Objective:To explore the team construction and treatment strategy of the Diabetic Foot-Multidisciplinary Team.Methods:The clinical data of 19 patients with severe ischemic diabetic foot treated by our Diabetic Foot-Multidisciplinary Team Center from Apr 2021 to Mar 2022 were collected, and the overall amputation rate, above-ankle major amputation rate, minor amputation rate and mortality, Diabetic Foot-Multidisciplinary Team consultation discipline participation rate and treatment participation degree were retrospectively analyzed.Results:Nineteen patients (15 males and 4 females) were enrolled, aged 26 to 94 (68.6±14.2). All were with severe ischemic diabetic foot ulcer:Rutherford grade 5 or up and dysfunction in 2 or more organs. Complications included arteriosclerosis obliterans of the lower extremities in 18 cases, heart diseases in 18, hypertension in 15, and renal insufficiencies in 10. The overall amputation rate was 36.8%, major amputation rate in 21.1%, minor amputation rate in 15.8%, and mortality rate was 15.8%. A total of 16 disciplines participated in Diabetic Foot-Multidisciplinary Team; the main participating disciplines were vascular surgery (19 times), endocrinology (12 times), and cardiology (11 times). The main treatment disciplines were vascular surgery (14 times), plastic surgery (3 times), and cardiology (2 times).Conclusion:For the diagnosis and treatment of diabetic foot, it is necessary to set up a multidisciplinary team as early as possible to control the causes of diabetic foot ulcer, prevent the recurrence of diabetic foot ulcer, reduce the mortality and amputation rate, and improve the quality of life of patients.

Via an insufficient coat protein complex I (COPI) retrieval signal, the majority of SARS-CoV-2 spike (S) is resident in host early secretory organelles and a tiny amount is leaked out in cell surface. Only surface-exposed S can be recognized by B cell receptor (BCR) or anti-S therapeutic monoclonal antibodies (mAbs) that is the trigger step for B cell activation after S mRNA vaccination or infected cell clearance by S mAbs. Now, a drug strategy to promote S host surface exposure is absent. Here, we first combined structural and biochemical analysis to characterize S COPI sorting signals. A potent S COPI sorting inhibitor was then invented, evidently capable of promoting S surface exposure and facilitating infected cell clearance by S antibody-dependent cellular cytotoxicity (ADCC). Importantly, with the inhibitor as a probe, we revealed Omicron BA.1 S is less cell surface exposed than prototypes because of a constellation of S folding mutations, possibly corresponding to its ER chaperone association. Our findings not only suggest COPI is a druggable target against COVID-19, but also highlight SARS-CoV-2 evolution mechanism driven by S folding and trafficking mutations.

Objective:T explore the longitudinal mediation of emotional labor and emotion regulation between occupational stress and job burnout in cinema employees.Methods:This study was a two-point longitudinal study (Interval of 2 months) with the 1067 employees from 44 city cinemas across the country as the sample,using the Emotional Labor Questionnaire (ELQ) to measure the degree of emotional labor,Emotion Regulation Questionnaire (ERQ) to measure the degree of emotion regulation,Occupational Stress Indicator-2(OSI-2) to measure the degree of occupational stress,Maslach Burnout Inventory(MBI) to measure the degree of job burnout and Job Satisfaction Scale to measure the degree of job satisfaction.A series of structural equation model analyses was conducted for data analyses.Results:The scores of expression suppression were negatively correlated with scores of occupational stress (r =-0.16,P ＜0.01),and positively correlated with the scores of job satisfaction (r =0.17,P ＜0.01).The structural equation model which include the scores of occupational stress as the predictive variable,the scores of emotional labor and emotion regulation as the mediator,the scores of job burnout and job satisfaction as the outcome variable fit well.Emotional labor (surface acting and deep acting) acted as a mediator between occupational stress and job burnout(95 ％ CI:0.03-0.05;0.02-0.05).Emotion regulation (cognitive reappraisal) acted as a mediator between occupational stress and job bumout(95％ CI:0.01-0.03).Conclusion:Emotional labor and emotion regulation acted as a mediator between occupational stress and occupational outcomes.Expression suppression has positive effect in Chinese culture.People who well in using cognitive reappraisal can lead to positive work effect througgh more deep acting and less surface acting.

Objective To explore the security and its influencing factors on benign airway stenosis treated with interventional of high pressure balloon expansion catheter.Methods Clinial data of 39 cases of inpatients suffered from benign airway stenosis were chosen.17 cases were male,and 22 cases were female.The ages of them ranged from 15 to 83 years old.According to the clinical symptoms,HRCT 3D reconstruction,and the results of bron-choscope,all patients were treated with balloon expansion catheter at different criterions.The balloon catheter with size that slightly smaller than the targeted normal bronchial tube was chosen,expansion for average 1 -4 times,single balloon expansion time ranged from 0.5 to 4 min,the pressures were kept at 3 -6 atmosphere,and the highest pres-sure did not exceed 8 atmospheric pressure.The efficacy and complications were retrospectively analyzed.Results 19 cases were completely effective,14 cases were basically effective,6 cases were completely ineffective,and the total effective rate was 84.6% (33 /39 ),the incidence of complications was 35.8% (14 /39 ),moreover,no deaths occurred.Conclusion High pressure balloon catheter expansion is one of commonly used technology in breathing interventional treatment;it has the characteristics of easy operation,and immediate curative effect,and so on.But if the improper operation,incorrect selection of the case,or inaccurate evaluation of the stenosis during operation,serious complications and unnecessary iatrogenic injury can be occurred.Therefore,it is worthy of attention and further summarizing by breathing interventional physicians.

Objective To observe the efficacy and safety of trimetazidine/coenzyme Q10 combination in the treatment of the elderly patients with chronic heart failure(CHF).Methods Sixty-two male patients aged over 80 years with CHF were randomly divided into intervention group and control group.Patients in control group received optimal conventional CHF therapy according to the guideline for CHF,while patients in intervention group received trimetazidine of 20 mg,3 times per day,coenzyme Q10 20 mg,3 times per day,additionally for 6 weeks.Left ventricular ejection fraction (LVEF),left ventricular end diastolic diameter (LVEDD),plasma brain natriuretic peptide (BNP),6 min walking distance (6MWT) and NYHA cardiac function classification of two groups before and after treatment were observed.Results Before treatmen,the NYHA function class of patients in intervention and control groups were 2.8±0.7,2.7±0.7 respectively,after treatment were 2.1± 0.6,2.4 ± 0.7 respectively,the differences were significant before and after treatment (t=6.808,2.249;P＜0.01,P＜0.05).Before treatment,BNP of intervention and control groups were (540±351)ng/L,(483 ± 351) ng/L respectively,after treatment were (219± 172) ng/L,(316 ± 202) ng/L respectively,the differences were significant before and after treatment (Z =-4.927,-4.042;P ＜ 0.01).Moreover,after treatment,NYHA function class and plasma BNP in intervention group were significantly better than those in control group (t =-2.109,P ＜ 0.05;Z =-2.219,P ＜ 0.05).Before treatment,LVEF,LVEDD and 6MWT of intervention group were (44.3 ± 3.1) ％,(54.0 ± 4.7) mm and (217.0 ± 60.9) m respectively,after treatment were (46.8±3.9) ％,(53.2±4.3) mm and (267.0±91.1) m respectively,the differences were significant before and after treatment(t=-8.313,2.254,-4.561;P＜0.01 or P＜0.05).Moreover,after treatment,LVEF and 6MWT in intervention group were significantly better than those in control group ((44.9± 3.5)％,(213.2 ±78.1) m;t =2.000,2.186;P ＜ 0.05).No significant adverse events were detected in the intervention group.Conclusion Combination of trimetazidine and coenzyme Q10 on the basis of the conventional treatment in the elderly with CHF,can further improve cardiac dysfunction and have a good safety.

Purpose To explore the expression of monocarboxylate transporters 4 (MCT4) and its clinicopathologic significance in cer-vical squamous cell carcinoma. Methods The expression level of MCT4 in 72 cervical squamous cell carcinoma tissues and 48 cervi-cal normal tissues were detected by immunohistochemistry assay, and its relationship with clinical pathological features was analyzed. Results The positive rate of MCT4 was 81. 9% (59/72) in cervical squamous cell carcinoma tissues and 35. 4% (17/48) in normal cervical tissues. The positive rate of MCT4 in cervical squamous cell carcinoma was significantly higher than that in cervical normal tis-sues (χ2 =26. 848, P<0. 001). In addition, the expression of MCT4 protein was correlated with clinical stage (χ2 =5. 389, P=0. 020) and lymph node metastasis (χ2 =4. 706, P=0. 030). However, it did not correlated with age (χ2 =1. 238, P=0. 266), tumor differentiation (χ2 =0. 530, P=0. 467) or infiltration degree (χ2 =1. 300, P=0. 254) in patients with cervical squamous cell carcinoma. Conclusion The expression of MCT4 is up-regulated in cervical squamous cell carcinoma and correlate with clinical stage and lymph node metastasis of cervical squamous cell carcinoma. MCT4 may be a biomarker for evaluating the biological behavior of cer-vical squamous cell carcinoma.

Objective To preliminaryly explore the effect and adverse reaction of Marine Injection combined therapy through local spray in benign tracheobronchial stenosis.Methods 19 cases of bronchial tuberculosis were collected in our department.By assessing cough,shortness of breath and other symptoms,chest high -resolution CT (HRCT)of three -dimensional reconstruction,and length were observed by ultrafine bronchial stenosis.According to the pathogeny and types of stenosis,combined multiple intervention were sequentially adopted,and then Marine Injec-tion was sprayed through one -off endoscopic spray tube.All the subjects were divided into the two groups,the higher concentration Marine injection (1 200 mg/mL)group was chosen with the condition of serious inflammation,edema, ulcer and necrosis,obvious local granulation tissue hyperplasia,severe scar stenosis,and the length of stenosis greater than 2 cm or the sectional area of stenosis less than 50% of the normal sectional area,otherwise the low concentration (600 mg/mL)group was chosen.The subjects were reexamined by clinical symptoms,high -resolution CT (HRCT) of three -dimensional reconstruction,and ultrafine bronchoscopy a week after the surgery to dynamically observe the local changes.Depending on the situation,the injection was sprayed once a week,adding up to 2 -4 times.Follow -up visit lasted for 3 months,cough,expectoration or hemoptysis,and dyspnea were observed.Results 11 cases were effective fully,17 cases were effective substantially,7 cases were ineffective,the total effective rate was 80% (28 /35).The overall complication rate was 42.8% (15 /35),no deaths occurred.No complications related to local spra-ying of Marine were seen.Conclusion Local spray of Marine Injection may have preferable effect that inhibits scar formationand prevention airway restenosis.It is worth further study with a high security,precise clinic effect,easy oper-ation and etc.

Adolescent ; Carcinoma, Renal Cell ; metabolism ; pathology ; Desmin ; metabolism ; Diagnosis, Differential ; Humans ; Leg ; MART-1 Antigen ; metabolism ; Male ; Melanoma ; metabolism ; pathology ; Melanoma-Specific Antigens ; metabolism ; Perivascular Epithelioid Cell Neoplasms ; metabolism ; pathology ; surgery ; Sarcoma, Clear Cell ; metabolism ; pathology ; Skin Neoplasms ; metabolism ; pathology ; surgery

Objective To retrospectively analyze the effect of two kinds of biological agents in volume -re-duced bullae .Methods 11 patients who suffered from bullae were operated under large C-arm locating ,and infused two kinds of biological agents through micro catheter of fibreoptic bronchoscopy .All of them were randomly divided into the two groups .The biological agents in group A were fibrinogen and diluent thrombin , and that of group B was Porcine Fibrin Sealant Kit .In group A,the micro catheter with diameter of micro thread less than 1.2mm was placed in bullae through fibreoptic bronchoscope ,and then the 2mL lidocaine,5 ml fibrinogen,and double of 500u diluent thrombin were inproperorder injected through micro catheter .In group B,the Porcine Fibrin Sealant Kit was injected at the same method,and then the suspension fluid was exacted .The operation time was recorded ,and then the clinical efficacy and incidence rate of complications were compared .Results The operation time of group A was 5-15 minutes, and that of group B was 6-20 minutes.For all the patients ,4 cases were totally effective ,2 cases were significantly effective,and 2 cases were totally non-effective.The total effective rate was 81.82%(9/11).The incidence rates of common complications in group A and B were 52.38%(22/42),58.33%(14/24),respectively,the difference was not significant (χ2 =0.22,P>0.05).Moreover,there were no serious complications in all cases .Conclusion The security and effect of two kinds of biological agents might be well enough ,but in view of less cases ,they were worth to further popularized and applied in clinical practice .

Objective To assess the clinical and histopathological features as well as treatment of Wells syndrome.Methods The clinical and pathological findings from 7 patients with Wells syndrome were retrospectively reviewed.Results Lesions were located on both lower extremities in 4 patients,on the back in 1 patient,on the face and trunk in 1 patient,and on the buttocks in 1 patient.Clinical manifestations included cellulitis (n =3),urticaria (n =1 ),annular plaques (n =1 ) and papulonodules (n =2).Histopathological examination of skin biopsies showed an infiltrate of numerous eosinophils with occasional flame figures in the dermis of all the patients.Leucocytoclastic vasculitis was found in 3 cases.No triggering factors were found in any of the 7 cases.The lesions nearly subsided in 3 patients after 2-week treatment with oral small-dosage prednisone and tripterygium glycosides.Conclusions Wells syndrome shows a wide diversity of clinical manifestations with distinct histological features.Systemic glucocorticoids and tripterygium glycosides are effective for the control of this condition.