Objective To explore the effect of formononetin on immunity of mice with transplanted H22 hepatocarcinoma. Methods Male C57BL/6 mice were subcutaneously inoculated with H22 cells (4×10⁵) to establish a tumor-bearing mouse model. The mice were treated with formononetin [10 mg/(kg.d)] or [50 mg/(kg.d)] for 28 days, and then the tumor inhibition rate was calculated. Carrilizumab was used as a positive control drug. The expressions of CD8, granzyme B and forkbox transcription factor 3 (FOXP3) in HCC tissues were analyzed by immunohistochemical staining. The mRNA and protein expression of programmed cell death protein 1 (PD-1) and its ligand 1 (PD-L1) in HCC tissues were detected by real-time PCR or Western blot analysis, respectively. The serum levels of interleukin-10 (IL-10) and transforming growth factor-β (TGF-β) were detected by ELISA. Results Formononetin increased the tumor inhibition rate and the positive rate of CD8 and granzyme B staining in tumor-bearing mice. There was no significant difference in the positive rate of FOXP3 staining in tumor tissues of mice in each group. Formononetin decreased the levels of IL-10 and TGF-β in serum of tumor-bearing mice, and decreased the relative expression of mRNA and protein of PD-1 and PD-L1 in tumor tissue of tumor-bearing mice. Conclusion Formononetin can activate CD8⁺ T cells and reduce the release of immunosuppressive factors in regulatory T cells by blocking PD-1/PD-L1 pathway and play an antitumor role.
Male ; Animals ; Mice ; Carcinoma, Hepatocellular/pathology* ; Liver Neoplasms/genetics* ; Interleukin-10/genetics* ; B7-H1 Antigen ; Granzymes/genetics* ; Programmed Cell Death 1 Receptor/metabolism* ; CD8-Positive T-Lymphocytes/metabolism* ; Mice, Inbred C57BL ; Transforming Growth Factor beta/genetics* ; RNA, Messenger/metabolism* ; Forkhead Transcription Factors/genetics* ; Cell Line, Tumor

Objective:To investigate the value of transperineal ultrasound assessment of levator hiatal antero-posterior (LHap) diameter changes in the diagnosis of pelvic floor dysfunction.Methods:The clinical data of 246 patients with suspected pelvic floor dysfunction who received treatment in Yuyao People's Hospital of Zhejiang Province from October 2020 to June 2021 were retrospectively analyzed. All these patients underwent clinical examination and modified Oxford score (MOS) evaluation. They were divided into observation group (low pelvic floor muscle contractility) and control group (normal pelvic floor muscle contractility) according to MOS. All patients were subjected to ultrasound examination and LHap diameter measurement under three conditions (at rest, pelvic floor muscle contraction, and maximal Valsalva maneuver). The percentage of shortening of LHap diameter (PDC%) and the percentage of elongation of LHap diameter (PIV%) were calculated. The differences of PDC% and PIV% were compared between the observation and control groups. The receiver operating curve was used to evaluate the values of PDC% and PIV% in the diagnosis of pelvic floor dysfunction.Results:Age, body mass index, the proportion of parturient women among included patients, and the proportion of patients who underwent vaginal delivery were significantly higher in the observation group than those in the control group (all P < 0.001). LHap diameters measured when patients were at rest, pelvic floor muscle contraction, and maximal Valsalva maneuver as well as PIV% in the observation group were (45.23 ± 5.74) mm], (37.71 ± 8.44) mm, (51.03 ± 7.41) mm and (11.42 ± 4.79)%, respectively, which were significantly higher than those in the control group [(41.78 ± 4.56) mm, (29.15 ± 4.64) mm, (44.28 ± 4.87) mm, (6.05 ± 2.13)%, t = -4.62, -8.29, -7.26, -9.36, all P < 0.001]. PDC% in the observation group was significantly lower than that in the control group [(17.52 ± 5.58)% vs. (32.19 ± 4.27)%, t = 20.39, P < 0.001]. MOS was positively correlated with PDC% ( r = 0.56, P < 0.001) and it was negatively correlated with PIV% ( r = -0.49, P < 0.001). Taking PDC% < 35.36% as the cut-off value, the area under the receiver operating curve was 0.85, the sensitivity, specificity and accuracy values were 66.40%, 97.38%, and 73.90%, respectively. Taking PIV% > 5.18% as the cut-off value, the area under the curve was 0.70, and the sensitivity, specificity and accuracy values were 71.45%, 57.90% and 68.15%, respectively. When PDC% and PIV% were used together, the area under the curve was 0.73 and the sensitivity, specificity and accuracy values were 84.57%, 55.05% and 77.32%, respectively. Conclusion:Transperineal ultrasound assessment of LHap diameter changes are of certain value in the prediction of pelvic floor dysfunction and can provide objective and quantitative data support for clinicians to diagnose pelvic floor dysfunction. This study is highly innovative and scientific.

Objective:To observe the efficacy of drug combined with red-blue light irradiation, chemical peeling by glycolic acid and intense pulsed light (IPL) in the treatment of moderate acne vulgaris.Methods:A total of 187 patients with moderate acne vulgaris were divided into five groups. There were 59 males and 128 females, aged from 16 to 29 years (21.79±2.52). In group A, patients were treated with oral medicines; the patients were treated with oral medicines combined with red-blue light irradiation, chemical peeling by glycolic acid and IPL respectively in group B, group C and group D. In group E, patients were treated with oral medicines combined with chemical peeling by glycolic acid and IPL. The number of different types of skin lesions (comedoes, papules, pustules) were compared between before and after treatment in five groups. The clinical effect of five treatment groups was evaluated by comparing regression rates of different types of skin lesions and total skin lesions and treatment efficiency.Results:All the patients with moderate acne vulgaris were brought into this study. The regression rates of comedoes, papules and total skin lesions were (86.37±9.64)%, (94.25±9.79)% and (88.80±9.40)% respectively in group E, and significantly higher than that of other four groups ( P<0.05). The treatment efficiency of group E also were significantly higher than that of other four groups ( P<0.05). Then, the regression rates of comedoes (70.91±18.52) in group C was significantly higher than that of group A and group B ( P<0.05). The regression rates of papules (91.42±13.86) in group D was significantly higher than that of group A and group B ( P<0.05). Conclusions:Oral medicines combined with chemical peeling by glycolic acid and IPL has obvious clinical efficacy in treatment of patients with moderate acne vulgaris. Oral medicines combined with chemical peeling by glycolic acid can obviously improve comedoes, and oral medicines combined with IPL can obviously improve papules.

OBJECTIVE: To develop a radioactive sewage purification device that can effectively filter the nuclides in low-level nuclide-contaminated wastewater. METHODS: The radioactive sewage purification device was composed of lifting pump, stack filter, multi-medium filter, security filter, tubular ultrafiltration membrane, high-pressure pump and reverse osmotic membrane. The combined process of adsorption-ultrafiltration-reverse osmosis was used to separate radioactive elements from wastewater by reverse osmosis membrane separation system. Through two-stage multi-medium filter circulation system circulation treatment, radioactive sewage was purified. The flow rate of water treatment is 20 L/min. The filtration efficiency and purification efficiency of the device were tested by filtration experiments on elements containing radionuclide and purification experiments on radionuclide.RESULTS: The filtration efficiency on iodine, potassium, strontium and cesium, that are the common elements in radioactive sewage samples were 97.88%, 98.38%, 99.99% and 99.80%, respectively. The single purification efficiency of radionuclide ~(40)K in low-level radioactive sewage was over 90.00%. CONCLUSION: The device has high filtering efficiency for common elements such as iodine, potassium, strontium and cesium in sewage and high removal rate of radioactive activity for sewage containing ~(40)K. It can be further optimized and transformed into a suitable radioactive sewage water purifier.

The stability of the occipitocervical region mainly depends on the integrity of the bony structure,surrounding ligaments and joint capsules.The instability of this region often leadsto the clinical symptoms of compression injury of nerve and vascular,which requires early surgical intervention to rebuild its stability.Posterior occipitocervical fixations are main surgical treatment for the occipitocervical diseases.However,the posterior fixations are not suitable for some patients with congenital or iatrogenic causes.Recently,the anterior occipitocervical fixation with the screws anchored at clivus or into the occipital condyles have been used for the following operations.1.Anterior bone graft fusion.One case which was performed by oral approach was reported well fusion,but the stability was poor and there was a possibility of displacement.2.Anterior shaped titanium cage and plate fixation.The literatures reported that this anterior operation was completed in 35 cases by oral,oral combined with mandibulotomy,and anterior retropharyngeal approaches.This fixation has a good biomechanical stability and is widely used in clinical applications,including occipitocervical tumors and deformities.And the complications including intraoperative vascular,spinal and dural injuries,postoperative drinking cough,non-fusion,deep infection,and death.3.Anterior occipital-atlantoaxial joint screw fixation.Seven cases were performed by anterior occipital-atlantoaxial joint screw fixation through anterior percutaneous approach.This fixation is less trauma,but required precise placement of screw and not conducive bone fusion,and it is suitable for traumatic instability of the upper cervical spine,atlantoaxial dislocation and basilar invagination.Each procedure of anterior occipitocervical fixation is not suitable for all patients,and it should be adopted according to the patient's condition,surgical hardware conditions and the surgeon's habits.

Objective To analyze the characteristics and treatment of aortic intramural hematoma ( IMH) in non-traumat-ic elderly patients, and to provide clinical reference for the diagnosis and treatment of this disease .Methods A retrospective analysis of clinical data of 36 elderly patients without trauma during the period from March 2013 to May 2017 in our hospital , to clarify the characteristics of pathogenesis and imaging feature , and to evaluate treatment options.Results 36 patients were followed up and the outcomes of them were satisfactory .Of which 17 asymptomatic patients were given conservative treatment . 19 cases of emergency patients, 7 patients received the emergency operation, 9 patients were given interventional treatment after initial conservative medical treatment, 3 patients received drug treatment, of which 1 patient was conservatively successful, and 2 patients progressed.During follow-up, the imaging data of most of the patients were obtained.The aortic enhanced CT indi-cated that the hematoma disappeared or decreased markedly, and the asymptomatic patients were in stable condition, and the dilatation of aorta was not obvious in patients who have access to imaging examination .Conclusion Elderly patients with IMH are more common in men, especially Stanford B type.IMH in asymptomatic elderly patients with multiple penetrating aortic ul-cer(PAU), but the range of hematoma is limited, no significant progress.And this type of patients can be considered only for conservative treatment.On the contrary, IMH of symptomatic elderly patients usually involve a wide range of aorta , and most of them were caused by single small ulcer.Although the patients have been treated with conservative medicine , the disease is still progress and endovascular treatment repair of aorta can be considered .

OBJECTIVETo conduct a clinical trial of ketogenic diet (KD) in patients with acute spinal cord injury (SCI) and evaluate its safety and feasibility by measuring blood ketone bodies and blood glucose levels.

METHODTen patients with acute SCI were recruited in the trial during the period from May, 2012 to October, 2013. The patients received a standard KD after fasting for 48 h. The levels of blood ketone, blood glucose and uric ketone were tested daily, and routine blood examination, electrolytes, liver and kidney function, body mass index (BMI), sensory and motor function, and adverse reactions were monitored weekly to assess the safety and feasibility of KD.

RESULTSKD treatment lasted for a mean of 12.9 days (4 to 29 days) in these patients. In all the patients, blood ketone level increased during the fasting and maintained a level above 2.0 mmol/L after taking KD, while the uric ketone level ranged from +++ to ++++. The blood glucose level was in the normal range during KD. Except for blood chloride level and BMI, routine blood test results, electrolytes, liver and kidney function showed no significant changes after KD. No significant changes were observed in the sensation of light touch and pinprick. The average motor ASIA score increased from 33.3 to 35.1 after KD. Gastrointestinal dysfunction (diarrhea, nausea, poor appetite, gastric pain, and abdominal distension) was recorded in 5 patients, hypoglycemia occurred in one patient early after KD, and one patient experienced urticaria during KD. All the adverse reactions were relieved after symptomatic treatments.

CONCLUSIONThis preliminary clinical trial demonstrated that KD could increase ketone bodies level and maintain a normal blood glucose level, suggesting its safety and feasibility in patients with acute SCI.

Adolescent ; Adult ; Aged ; Diet, Ketogenic ; adverse effects ; methods ; Feasibility Studies ; Female ; Humans ; Male ; Middle Aged ; Spinal Cord Injuries ; diet therapy ; Treatment Outcome ; Young Adult

OBJECTIVETo compare the clinical efficacy and safety of percutaneous vertebroplasty by unipedicular and bipedicular approach for treatment of Kummell's disease.

METHODSThe clinical data of patients with Kummell's disease undergoing percutaneous vertebroplasty via unilateral or bilateral approach between January, 2006 and January, 2011 were reviewed. The clinical efficacy, operation time, bone cement injection volume, incidence of cement leakage, degree of vertebral height restoration, and degree of kyphosis correction were compared between the patients receiving surgery via the two approaches.

RESULTSThe operation time was shorter in the unipedicular group than in the bipedicular group (P<0.05), but bone cement injection volume, incidence of cement leakage, degree of anterior vertebral height restoration, degree of middle vertebral height restoration, degree of kyphosis correction, and VAS scores were all comparable between the two groups (P>0.05). In both groups, the VAS scores at 24 h, 3 months and at the last follow-up after the surgery were lowered compared to the preoperative scores (P<0.05).

CONCLUSIONBoth unipedicular and bipedicular percutaneous vertebroplasty can achieve satisfactory analgesia in the treatment of Kummell's disease with similar clinical efficacy. The unipedicular approach is sufficient for treatment of Kummell's disease.

Bone Cements ; Humans ; Spinal Fractures ; surgery ; Spine ; Treatment Outcome ; Vertebroplasty ; methods

Objective To conduct a clinical trial of ketogenic diet (KD) in patients with acute spinal cord injury (SCI) and evaluate its safety and feasibility by measuring blood ketone bodies and blood glucose levels. Method Ten patients with acute SCI were recruited in the trial during the period from May, 2012 to October, 2013. The patients received a standard KD after fasting for 48 h. The levels of blood ketone, blood glucose and uric ketone were tested daily, and routine blood examination, electrolytes, liver and kidney function, body mass index (BMI), sensory and motor function, and adverse reactions were monitored weekly to assess the safety and feasibility of KD. Results KD treatment lasted for a mean of 12.9 days (4 to 29 days) in these patients. In all the patients, blood ketone level increased during the fasting and maintained a level above 2.0 mmol/L after taking KD, while the uric ketone level ranged from+++to++++. The blood glucose level was in the normal range during KD. Except for blood chloride level and BMI, routine blood test results, electrolytes, liver and kidney function showed no significant changes after KD. No significant changes were observed in the sensation of light touch and pinprick. The average motor ASIA score increased from 33.3 to 35.1 after KD. Gastrointestinal dysfunction (diarrhea, nausea, poor appetite, gastric pain, and abdominal distension) was recorded in 5 patients, hypoglycemia occurred in one patient early after KD, and one patient experienced urticaria during KD. All the adverse reactions were relieved after symptomatic treatments. Conclusion This preliminary clinical trial demonstrated that KD could increase ketone bodies level and maintain a normal blood glucose level, suggesting its safety and feasibility in patients with acute SCI.

Objective To conduct a clinical trial of ketogenic diet (KD) in patients with acute spinal cord injury (SCI) and evaluate its safety and feasibility by measuring blood ketone bodies and blood glucose levels. Method Ten patients with acute SCI were recruited in the trial during the period from May, 2012 to October, 2013. The patients received a standard KD after fasting for 48 h. The levels of blood ketone, blood glucose and uric ketone were tested daily, and routine blood examination, electrolytes, liver and kidney function, body mass index (BMI), sensory and motor function, and adverse reactions were monitored weekly to assess the safety and feasibility of KD. Results KD treatment lasted for a mean of 12.9 days (4 to 29 days) in these patients. In all the patients, blood ketone level increased during the fasting and maintained a level above 2.0 mmol/L after taking KD, while the uric ketone level ranged from+++to++++. The blood glucose level was in the normal range during KD. Except for blood chloride level and BMI, routine blood test results, electrolytes, liver and kidney function showed no significant changes after KD. No significant changes were observed in the sensation of light touch and pinprick. The average motor ASIA score increased from 33.3 to 35.1 after KD. Gastrointestinal dysfunction (diarrhea, nausea, poor appetite, gastric pain, and abdominal distension) was recorded in 5 patients, hypoglycemia occurred in one patient early after KD, and one patient experienced urticaria during KD. All the adverse reactions were relieved after symptomatic treatments. Conclusion This preliminary clinical trial demonstrated that KD could increase ketone bodies level and maintain a normal blood glucose level, suggesting its safety and feasibility in patients with acute SCI.