ObjectiveTo investigate the preventive and therapeutic effects of Tiaogan Huaxian pills combined with entecavir on hepatic fibrosis in chronic hepatitis B with liver Qi stagnation， spleen deficiency， and blood stasis syndrome and its effect on diffusion-weighted imaging （DWI）. MethodClinical data of 117 patients with liver disease who visited the Department of Hepatology at the First Affiliated Hospital of Guangxi University of Chinese Medicine from January 2021 to April 2022 were retrospectively analyzed. According to different treatment plans， they were divided into a control group （59 cases） and a treatment group （58 cases）. Both groups of patients received entecavir-based etiology treatment， and the treatment group added Tiaogan Huaxian pills on the basis of basic treatment. Both groups were treated for 24 weeks. Before and after treatment， the two groups were compared in terms of alanine aminotransferase （ALT）， advanced surgical technologies （AST）， total bilirubin （TBil）， hepatitis B virus （HBV）-DNA conversion rate， liver stiffness measurement （LSM）， four items of liver fibrosis （hyaluronidase， type Ⅲ pro-collagen， type Ⅳ collagen， and laminin）， the fibrosis index based on four factors （FIB-4）， the aspartate aminotransferase to platelet ratio index （APRI）， the apparent diffusion coefficient （ADC） value in magnetic resonance imaging （MRI）， and traditional Chinese medicine symptom scores， so as to analyze the efficacy of the two groups. ResultBefore treatment， there was no significant difference in ALT， AST， TBil， LSM， four items of liver fibrosis， FIB-4， APRI， HBV-DNA conversion rate， ADC value， and traditional Chinese medicine symptom scores between the two groups. After treatment， both groups of patients showed significant reductions in ALT， AST， TBil， LSM， hyaluronidase， type Ⅲ pro-collagen， type Ⅳ collagen， laminin， FIB-4， and APRI （P<0.05） and a significant increase in ADC value （P<0.05） and HBV-DNA conversion rate （P<0.01）. The traditional Chinese medicine symptom score of the treatment group decreased significantly （P<0.05）. Compared with the control group after treatment， the effective rate of clinical traditional Chinese medicine in the treatment group was 91.38% （53/58）， which was significantly higher than that of the control group （54.23%， 32/59） （Z=-4.325， P<0.01）. In the treatment group， ALT， AST， TBil， LSM， hyaluronidase， type Ⅲ pro-collagen， type Ⅳ collagen， laminin， FIB-4， APRI， and traditional Chinese medicine symptom scores all decreased significantly （P<0.05）， and the increase in ADC values was more significant （P<0.05）， while the difference in HBV-DNA conversion rate was not statistically significant. There were no serious adverse reactions or events in either group. ConclusionTiaogan Huaxian pills combined with entecavir have significant clinical efficacy in the treatment of hepatic fibrosis in chronic hepatitis B， which can reduce liver inflammation activity， delay hepatic fibrosis progression， and reduce traditional Chinese medicine symptom scores. It is worthy of clinical promotion and application.

To study an automatic plan(AP) method for radiotherapy after breast-conserving surgery based on TiGRT system and and compare with manual plan (MP). The dosimetry parameters of 10 patients and the evaluation of scoring table were analyzed, it was found that the targets dose of AP were better than that of MP, but there was no statistical difference except for CI, The V5, V20 and V30 of affected lungs and whole lungs in AP were lower than all that in MP, the Dmean of hearts was slightly higher than that of MP, but the difference was not statistically significant, the MU of AP was increase by 16.1% compared with MP, the score of AP evaluation was increase by 6.1% compared with MP. So the AP could be programmed and automated while ensuring the quality of the plan, and can be used to design the plans for radiotherapy after breast-conserving surgery.
Breast Neoplasms/surgery* ; Female ; Humans ; Mastectomy, Segmental ; Organs at Risk ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; Radiotherapy, Intensity-Modulated

Objective:To investigate the protective effect of human umbilical cord mesenchymal stem cell conditioned medium (HucMSC-cm) against lipopolysaccharide (LPS)-induced acute lung injury (ALI) and relevant mechanism of action.Methods:Forty 6-week-old male C57BL/6 mice were selected and randomized (random number) into the sham group, LPS group, LPS + HucMSC-cm (LPS+cm) group, and LPS+HucMSC-cm+Compound C (LPS+cm+cc) group, with 10 mice in each group. Mice were intratracheally injected with LPS (5 mg/kg) to establish ALI model, and intratracheally injected with hucMSC-CM (50 μL) 4 h after LPS treatment. Mice in the LPS+cm+cc group were intraperitoneally treated with Compound C (15 mg/kg) prior to LPS treatment. Neutrophils in peripheral blood were counted with the automated hematology analyzer 72 h after LPS administration. After that, mice were sacrificed, and the lung tissue pathology was observed using hematoxylin eosin (HE) staining. Besides, the expressions of IL-6, ICAM-1, VCAM-1 and P-AMP-activated protein kinase (P-AMPK) in the lung tissues were analyzed by Western blot and immunohistochemical assay. In vitro, human lung microvascular endothelial cells (HuLEC-5a) were cultured and divided into three groups: control group, LPS group (10 μg/ mL), and LPS + HucMSC-cm group. After 24 h of treatment, the expressions of p-AMPK and AMPK were detected by Western blot, and the expressions of IL-6 and IL-8 were detected by real-time fluorescence quantitative PCR. Oneway analysis of variance was used to compare the mean values of normally distributed measurement data between groups. Comparisons between two groups were performed using the Tukey’s multiple comparison test. Results:Compared with the sham group, the LPS group showed lungs with congestion and swelling, thickened pulmonary septum, and inflammatory cell infiltration. Moreover, in the LPS group, the protein expressions of IL-6 ( P=0.003), ICAM-1 ( P<0.001) and VCAM-1 ( P=0.001) were increased significantly, while the expression of p-AMPK was decreased ( P=0.013), accompanied by an increase in the proportion of neutrophils in peripheral blood ( P<0.001). Compared with the LPS group, the LPS+HucMSC-cm group demonstrated eased congestion, edema and pathological injury of lung tissue, reversed protein expressions of IL-6 ( P=0.003), ICAM-1 ( P=0.002), VCAM-1 ( P=0.006) and P-AMPK ( P=0.002), as well as decreased proportion of neutrophils in peripheral blood ( P<0.005). Compared with the LPS+HucMSC-cm group, the LPS+cm+cc group exhibited more severe lung histopathological injury, significantly increased protein expressions of IL-6, ICAM-1 and VCAM-1 in lung tissues, as well as decreased expression of P-AMPK protein. The results of immunohistochemistry were consistent with those of protein. In vitro experiment, after LPS treatment, the mRNA expressions of IL-6 ( P<0.001) and IL-8 ( P=0.027) were increased and p-AMPK protein expression ( P=0.005) was decreased as compared with the control group. In comparison with the LPS group, the LPS+HucMSC-cm group showed decreased mRNA expression levels of IL-6 ( P=0.003) and IL-8 ( P=0.002), but increased protein level of p-AMPK ( P=0.003). Conclusions:HucMSC-cm has a protective effect against LPS-induced acute lung injury, which is mainly attributed to the inhibited expression of adhesion molecules and inflammatory factors under the activation of AMPK.

Objective:To analyze the anatomical distribution of complex facial injuries (woun-ds ≥8 cm in length and involving two or more anatomical areas) in children, and to explore the effect of plastic and aesthetic surgery.Methods:A total of 157 children with complex facial injury were admitted to the Plastic Surgery Department of Hangzhou Plastic Surgery Hospital from January 2019 to June 2021, including 94 males and 63 females, aged from 2 to 18 years, with an average age of 6.2 years. The wound length was 8-20 cm, with an average length of 10.3 cm. Plastic surgery techniques were used to design different primary repair schemes according to specific wound conditions, and early postoperative scar prevention and treatment were carried out.Results:In 157 cases, 331 anatomical areas were involved, most of which were buccal (75 sites). The injury caused by sharp instruments (glass, ceramic tile, cutting tools, etc.) ranked the first place with 78 cases. All patients were followed up for more than 3 months, and the results showed 146 cases of primary healing, 11 cases of delayed healing, 8 cases of scar hyperplasia, 149 cases of good morphological and functional recovery.Conclusions:The advantages of using plastic and cosmetic surgery techniques to treat complex facial injuries lie in the emphasis on anatomical and functional reduction and tension-reducing suture, combined with a variety of postoperative scar prevention and treatment measures, and the results are satisfactory.

Drug delivery with customized combinations of drugs, controllable drug dosage, and on-demand release kinetics is critical for personalized medicine. In this study, inspired by successive opening of layered structures and compartmentalized structures in plants, we designed a multiple compartmentalized capsular structure for controlled drug delivery. The structure was designed as a series of compartments, defined by the gradient thickness of their external walls and internal divisions. Based on the careful choice and optimization of bioinks composed of gelatin, starch, and alginate, the capsular structures were successfully manufactured by fused deposition modeling three-dimensional (3D) printing. The capsules showed fusion and firm contact between printed layers, forming complete structures without significant defects on the external walls and internal joints. Internal cavities with different volumes were achieved for different drug loading as designed. In vitro swelling demonstrated a successive dissolving and opening of external walls of different capsule compartments, allowing successive drug pulses from the capsules, resulting in the sustained release for about 410 min. The drug release was significantly prolonged compared to a single burst release from a traditional capsular design. The bioinspired design and manufacture of multiple compartmentalized capsules enable customized drug release in a controllable fashion with combinations of different drugs, drug doses, and release kinetics, and have potential for use in personalized medicine.

Data of 643 patients who underwent endoscopic polypectomy with high-frequency electrotome in 6 hospitals of Sichuan Province between June 2020 and September 2020 were summarized. The rate of complete polypectomy and the incidence of delayed post-polypectomy bleeding (DPPB) and perforation were analyzed. DPPB occurred in 18 cases (2.80%) and postoperative perforation occurred in 1 case (0.16%). All of the 1 828 polyps were completely resected (100.0%). Univariate analysis showed that polyps′ diameter≥10 mm, long peduncle or laterally spreading tumor (LST), adenomatous polyp, endoscopic mucosal resection, mixed cutting mode 1 of electrocoagulation were significantly correlated with DPPB( P<0.05). Multivariate Logistic regression analysis revealed that polyp diameter≥10 mm ( P=0.001, OR=3.575, 95% CI: 1.175-9.955), morphology of long peduncle or LST ( P=0.004, OR=2.981, 95% CI: 1.233-14.858) were independent risk factors for DPPB. Endoscopic colorectal polypectomy with high-frequency electrotome is effective and safe. Polyps′ diameter≥10 mm, polyps with long pedicle or LST are the risk factors for DPPB.

Objective:To explore the clinical effect and safety of interventional treatment of autogenous arteriovenous fistula(AVF) stenosis.Methods:From July 2017 to September 2018, 96 patients with arteriovenous fistula stenosis and occlusion admitted to Handan First Hospital, Hebei Province were retrospectively analyzed.All of them were dialysis patients with chronic renal failure.All patients underwent percutaneous balloon angioplasty via the cephalic vein.The success rate of technique, clinical success rate, perioperative complications and follow-up were observed.Results:(1) Technical success rate and clinical success rate: 90 patients were treated with percutaneous transluminal angioplasty (PTA) via the cephalic vein, the other 3 patients were treated with interventional therapy via the brachial artery, and 3 patients underwent reconstruction of internal fistula.The technical success rate was 93.8% (90/96), and the clinical success rate was 89.6% (86/96). (2) Perioperative complications: thrombosis in 4 cases, vasospasm in 3 cases.There were no serious complications such as vascular rupture, aneurysm, vascular dissection, and no perioperative death.(3) The first stage patency rate was 100% (90/90), 74.4% (67/90), 62.2% (56/90) and 46.7% (42/90) in 3, 6, 12 and 18 months after operation.Conclusion:Venipuncture can be used as the first choice for AVF stenosis interventional therapy because of its advantages of small trauma, no serious complications, no need of long-term compression at the puncture point, immediate dialysis, and avoidance of local hematoma and other complications caused by artery puncture.

Objective:To compare the clinical effect and perioperative complications of the treatment of autogenous arteriovenous fistula stenosis by arterial and venous approach.Methods:The clinical data of 120 patients with AVF stenosis and occlusion who were treated with interventional therapy and met the inclusion criteria were collected and analyzed by retrospective case-control study.from September 2017 to August 2018, 60 patients with internal fistula stenosis were treated by transarterial approach (arterial approach group), and from September 2018 to may 2019, 60 patients were treated with a new surgical scheme(venous approach group). The operation success rate, perioperative complications and patency rate of 3, 6, 12 months after operation were compared between the two groups.Results:(1) The technical success rate was 96.7% (58/60) and the clinical success rate was 91.7% (55/60) in the arterial approach group, and 95.0%(57/60) and 93.3%(56/60) in the venous approach group.There was no significant difference in the technical success rate and clinical success rate between the two groups ( P=0.718 and 1.000, respectively) (2) Perioperative complications: in the arterial approach group, 3 patients had hematoma at the puncture point, 2 pseudoaneurysms and 5 thrombosis.There were 3 patients with thrombosis in the venous access group, and the difference in the incidence of complications between the two groups was statistically significant (χ 2=4.227, P=0.036). (3)The primary patency rates at 3, 6 and 12 months after operation were 95.0%(57/60), 75.0%(45/60) and 60.0%(36/60) in the arterial approach group, and 96.7%(58/60), 71.7%(43/60) and 61.7%(37/60) in the venous access group, respectively.There was no statistically significant difference between the two groups ( P=0.718, 0.749, 0.885). Conclusion:The interventional treatment for autogenous arteriovenous fistula stenosis through artery and vein approach can achieve good effect.There were many complications during the perioperative period, It is suggested that venous approach is preferred.

Objective: To observe the clinical effect of hyperbaric oxygen therapy on cervical spondylotic myelopathy (CSM) in the peri-operative period, and to explore its neural mechanism. Methods: Eighty patients who underwent surgical decompression for CSM were randomly divided into a hyperbaric oxygen group (n=40) and a control group (n=40). Both groups received cervical laminoplasty and systematic rehabilitation treatment after the surgery, while the hyperbaric oxygen group was additionally provided with hyperbaric oxygen therapy in the peri-operative period. The patients′ neurological status was evaluated using Japanese Orthopaedic Association (JOA) scores. Both groups received conventional MRI and diffusion tensor imaging (DTI) before and 6 months after the surgery. Results: After the surgery, both groups gained significant improvement in their average JOA score, with the improvement of the hyperbaric oxygen group significantly greater than in the control group. Pearson correlation analysis showed that the average pre-operative JOA score was significantly correlated with the anisotropic fraction (FA) and the apparent dispersion coefficient (ADC) of the compressed spinal cord. Six months after the surgery such correlation still persisted. During the six months, significant increase was observed in the average FA and significant decrease in the average ADC in both groups, with the average FA of the hyperbaric oxygen group (0.726±0.087) significantly higher at the end of the 6 months than that in the control group. The average ADC (1.148±0.079)×10^-3 mm²/s) was significantly lower. Conclusions DTI′s quantitative indicators can objectively show changes in the microstructure and pathological state of spinal cords. Exposure to hyperbaric oxygen may relieve ischemia and hypoxia of the spinal cord, promoting the repair of injured neurons and accelerating the regeneration of nerve fibers.

Objective: To explore the role of tumor suppressor gene programmed cell death 5 gene (PDCD5) in the growth and temozolomide (TMZ) sensitivity of brain glioma cells. Methods:Atotal of 116 patients with cerebral glioma admitted to the Department of Neurosurgery, First Clinical Hospital of Jilin University from January 2009 to December 2014 were enrolled in this study. QPCR, WB and immunohistochemistry method were used to detect the mRNAand protein expressions of PDCD5 in glioma cell lines (U87, U251), U87 cell line with stable PDCD5 expression (U87-PDCD5), glioma cells with si-PDCD5 transfection and primary cerebral glioma tissues, respectively. MTT assay was used to detect the effect of over-expression or knockdown of PDCD5 on the growth and TMZ-sensitivity of glioma cells. The subcutaneous tumor-bearing model of glioma cell line U87 was established in nude mice, and then the experimental mice were randomly divided into control group, TMZ group, PDCD5 group and TMZ+exogenous PDCD5 recombinant expression vector group.After 20 days, the animals were sacrificed by cervical dislocation and the tumor tissue was excised to measure the tumor volume and weigh. The expression of PDCD5 in tumor tissues was detected by qPCR and WB methods, and the effects of PDCD5 combined with TMZ on the growth of gliomas were also analyzed. Results: The relative mRNA and protein expressions of PDCD5 in U87 cells were significantly lower than those in U251 cells (both P<0.05), and the mRNA and protein expressions of PDCD5 in high level glioma tissues were significantly lower than those in low level tissues (all P<0.05). The sensitivity of U87-PDCD5 cells and U251 cells to TMZ was higher than that of U87 cells (all P<0.05). The sensitivity of cells to TMZ in U87-PDCD5-siRNA group and U251siRNA group was significantly lower than that of the control group (both P<0.05). The tumor volume and weigh to fnudemicexenografts were compared,and the results showed control group>TMZ group>PDCD 5group>combined group(allP<0.05);however, the mRNA and protein expressions of PDCD5 in the transplanted tumor tissues of each group showed the opposite trend (all P<0.05). Conclusion: PDCD5 over-expression can enhance the chemosensitivity of braingliomato the chemotherapy drug TMZ, while silencing of PDCD5 expression exertsthe opposite effect.The combination of PDCD5 and TMZ can better inhibit the growth of xenografts in nude mice.