【Objective】 To investigate the correlation of serum exosomal microRNA-301a (miR-301a) with cardiovascular and cerebrovascular events after peritoneal dialysis in diabetic nephropathy. 【Methods】 A total of 211 patients with diabetic nephropathy treated with peritoneal dialysis from June 2019 to June 2020 in the First Hospital Affiliated of Hebei North University were selected as study subjects. Serum exosomal miR-301a was detected by real-time fluorescence quantitative polymerase chain reaction. The patients were divided into high miR-301a group and low miR-301a group based on the median of miR-301a; the clinical data of the two groups were compared. The correlation of miR-301a with high-sensitivity C-reactive protein (hs-CRP) was analyzed by Spearman. Linear regression was applied to analyze the factors associated with the effect of miR-301a. The patients were followed up for two years. Kaplan-Meier and Log-Rank were conducted to compare the cumulative incidence of cardiovascular and cerebrovascular events between the two groups, and COX regression and restricted cubic spline were used to analyze the level-effect relationship between miR-301a and cardiovascular and cerebrovascular events after peritoneal dialysis. 【Results】 Thirty-seven cases (17.54%) of cardiovascular and cerebrovascular events occurred during follow-up. The hs-CRP level and dialysis duration were lower in low miR-301a group than in high miR-301a group (P<0.05). There was a positive correlation between miR-301a and hs-CRP (rs=0.237, P=0.001). Linear regression analysis showed that hs-CRP was independently associated with miR-301a (P<0.05). The cumulative cardiovascular and cerebrovascular event rate in low miR-301a group was 3.70% (4/108), which was lower than that in high miR-301a group [32.04% (33/103), P<0.001]. COX regression analysis showed that high serum albumin level was an independent protective factor for cardiovascular and cerebrovascular events after peritoneal dialysis in diabetic nephropathy,while high hs-CRP level and miR-301a >1.46 were independent risk factors for cardiovascular and cerebrovascular events after peritoneal dialysis in diabetic nephropathy. Restricted cubic spline fitting COX regression analysis showed a non-linear relationship between miR-301a and cardiovascular and cerebrovascular events after peritoneal dialysis in diabetic nephropathy (P<0.05). 【Conclusion】 hs-CRP is independently associated with miR-301a in diabetic nephropathy peritoneal dialysis patients. High miR-301a level suggests a high risk of cardiovascular and cerebrovascular events after peritoneal dialysis in diabetic nephropathy.

BACKGROUND: Circulating tumor cells (CTC) play an important role in the screening and prognosis of lung cancer, but the low efficiency and specificity of CTC isolation obviously restrict its clinical application. The purpose of this study is to explore a new and efficient isolation method of CTC in patients with non-small cell lung cancer (NSCLC) in order to achieve the purpose of early diagnosis of NSCLC. METHODS: Three kinds of immunolipid magnetic spheres of epidermal growth factor receptor (EGFR), vimentin and folic acid (FA) were prepared by thin film method. After characterization, the sorting scheme of cell line was explored, the optimal sorting scheme of NSCLC CTC was constructed, and its clinical application value was studied. RESULTS: The average capture efficiency of EGFR, Vimentin and FA magnetic spheres used alone and in combination to lung cancer cell lines was 78%, 79%, 82% and 91%, respectively. In 60 patients with lung cancer, using 2 CTC per 7.5 mL blood as cutoff value, the positive rates of EGFR, Vimentin and FA magnets used alone and in combination were 65.0%, 33.3%, 93.3% and 100%, respectively. It was also found that the number of CTC detected by combined use of the three magnetic spheres was correlated with clinical stages (P<0.05). CONCLUSIONS The combination of three kinds of magnetic spheres can separate EGFR+, Vimentin+, FA+ expressed CTC, which is beneficial to the downstream analysis of CTC correlation. This study provides a new method to improve the efficiency of NSCLC CTC capture, and verifies that the captured CTC counting method can be used in the auxiliary diagnosis of lung cancer.

At present, the prevention and control of the COVID-19 is still severe, its pathogen SARS-CoV-2 is highly infectious and pathogenic, and the population is generally susceptible. In order to deal with the epidemic, selective operation can be postponed, but most of the patients with acute abdominal diseases are commonly in clinic, with acute onset and severe condition, and most of them are accompanied with fever and gastrointestinal symptoms, so emergency operation is needed.Under the condition of the current epidemic—COVID-19, it requires a higher standard to diagnose and treat patients with acute abdomen. The first step is to carry out procedures to identify whether the patient is infected or not. Those who are not infected can go through the normal treating procedures.For patients diagnosed with COVID-19 or suspected patients, the second step is to achieve classified diagnoses and treatments, and to adopt a treating plan that integrates TCM and western medicine.In order to protect patients and medical staff, the COVID-19 in hospital transmission must be avoided. For patients with COVID-19 who need emergency surgery, we must strictly comply with the hospital's protection regulations, closely coordinate the relevant departments of surgery, perform the three-level protection, operate in accordance with the principle of damage control in the negative pressure surgery room, and return to the isolation ward according to the prevention and control process after operation. For units without surgical conditions, patients should be transferred to hospital in time on the premise of maximum damage control, and patients must not be delayed for timely diagnosis and treatment due to the epidemic.

At present,the prevention and control of the COVID-19 is still severe,its pathogen SARS-CoV-2 is highly infectious and pathogenic,and the population is generally susceptible.Thus,it requires a higher standard to diagnose and treat patients with acute abdomen.The first step is to carry out procedures to identify whether the patient is infected or not.Those who are not infected can go through the normal treating procedures.For patients diagnosed with COVID-19 or suspected patients,the second step is to achieve classified diagnoses and treatments,and to adopt a treating plan that integrates TCM and western medicine.In order to protect patients and medical staff,the COVID-19 in hospital transmission must be avoided.For patients with COVID-19 who need emergency surgery,we must strictly comply with the hospital 's protection regulations,closely coordinate the relevant departments of surgery,perform the three-level protection,operate in accordance with the principle of damage control in the negative pressure surgery room,and return to the isolation ward according to the prevention and control process after operation.For units without surgical conditions,patients should be transferred to hospital in time on the premise of maximum damage control,and patients must not be delayed for timely diagnosis and treatment due to the epidemic.

The distribution of peripheral blood lymphocyte subsets were compared between patients with colorectal cancer and healthy controls.The number of natural killer(NK) cells and CD8+T cells and the percentage of naive CD4+T cells were all decreased significantly in patients.On the contrary,the percentages of memory CD4+T cells,HLA-DR+ CD8+ T cells and CD38+ CD8+ T cells were significantly increased.It suggests that the tumor killing effect of cytotoxic lymphocytes in peripheral blood is impaired in patients with colorectal cancer,whereas the immune response is over stimulated.

We retrieve and analyze the articles on body surface temperature of acupoints in the recent 50 years. Surface temperatures have been compared between acupoints and nonacupoints, and among acupoints in different states. The impacts of interventions for acupoint temperature are explored, including acupuncture,moxibustion and cupping, etc. We summarize the features and the rules of acupoint skin temperature. It is considered that there exists distribution rule for healthy people's acupoint skin temperature. That means acupoints have higher surface temperature than nonacupoints. In the same meridian the nearer acupoints close to the head and trunk, the higher the temperature is. The difference in symmetrical acupoints temperatures between the left and right side is about 0.5℃. In the different meridians the skin temperatures of adjacent acpoints are similar. The changes of acupoint's skin temperature in illness can be used as the auxiliary diagnosis. Acupuncture, moxibustion and cupping can produce acupoints stimulating, metabolism improving,balance, acupoint temperature regulating. Thus,diseases are relieved. The specificity and regularity that acupoint's skin temperature presents may be one of the manifestations of the acupoint specificity, also it is an important starting point of the research on acupoint sensitization. The further studies should consider different diseases and modern biological engineering techniques, so that more rules of acupoints temperature can be found by more sensitive and objective temperature measurements as well as experimental and the mathematical models.

The efficacy and safety of Saccharomyces boulardii in treatment of candida esophagitis was investigated by a single center, prospective, open label and non-inferiority trial.Eighty nine patients with candida esophagitis attending in Shanxi Provincial People′s Hospital during April 2015 to March 2016 were randomly divided into Saccharomyces boulardii group (45 cases) and nystatin group (44 cases), and oral Saccharomyces boulardii powder and Nystatin tablets were given to two groups respectively.The curative effect was evaluated by gastroscopy after the treatment.The results showed that the cure rate of Saccharomyces boulardii group and nystatin group was 68.9%(31/45)and 63.6%(28/44), and the Saccharomyces boulardii was noi inferior to nystatin (x2=3.027, P<0.05).Chi-square test showed that there was no significant difference in effective rate between two groups [91.1%(41/45)vs.93.2%(41/44), x2<0.001, P>0.05].The incidence of adverse reactions in boulardii group was significantly lower than that in nystatin group [2.2%(1/45) vs.22.7%(10/44), x2=8.636, P<0.05].The study suggests that the cure rate of Saccharomyces boulardii is not inferior to nystatin in treatment of candida esophagitis, while the incidence of adverse reactions of Saccharomyces boulardii is lower.

Traditional Chinese medicine considers that the final purpose of acupuncture treatment for disease is to harmonize yin and yang. Acupuncture redresses a balance between yin and yang by transmitting information to acupoints and then to corresponding visceral tissues and organs and the brain through the meridian system or the nervous system. In recent years, scholars at home thoroughly studied heart rate variability (HRV) analysis for acupuncture treatment of diseases and found that the regulating effect of acupuncture on visceral organs was closely related to autonomic nerves and acupuncture could restore a balance between sympathetic and parasympathetic nerves. Many scholars explored the effect of acupuncture on diseases related to autonomic nervous dysfunction by HRV frequency domain or time domain analysis and gained a certain achievements. This article summarizes recent years’ domestic studies on HRV-based analysis of acupuncture for diseases with autonomic nervous dysfunction and reviews the close relationship between autonomic nerves and diseases and the related mechanism of acupuncture action.

BACKGROUND:In the process of designing knee joint prosthesis and operating total knee arthroplasty for the Chinese people, we should not only take into account the proximal tibial anatomical characteristics and the difference of geometry, but also should pay attention to the differences between different races. OBJECTIVE:To compare the anatomical morphological differences between Mongolian and Han nationality through measuring the CT tomography scanning and three-dimensional reconstruction measurement of tibia proximal part of Han and Mongolian nationality, so as to provide the data references for prosthesis selection used for total knee arthroplasty. METHODS:Total y 60 patients who received the treatment at the Department of Joint Surgery were col ected, and divided into Han nationality and Mongolian nationality groups (n=30/group, 15 males and 15 females in each group). The age was (36.00+7.22) years old. 16-row helical CT scan (American GE Lightspeed 16) was used for spiral scanning, slice thickness 0.625 mm. Scanning images were exported in DICOM format and saved. Digital three-dimensional reconstruction measurement was conducted using Mimics 15.0 three-dimensional reconstruction software. The tibial plateau width, anteroposterior diameter of the medial tibial plateau and lateral anteroposterior diameter were measured respectively to observe whether there were any differences among sex, sides and nationality. RESULTS AND CONCLUSION:There were no significant differences in the above indicators between left and right sides (P>0.05). There were significant differences in tibial plateau width, anteroposterior diameter of the medial tibial plateau and lateral anteroposterior diameter between males and females, and Han and Mongolian nationality groups (P<0.05). Specific performed in:(1) There was significant difference in the morphological measurement parameters of proximal tibia between sex for Han and Mongolian nationality, and the mean value of male was larger compared with that of female. (2) There was certain significant difference in the part of the parameter indicators between Han and Mongolian nationality groups. These results suggest that the prosthesis should be chose and placed correctly according to the differences of morphological characteristics, gender, nationality, region of the Chinese people. (3) Digital three-dimensional reconstruction technology and individualized design can choose suitable prosthesis for different people, so as to ensure a good repair effect in patients after total knee replacement.

BACKGROUND:The conditions of teenager and adult skeletons have great differences. Thus, it is dangerous to place screw on teenagers using the methods for adults.
OBJECTIVE:To observe the anatomical features of teenagers’ upper-middle thoracic vertebra images, and to provide experimental basis for pedicle nailing and pedicle-rib head unit nailing in teenagers’ upper-middle thoracic vertebrae.
METHODS:We chose 30 teenagers (13 to 18 years old) without spine lesions, and then they were scanned (0.625-1.25 mm) from T 1 to T 12 segments using CT. The original data were loaded into a three dimensional software in DICOM format for measuring related indicators. At last, we analyzed the data according to different segments.
RESULTS AND CONCLUSION:The trend between the width of pedicle and pedicle-head unit was similar, showing a“V”shape. The minimum of width was located in the T 4 , and there were significant differences between the corresponding vertebral bodies (P<0.05). The trend between pedicle nail road length and pedicle-rib head unit nail road length was similar, and the trend between them was gradual y increasing. The minimum of length was located in T 1 , and the maximum of length was located at T 10 , and there were significant differences between the corresponding vertebral bodies (P<0.05). The trend between the pedicle transverse angle and pedicle rib-head unit transverse angle was similar. The trend from T1 to T10 was on a decline, and there were significant differences in corresponding vertebrae (P<0.05). The trend of curves between pedicle sagittal angle and pedicle rib-head unit sagittal angle was similar, showing a wavy shape, and there were significant differences in corresponding vertebrae (P<0.05). These results confirmed that the same segmental pedicle rib-head unit can provide a safer nailing place than the pedicle relatively.