human chordoma cell lines CM-319 and U-CH1 were divided into si-NC group (transfected si-NC), si-CYTOR group (transfected si-CYTOR), miR-NC group (transfected miR-NC), MiR-24-3p group (transfected miR-24-3p), si-CYTOR+anti-miR-NC group (co-transfected with si-CYTOR and anti-miR-NC), si-CYTOR+anti-miR- Group 24-3p (co-transfected with si-CYTOR and anti-miR-24-3p). Western blot was applied to detect the expression levelsof proteinsrelatedtoproliferation, migration and invasion. MTT was used to measure the proliferation of CM-319 and U-CH1 cells. Transwell assay was implemented to detect the migration and invasion ability of cells. Colony formation assay was used to detect the survival fraction of CM-319 and U-CH1 cells after different doses of radiation treatment. The relationship between CYTOR and miR-24-3p was verified by dual-luciferase reporter assay system.Results:The detection of 20 samples of chordoma tissues and 20 samples of nucleus pulposus tissuesrevealed that the expression level of CYTOR in chordoma tissues was significantly higher than that in nucleus pulposus tissues ( t=19.837, P<0.05), and the expression level of miR-24-3p in chordoma tissues was significantly lower than that in nucleus pulposus tissues ( t=22.061, P<0.05). Either inhibiting CYTOR or overexpression of miR-24-3p inhibited the proliferation, migration and invasion of CM-319 and U-CH1 cells, enhanced the radiosensitivity of CM-319 and U-CH1 cells. The result of dual-luciferase reporter assay system suggested that CYTOR negatively regulated the expression of miR-24-3p. Inhibition of miR-24-3p reversed the effects of inhibiting CYTOR on the proliferation, migration, invasion and radiosensitivity of CM-319 and U-CH1 cells. Coconlusion:CYTOR inhibits the proliferation, migration, invasion and enhanceds the radiosensitivityof CM-319 and U-CH1 cells by targetingmiR-24-3p, and CYTOR is a potential molecular therapeutic target for chordoma.

Objective:Calcium/calmodulin-dependent kinase kinase (CAMKK2) is activated in prostate cancer (PCa). The aim of our study is to identify the effects of preadipocyte and CAMKK2 on the PCa cell invasion.Methods:The coculture system between PCa cells and preadipocyte cells (3T3L1) was established and then Transwell assay was used to determine the invasive effect after coculture. Quantitative real-time polymerase chain reaction (qRT-PCR) was conducted to investigate the CAMKK2 expression in the coculture system.Results:The 3T3L1 cells promoted the invasion of PCa cells (DU145 and 22RV1; P<0.01). Meanwhile, the 3T3L1 cells can increased expression of CAMKK2 in PCa cells ( P<0.01). CAMKK2 reversed the invasive effects of preadipocyte cells on the PCa cells. Conclusions:Our study demonstrates that the preadipocyte may promote the PCa cell invasion possibly by mediating the CAMKK2 expression.

Objective To Analyze the etiology and antibiotic susceptibility in exacerbated bronchiectasis, and guide rational drug use in clinic. Methods Pathogenic microorganism culture and drug sensitivity of sputum samples of 496 cases were collected from 2015 to 2016 in Shengjing Affiliated Hospital, China Medical University. The Excel software was used to analyze the screening data and the SPSS 22.0 was used for statistical analysis to obtain the drug resistance of the bacteria to the commonly used antibiotics. Results In 469 patients, there were 551 pieces of sputum , with 198 strains positive bacterium. Positive rate was 35.93％(198/551), and bacterium was 171 strains (86.36％). Bacteria of top three positive rate was 86 strains of Pseudomonas aeruginosa (50.29％), 54 strains of Acinetobacter baumannii (31.58％) and 10 strains of Klebsiella pneumoniae (5.85％). The resistance rate of Acinetobacter baumannii and Pseudomonas aeruginosa was higher, and other pathogens also showed various degrees of tolerance to antibiotic. Conclusions The pathogens in patients with acute exacerbation of bronchiectasis are Gram-negative bacteria. Considering the characters of Pseudomonas aeruginosa, it is not suggested to use cephalosporin of the third and fourth generation in treating Pseudomonas aeruginosa. Clinical selection of antibiotics should combine with the disease characteristics of patients in our hospital.

Objective: To explore the clinical effect and safety of minor liver resection for hilar cholangiocarcinoma (HC) of Bismuth-Corlette type Ⅲ and Ⅳ. Methods: From May 2007 to May 2017, the clinical data of 108 patients with Bismuth-Corlette type Ⅲ and Ⅳ HC underwent hepatectomy were collected and analyzed retrospectively.There were 56 males and 52 females, aged (57.2±5.3) years (ranged 48-76 years) .Among the 108 cases, there were 51 cases of type Ⅲa, 40 cases of type Ⅲb and 17 cases of type Ⅳ. Small-scale hepatectomy (≤3 hepatectomy) was performed in 70 cases, including 8 cases of 4b segment resection, 28 cases of 4b segment+5 segment resection, and 34 cases of partial 4 segment+partial 7 segment+partial 1 segment resection. Large-scale hepatectomy was performed in 38 cases (>3 segments) , of which 30 cases were treated with 2 segments+3 segments+4 segments+1 segment, and 8 cases were treated with 5 segments+7 segments+8 segments+1 segment. t′ test was used to analyze the data which did not conform to the normal distribution, and χ² test was used to calculate the incidence of postoperative complications and the 1, 3, and 5-year cumulative overall survival rate. Results: (1) The operation time of minor liver resection group ((180±25)minutes) was shorter than that of major liver resection group ((210±35)minutes) (t′=4.676, P<0.05) , the amount of blooding operation time of minor liver resection group ((310±80)ml) was less than that of major liver resection group ((500±110)ml)in the operation (t′=9.385, P<0.05) , and the difference was statistically significant. (2) The incidence of complications was lower in minor liver resection group and major liver resection group, and the difference was statistically significant (χ²=5.230, P<0.05) . (3) The actual 1-, 3- and 5-year survival rates were 87.1%, 58.4%, 30.0% and 84.2%, 57.9%,31.6%, respectively. There were no significant differences in survival rates in two groups in 1-, 3- and 5-year survival rates (χ²=0.177, P=0.674; χ²=0.005, P=0.946; χ²=0.029, P=0.865) . Conclusions Compared to patients with major liver resection, Minor liver resection for selected patients with HC of Bismuth-Corlette Ⅲ and Ⅳaccording to our criteria achieved better long-term outcomes. Chen′s biliojejunostomy is a simple, effective and safe method, which can be widely used when there are multiple biliary intestinal anastomosese.