The angiogenic microenvironment is a new blood vessel with different molecular and functional characteristics that sprouts on the original blood vessels through different mechanisms,which directly affects the process of tumor cell growth,proliferation,and migration and has an important impact on the occurrence and development of precancerous lesions of gastric cancer.Correa mode has shown that precancerous lesions of gastric cancer is the key pathological stage before the occurrence of gastric cancer,and it is of great significance to advance the prevention and treatment strategy to this stage.TCM believes that qi deficiency and blood stasis is the key pathogenesis of precancerous lesions of gastric cancer,and its basic treatment is to replenish qi and remove blood stasis,and based on the syndrome differentiation,drugs with the efficacy of nourishing yin and tonifying stomach,soothing the liver and regulating qi,resolving phlegm and dispersing lumps,and clearing heat and dampness for treatment.This article discussed the correlation between precancerous lesions of gastric cancer and angiogenic microenvironment and its regulatory pathways,and summarized the methods and mechanisms of TCM in the treatment of precancerous lesions of gastric cancer from the perspective of regulating angiogenic microenvironment-related pathways,in order to provide a reference for the treatment of precancerous lesions of gastric cancer with TCM.

Chronic myeloid leukemia (CML) is a malignant tumor formed by clonal proliferation of bone marrow hematopoietic stem cells. With the improvement of disease awareness and the introduction of new drugs, more than 90% of CML patients can achieve long-term survival. However, a few patients still show drug resistance. This article reviews the mechanism of drug resistance in CML patients treated with tyrosine kinase inhibitor (TKI) and the characteristics of ABL kinase region mutation.

Objective:To investigate the clinical characteristics and prognosis of acute myeloid leukemia (AML) patients with positive TLS-ERG fusion gene.Methods:The clinical data of 9 AML patients with positive TLS-ERG fusion gene in the First Hospital of Jilin University from June 2013 to August 2020 were retrospectively analyzed, and the relevant literature was reviewed.Results:Among 9 patients with positive TLS-ERG fusion gene, there were 5 males and 4 females, with a median age of 16 years old (6-40 years old). Five patients received chemotherapy alone, 3 patients received allogeneic hematopoietic stem cell transplantation (allo-HSCT), and 1 patient did not receive systematic treatment. Among 8 patients with systematic treatment, 1 patient had complete remission after the first induction chemotherapy and 5 patients had complete remission after induction therapy. The median overall survival time of 5 patients with chemotherapy alone was 1.5 months (1-11 months), of which 3 patients did not respond to the first course of treatment and died of infection, and 2 patients died after relapse. The median overall survival time of 3 patients with allo-HSCT was 16 months (13-17 months), of which 2 patients died after relapse and 1 patient had sustained molecular complete remission by the end of follow-up.Conclusions:AML with positive TLS-ERG fusion gene has low incidence rate and poor induction efficacy. Hematopoietic stem cell transplantation may partially improve the survival prognosis of patients, but it cannot overcome the adverse effect of positive TLS-ERG fusion gene on prognosis.

Objective: To analyze the epidemiological characteristics of varicella epidemic situation at schools and kindergartens in Fengxian district of Shanghai during 2012-2018, and to provide evidence for developing control and prevention strategies. Methods: Data of varicella epidemic situation at schools and kindergartens and varicella cases were analyzed by descriptive methods. The rates were compared with chi-square test. Results: A total of 6 727 varicella cases were reported in Fengxian during 2012-2018, for an incidence of 85.34 per 100 000 population. Totally 66 varicella epidemic outbreaks and public health emergencies caused by varicella were reported, which involved 741 varicella cases. Among them, 426 were breakthrough cases (57.49%). The average interval time of breakthrough cases were (6.78±2.79)years, and the incidence was more concentrated in the 3-9 years after vaccination with varicella vaccine. Most breakthrough cases appeared 5 years past vaccination. The peak time of varicella was from April to June and from October to December. Most of cases were in the 5-11 year-old group and 15-17 year-old group. The cases in males was higher than in females. Kindergarten childcare and primary school children were at high risk of varicella. Timeliness of reporting was positively correlated with the duration of the varicella epidemic situation( r =0.52， P <0.05). Conclusion Most varicella epidemic situation in Fengxian district of Shanghai occued in primary schools during autumn and winter, and most of the varicella cases were breakthrough cases. Emergency vaccination of varicella vaccine can effectively control the spread of the epidemic. It is suggested to increase the publicity of the immunization program of 2 doses of varicella vaccine and raise the awareness of varicella vaccination of children’s parents.

With the rapid development and wide application of traditional Chinese medicine injection (TCMI), a number of adverse events of some TCMIs have incessantly been reported and have drawn broad attention in recent years. Establishing effective and practical analytical methods for safety evaluation and quality control of TCMI can help to improve the safety of TCMIs in clinical applications. In this study, a sensitive and rapid high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) method has been developed and validated for the quantitative determination of potentially harmful substance 5,5'-oxydimethylenebis (2-furfural, OMBF) in TCMI samples. Chromatographic separation was performed on a C18 reversed-phase column (150 mm × 2.1 mm, 5 µm) by gradient elution, using methanol-water containing 0.1% formic acid as mobile phase at the flow rate of 0.3 mL/min. MS/MS detection was performed on a triple quadrupole mass spectrometer with positive electrospray ionization in the multiple reaction-monitoring mode. The method was sensitive with a limit of quantification of 0.3 ng/mL and linear over the range of 0.3-30 ng/mL (=0.9998). Intra- and inter-day precision for analyte was <9.52% RSD with recoveries in the range 88.0-109.67% at three concentration levels. The validated method was successfully applied to quantitatively determine the compound OMBF in TCMIs and glucose injections. Our study indicates that this method is simple, sensitive, practicable and reliable, and could be applied for safety evaluation and quality control of TCMIs and glucose injections.

OBJECTIVETo investigate the changes of aldehyde dehydrogenase 2 (ALDH2) expression in H O inducedcardiomyocytes oxidative stress injury.

METHODSCultured H9C2 cardiomyocytes were exposed to H O -inducedoxidative stress and the effects of the ALDH2 agonist Alda-1 and ALDH2 inhibitor Daidzin were tested on the stress level ofthe exposed cells. MTT colorimetric assay was used to assess the cell viability after the treatments. The oxidative stress level inthe myocardial cells was detected using DHE fluorescence staining, and the activity and protein level of ALDH2 were detectedwith spectrophotometry and Western blotting.

RESULTSCompared with normal control cells, Alda-1 treatment did notsignificantly affect the cell viability, oxidative stress level, or ALDH2 activity and protein level. H O exposure significantlylowered the cell activity and ALDH2 activity and protein expression and increased the oxidative stress level; Alda-1 treatmentobvious antagonized the effects of H O . Blocking ALDH2 with Daidzin produced similar effects to H O exposure on theviability, oxidative stress level, and ALDH2 activity and expression in the myocardial cells.

CONCLUSIONSH O exposure lowersthe activity and reduces the protein expression of ALDH2 in cardiomyocyte H9C2 cells, and activation of ALDH2 can alleviateH O -induced oxidative stress in the cells.

Objective To investigate the expression of serum platelet factor 4 (CXCL4) in high-grade intraepithelial neoplasia (HGIN) of gastric cardia and its clinical significance. Methods Sixty-four HGIN patients and 29 patients with advanced cardiac cancer (ACC) from January 2010 to December 2011 in the Fourth Hospital of Hebei Medical University were selected as the research objects. Forty healthy people treated with endoscope screening were chosen as the control group. Enzyme linked immunosorbent assay (ELISA) was used to detect the expression of CXCL4 in serum. The expression differences were compared by using variance analysis and LSD-t. Results The CXCL4 detection showed that the expression levels of CXCL4 were(0.75±0.37)ng/ml,(0.87±0.33)ng/ml,(1.13±0.51)ng/ml respectively in HGIN group,ACC group and the control group (F = 10.77, P < 0.05). The CXCL4 expression levels in HGIN and ACC group were lower than that in the control group (t = 4.80, t = 2.67, both P < 0.05). There was no difference between the CXCL4 expression levels in HGIN and ACC group(t =1.27,P >0.05).Conclusions The expression level of CXCL4 in HGIN patients with gastric cardia is significantly decreased. CXCL4 may be related with the occurrence and angiogenesis of gastric cardia cancer, which can be considered as an important serum marker for early screening of gastric cardia cancer.

Cardiovascular surgery is a type of high-risk surgery for pressure ulcers. This review summarizes the risk factors of pressure ulcers in patients undergoing cardiovascular surgery, including preoperative, intraoperative and postoperative risk factors. At the same time, it points out that in the present study, there is a dispute about whether the pressure sore is associated with the time of cardiopulmonary bypass and the change of body temperature in patients undergoing cardiovascular surgery. In addition, here is a lack of related research on whether the anticoagulant of protamine has an effect on pressure sores during the operation. This article aims to provide a basis for the clinical observation of the risk factors of pressure sores in cardiovascular surgery.

Objective To observe the effects of Hedysari Polysaccharide (HPS) on the expressions of TSP-1 and PDGF-B in the retina of diabetic rats;To discuss the protective effect and possible mechanism on diabetic retinopathy. Methods The diabetic model was established by intraperitoneal injection of streptozotocin. 50 male SPF Wistar rats were randomly divided into 5 groups:model group, calcium dobesilate group, and HPS high-, medium-, and low-dose group, extra 10 rats were set as the normal group, 10 rats in each group. Each administration group was given relevant medicine for gavage, while model group and normal control group were given same amount NS for gavage, once a day for 8 weeks. The mRNA and protein expression of TSP-1 and PDGF-B were detected by qRT-PCR and immunohistochemistry. The retinal structure was observed by HE staining. Results HE staining showed that each layer of the retina of the model group was clear and complete, but the outer nucleus layer became looser, thinner and more disorderly, and the number of ganglion cells decreased slightly; the administration groups were improved markedly compared with the model group. Compared with the normal control group, the mRNA level and protein expression of retina TSP-1 on the model group dramatically dropped (P<0.01), and those of PDGF-B strikingly increased (P<0.01);Compared with the model group, the mRNA level and protein expression of retina TSP-1 on alladministration groups rose (P<0.05, P<0.01), and those of PDGF-B went down (P<0.01); Compared with all other administration groups, there was statistical significance in the mRNA level and protein expression of retina TSP-1 and PDGF-B on HPS high-dose group (P<0.05, P<0.01). Conclusion HPS may prevent the angiogenesis and proliferation in diabetic retinopathy process through adjusting the content of TSP-1 and PDGF-B in retina of diabetic rats so as to protect the retina.

Objective To investigate MRI features of metanephric adenoma(MA). Methods The retrospective analysis was performed on 6 adult patients that were scanned by regular, DWI and dynamic-enhancement MRI two weeks before surgery and diagnosed with MA pathologically after surgery. MRI features of lesions were observed. The signal intensities of lesions and contralateral normal renal cortex and medulla were respectively measured in plain scan, cortex, parenchyma and delayed phase. The enhancement magnitudes were calculated and the ADC values of lesions were measured. The differences of the signal intensity and enhancement magnitude were assessed by paired-sample t test among renal cotex, medulla and lesions. Results All lesions in MA were single and solid masses. Four cases occurred in the right kidney and two cases in the left kidney. The maximum diameters of the lesions ranged from 21 to 79 mm and the mean value was(41 ± 20)mm. Five cases were round or oval, while one case was irregular. The signal intensity in five cases was slightly lower in T2WI than the renal parenchyma, while one case was slightly higher than the renal parenchyma. The hyperintentsity of DWI and hypointensity of ADC were seen in all cases. The mean ADC value was(0.759 ± 0.211) × 10-3mm2/s. Hemorrhage were seen in two cases. Necrosis was present in one case and the capsules were seen in two cases. No scar, fat and swollen lymph nodes was seen in all cases . There was no statistical significance of the signal intensity between lesions measure in the plain scan and normal renal parenchyma(P>0.05). After adminstrating contrast materials, all lesions shown persistently mild to moderate enhancement . The siganl intensities of lesions measured in three phases after enhancement were signifcantly lower than those of the renal cortex(P<0.05). No significant differences of the signal intensity measured in cortex and medulla phase between lesions and normal renal medulla was present(P>0.05). But the signal intensities of leisons in delayed phases were significantly lower than thoseof renal medulla(P<0.05). Except from the difference of enhanced magnitude in cortex phase between lesions and normal medulla, significant differences were present between leisons and normal renal parenchyma(P<0.05). Conclusion MRI manifestations of MA show certain distinction, including, dominantly solid lesions, relatively lower signal intensity of lesions than that of renal cortex, slowly persistent enhancement, high signal on DWI and low signal on ADC.