OBJECTIVE To investigate the effect of Lycii Fructus-Chrysanthemi Flos herbal pair on the occurrence and progres-sion of light source-induced myopia in guinea pigs.METHODS The three-band fluorescent lamp was used to irradiate guinea pigs to establish a model of light source-induced myopia.Lycii Fructus-Chrysanthemi Flos herbal pair extract was added in the feed to raise guinea pigs.Ophthalmic A-type ultrasonic measuring instrument was used to detect the eye axis.HE staining was used to observe pathological damage to the retina of the guinea pigs.Enzyme-linked immunosorbent assay(ELISA)was used to detect dopamine(DA)and melatonin(MT)levels in guinea pig retinas,and transcriptomic analysis and other methods were used to explore the effects of Lycii Fructus-Chrysanthemi Flos on light-induced myopia in guinea pigs.RESULTS After 6 weeks,compared with the normal group,the eye axis of model group guinea pigs increased significantly(P<0.01),thus,the myopia model was successfully established.Lycii Fruc-tus-Chrysanthemi Flos herbal pair extract could effectively slow down the thickening of the lens and the deepening of the vitreous cavi-ty,thereby delaying the overgrowth of the eye axis in model guinea pigs.The retinal tissue of guinea pigs in the model group became thinner,the thickness and number of cells in the inner and outer nuclear layer of the retina were significantly reduced,the ganglion nu-clei were sparse,the vacuolization of the ganglion cell layer was obvious.Lycii Fructus-Chrysanthemi Flos extract could protect retinal cells.The thickness and cell number of the retinal inner nuclear layer and outer nuclear layer were increased,and ganglion cell nuclei were increased.ELISA assay showed that the concentrations of DA and MT in the retina of model group guinea pigs were significantly reduced(P<0.05),and the medium and high doses of Lycii Fructus-Chrysanthemi Flos herbal pair extract could effectively increase the concentration of dopamine in the retina and serum of guinea pigs in the model group(P<0.01,P<0.001).The differential genes screened by eye transcriptomics analysis were mainly enriched in PPAR signals pathway,collagen-containing extracellular matrix and other related pathways.ELISA results showed that the high dose of Lycii Fructus-Chrysanthemi Flos extract could significantly increase the content of PPARγ and COL1A1(P<0.01)and reduce the content of SMA(P<0.05).CONCLUSION The Lycii Fructus-Chry-santhemi Flos herbal pair extract has effects on delaying the occurrence and progression of light source-induced myopia in guinea pigs,protecting retinal cells,improving DA secretion disorders caused by artificial light environment,and regulating the level of PPAR,which has positive significance for the prevention and control of light source-induced myopia and provides a scientific basis for the ra-tional use of drugs in clinical practice and the creation of eye health products.

Blast injury of the chest injury is the most common wound in modern war trauma and terrorist attacks, and is also the most fatal type of whole body explosion injury. Most patients with severe blast injury of the chest die in the early stage before hospitalization or during transportation, so first aid is critically important. At present, there exist widespread problems such as non-standard treatment and large difference in curative effect, while there lacks clinical treatment standards for blast injury of the chest. According to the principles of scientificity, practicality and advancement, the Trauma Society of Chinese Medical Association has formulated the guidance of classification, pre-hospital first aid, in-hospital treatment and major injury management strategies for blast injury of the chest, aiming to provide reference for clinical diagnosis and treatment.

Objective To evaluate the radiosensitization effect and micro CT imaging of multifunctional gold nanoparticles in lung adenocarcinoma A549 tumor-bearing mouse models.Methods The tumor-bearing mice were injected with gold nanoparticles and irradiated with different energy levels of 160 kV and 6 MV X-ray.The tumor volume changes were measured.Intra-tumoral injection of gold nanoparticles was administered and micro CT scan was performed at different time points to observe the imaging and retention time of gold nanoparticles in the tumor tissues.Results The tumor volume did not significantly differ between the control and gold nanoparticles groups (P=0.941).The tumor volume in the 6 MV X-ray combined with gold nanoparticles group was slightly reduced compared with that in the 6 MV X-ray group with no statistical significance (P=0.730).The tumor volume in the 160 kV X-ray combined with gold nanoparticles group was significantly smaller than that in the 160 kV X-ray group (P=0.026).Micro CT scan demonstrated that gold nanoparticles could be deposited in the tumors for 30 d and yielded excellent imaging effect.No gold nanoparticles-induced toxicity was observed.Conclusions Multifunctional gold nanoparticles exert significant radiosensitization effect in the lung adenocarcinoma A549 transplanted tumors irradiated with 160 kV X-ray.Stable CT imaging of the gold nanoparticles-injected tumors can be used as a potential method for mapping and delineating the target area in tumor-guided radiotherapy.

Objective To examine the short-term prognostic value of procalcitonin ( PCT ) combined with coagulation factors for cirrhotic patients complicated with spontaneous bacterial peritonitis (SBP).Methods Clinical data of 128 cirrhotic patients complicated with SBP admitted in Jinhua Central Hospital from June 2014 to October 2017 were retrospectively analyzed .In 3 months after admission , 83 patients survived ( survival group ) and 45 patients died ( fatal group ) .The factors related to prognosis were analyzed with Logistic regression and the prediction model was constructed with the weights derived from regression coefficients.The ROC curve and the area under the curve (AUC) of combination of PCT with coagulation factors were used to predict the survival of patients .Results Univariate analysis indicated that the level of PCT , total bilirubin ( TBil ) , serum creatinine ( Scr ) , prothrombin time ( PT ) , prothrombin activity ( PTA ) , blood coagulation factor Ⅱ, Ⅴ, Ⅶ, Ⅸ, Ⅹ, Ⅺ and Ⅻ were factors affecting the prognosis of cirrhotic patients complicated with SBP (P<0.01).Multivariate analysis showed that PCT , blood coagulation factors Ⅴ and Ⅸ were independent factors of short-term prognosis of cirrhotic patients complicated with SBP.The constructed predictive model was Logit (P) =1.200+0.099 ×PCT-0.026 × clotting factor Ⅴ-0.038 ×clotting factor Ⅸ.The sensitivity and specificity of the model were 0.822 and 0.675, respectively, and the AUC was 0.829.Compared with the classic MELD score , the difference was not statistically significant (P>0.05).Conclusions The predictive model based on PCT and coagulation factors Ⅴand Ⅸcan effectively predict the short-term survival of cirrhotic patients complicated with SBP . The overall prognostic ability is not different from MELD score , but the model is more simple and easier to apply.

Objective To evaluate the change of clinicopathological features and prognosis of papillary thyroid cancer over a 15-year period.Methods The clinicopathological features and outcomes of papillary thyroid cancer patients were analyzed in three groups according to the time of diagnosis:group Ⅰ (1997-2001),group Ⅱ (2002-2006),and group Ⅲ (2007-2011).Results As time advanced,the average age of papillary thyroid cancer patients increased,tumor stage,like size,extrathyroid invasion and lymph node metastasis decreased dramatically (P ＜ 0.01).The percentage of multifocality and bilaterality increased.The long-term follow up data (median follow up time was 6.6 years),indicated that the 15-year over all survival was 97.8％ and the 15-year disease-free survival was 90.2％.Tumor ≥3 cm,bilaterality,extrathyroid invasion,lymph node metastasis and AJCC stage were correlated with tumor recurrence.By multivariate COX-regression analysis only lymph node metastasis and bilaterality were independent risk factors.Conclusion The clinicopathological features of papillary thyroid cancer changed over 15 years,with the percentage of early-staged patients increased.Lymph node metastasis and bilaterality are two risk factors for tumor recurrence.

Objective    To analyze the Podoplanin expression in patients with esophageal squamous cell carcinoma and to find out the relationship between Podoplanin expression and tumor embolus, lymph node metastasis, tumor differentiation as well as prognosis, and to provide clinical evidence for reducing the recurrence of esophageal squamous cell carcinoma and prolonging the disease-free survival and overall survival. Methods    A retrospective analysis of 70 patients with esophageal squamous cell carcinoma in our hospital from June 2010 to June 2012 was conducted, including 39 males and 31 females, with a mean age of 63.6 years. Positive diagnosis of tumor thrombus was achieved in 35 patients and negative in 35 patients. Postoperative pathological specimens were examined and normal esophageal tissues (esophageal tissue more than 5 cm from the edge of the tumor) of patients were excised as a control group. Results    The positive rate of Podoplanin was 34.2% in normal esophageal tissues and 62.8% in tumor tissues. The positive rate of Podoplanin expression was 77.1% and 48.6% in esophageal squamous cell carcinoma patients with or without tumor embolus, respectively. The positive rate of Podoplanin expression in tumor cells of patients with positive and negative lymph node metastasis was 71.9% and 23.1%, respectively (P<0.05). The mean disease-free survival of patients with Podoplanin expression-negative esophageal squamous cell carcinoma was 15.2 months, which was significantly longer than that of patients with Podoplanin expression-positive esophageal squamous cell carcinoma (P<0.05).  Conclusion    Podoplanin expression in the tumor cells and vessels can be an important reference index to the prognosis of patients with esophageal squamous cell carcinoma.

Objective    To observe the expression of Twist in esophageal squamous cell carcinoma (ESCC) and analyze the relationship between positive expression of Twist and disease-free survival, and to provide clinical evidence for reducing tumor recurrence, prolonging disease-free survival and improving prognosis. Methods    Retrospective analysis of 70 ESCC patients receiving thoracic surgery from June 2010 to June 2012 in the Department of Thoracic Surgery, Sichuan Cancer Hospital was done, including 39 males and 31 females with an average age of 63.6 years. The expression of Twist in normal esophageal tissue, tumor tissue and vascular tumor emboli was observed by immunohistochemical staining of paraffin specimens. Results    The positive rate of Twist in normal esophageal tissues was 42.9%, and in tumor tissue was 77.1% (P<0.05). The positive expression rate of Twist in tumor cells was 74.3% in patients with vascular tumor emboli and 80.0% in patients without vascular tumor emboli (P>0.05). The positive expression rate of Twist in tumor cells and in vascular tumor emboli was 74.3% and 71.4%, respectively (P>0.05). The expression of Twist in lymphatic vessels and blood vessels of patients with vascular tumor emboli was 56.0% and 72.0%, respectively (P>0.05). Conclusion    Twist expression in esophageal cancer tissues is significantly higher than that in normal tissues, but there is no significant difference in the positive expression of Twist between tumor cells and the mean disease-free survival (P>0.05). At present, Twist expression can not be used as a prognostic indicator of esophageal cancer, and more researches need be further implemented.

ObjectiveTo observe the clinical effects of locking proximal humerus plate(LPHP) in the treatment of complex proximal humeral fracture of aged patients and to analyze the influencing factors. Methods Among 39 cases with complex humeral fractures (aged 60-83 years),there were 29 cases with three-part fractures and 10 with four-part fractures according to the Neer classification.They were operated by LPHP via deltoid-pectoral approach. Neer numerical rating system was employed to evaluate postoperative function of shoulders.Results39 cases were followed up for average of 16 months.According to Neer numerical rating system,the excellence rates of three-part fractures and four-part fractures were 86.2％ (25 cases) and 50.0％ (5 cases),respectively,with total excellence rate of 76.9％(30 cases). Age (OR =1.314, P＜0.05) and fracture type ( OR =1.295, P＜0.05)ofpatientswereindependentriskfactorsforprognosis of proximal humeral fracture of aged patients by multiple logistic regression. Conclusions LPHP is an effective implant for treating complex proximal humeral fracture of aged patients,with age and fracture types as important risk factors of prognosis.<英文关键词>=humeral fractures

Objective To investigate the effects of dynamic ventilatory factors on inflammatory response and function of extrapulmonary organs in acute respiratory distress syndrome (ARDS) dogs. Method Thirty-six healthy dogs were randomly divided into 6 groups: normal control group (N group), ARDS group ( M group) and ventilation groups (A～D groups)hased on a series of random number. The ARDS dog model was replicated by iutrawacheal instillation of hydrochloric acid and mechanical ventilation was carried out according to the following protocols. Group A:low VT, low inspiratory flow and high respiratory rate. Group B: large VT, high inspiratory flow and high respiratory rate. Group C: large VT, high inspiratory flow and low respiratory rate. Group D: large VT, low inspiratory flow and low respiratory rate. After 4 hours of mechanical ventilation, animals were sacrificed.Tumor necrosis factor (TNF)-α and intefleukin (IL)-8 levels in blood serum were measured by radioimmunoassay.Histopathological changes of liver and kidney were observed under light microscope. Results The level of IL-8 and TNF-u of group B and C were much higher than those of group D, A and M ( P<0.05), but there was no significant difference among group D, A and M ( P>0.05). The level of IL-8 and TNF-α of group N were much lower than other groups ( P<0.05). The change of histopathology was the most significant in group B and C while the change of histopathology on group C was better than group B. The change of histopathology on group A and D was better than group B and C. The change of group A was similar to group M. All the data were analyzed by statistical F test. There was statistical difference with P<0.05. Comclusions Large tidal volumes with high inspiratory flow and high respiratory rate may increase mediators of inflammation in blood sennn, and aggravate the irflamnnmtory response of extrapulmonary organs. Beducfion of inspiratory flow and respiratory rate ventilation may prevent the occurrence d multiple organ dysfunction syndrome.

Objective To measure and assess CT perfusion value for peri-pancreatic metastatic lymph node by using multiple spiral CT (MSCT) with body perfusion software package. Methods The MSCT perfusion imaging was performed for peri-pancreatic metastatic lymph nodes and muscle on a multi-section CT scanner (SOMATOM Sensation Cardiac 64). 4 x 5 mm collimation, 120 kV, 60mA. Contrast injection was done with 40 ml nonionic contrast agent (300 mg l/ml), at a flow rate of 4.0 ml/s, and 5 seconds delay, and data acquisition lasted for 40 seconds. The mean blood flow (BF) were measured and analyzed in patients with pathologically proven peri-pancreatic metastatic lymph nodes(n=29)and hyperplastic lymph nodes(n=15) on work station using body perfusion software (Siemens) with deconvolution method. Results The mean BF in peri-pancreatic metastatic lymph nodes were (53.63±18.82) ml·min-1·100 ml-1, in hyperplastic lymph nodes were 29.78±7.52 ml·min-1·100 ml-1, the difference was significant (P<0.001). Conclusions Perfusion imaging of MSCT was useful in differentiation between peri-pancreatic metastatic lymph nodes and hyperplastic lymph nodes.