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Objective:To investigate the effect of infliximab combined with miRNA-21 on lung cancer A549 cells.Methods:A549 cells were cultured in vitro and then divided into four groups (blank group, infliximab group, miRNA-21 inhibitor group and combined treatment group) ; CCK-8 test was used to detect cell proliferation; Flow cytometry experiments was employed to detect apoptosis; Western blot was used to detect protein expression.Results:The survival rates of A549 cells in the miRNA-21 inhibitor group and the combined treatment group were 48.67%±2.83% and 25.69%±1.98%, which were significantly different ( P<0.001) ; The proportion of A549 apoptotic cells in the miRNA-21 inhibitor group and the combined treatment group were 46.73%±2.18% and 76.58%±3.67%, respectively, with significant differences ( P<0.001) ; The expression of Caspase-3 (1.21±0.26 vs 0.57±0.07) and Bad (1.08±0.11 vs 0.52±0.06) in the combined treatment group was significantly higher than that of the miRNA-21 inhibitor group in the detection of apoptosis-related proteins, and the expression of Bcl-2 was significantly reduced, with a significant difference ( P<0.001). In the combined treatment group, the expression levels of TNF-α (0.63±0.11 vs 1.23±0. 22, 1.18±0.17, 1.14±0.17) and NF-κB p65 (0.34±0.08 vs 1.31±0.09, 1.29±0.12, 1.11±0.06) were both reduced, and there was a significant difference compared with the other three groups ( P<0.001) . Conclusion:Infliximab combined with miRNA-21 inhibitors can play a synergistic role in lung cancer cells, inhibit the TNF-α/NF-κB signaling pathway, regulate the expression of the Bcl-2 family and Caspase-3, and promote apoptosis, thereby inhibiting lung cancer A549 cell proliferation.
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Objective:To investigate the diagnostic and therapeutic value of one-time biliopancreatic-duct-imaging-system (eyeMax)-assisted endoscopic retrograde appendicitis therapy (ERAT) for children.Methods:A total of 11 children who were diagnosed as having uncomplicated acute appendicitis by imaging in Xi′an Children′s Hospital from August to November 2022 were enrolled. All patients received subscope-assisted ERAT. Subscope was intubated into the appendix cavity to observe the mucosa directly. Appendicitis was treated through cleansing, fecalith extraction, stent drainage. The clinical manifestations under subscope were recorded, as well as the treatment success rate, intubation success rate, the effective rate, complication incidence during and after the operation.Results:The age of 11 children was 7.93±2.67 years old. Appendix intubation was successful in all patients. Congestion and swelling of the mucosa in appendiceal orifice and appendix cavity were seen under the subscope in 11 children. There were 6 cases with appendiceal fecaliths, 8 cases with pus and 6 cases with luminal distortion or stenosis. Perforation was observed in 1 case during the operation and no other complication occurred. All patients were treated under subscope, including flushing appendiceal cavity (11 cases), fecalith extraction with extraction basket (3 cases), and appendiceal drainage with stenting (2 cases). The symptoms and signs were relieved after the operation, and the effective rate within 48 hours was 10/11. There were no procedure-related complications or recurrence during postoperative follow-up for 1 week to 4 months.Conclusion:Acute appendicitis could be diagnosed by observing the appendix cavity directly under one-time biliopancreatic-duct-imaging-system-assisted ERAT, and also could be treated with the system, where appendix could be preserved and radiation damage could be avoided with safety and effectiveness.
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OBJECTIVE To sum marize the pro cedure and informatization construction of centralized volume-based procurement（VBP）in our hospital ，in order to give references for normal development of centralized VBP. METHODS The standardized workflow system was established ，including using flow chart method to establish standardized workflow ，carrying out procedure training and inspection of procedure implementation ， and continuously conducting procedure optimization. The information system was developed for the task links that needed a lot of calculation to improve the automation level of information processing. RESULTS & CONCLUSIONS Eight specific work procedures were established in our hospital ，including the work procedures of submitting the demand data of centralized VBP and the implementation of centralized VBP ，and has taken measures such as procedure training ，establishing supervision and inspection system and using auxiliary means to promote the implementation of the procedure ，so as to optimize the procedure and work form. An informatization platform for the clinical task allocation of the agreed purchase quantity of centralized VBP and a supervision platform for the daily use of VBP were also established in our hospital，then the two tasks with a large amount of calculation could be finished. Standardized workflow system and informatization platform construction has improved the operation and supervision efficiency of centralized VBP in our hospital ，ensured the completion of centralized purchase tasks and saved human resources ，which has a certain promotion value.
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Objective:To evaluate the safety and effectiveness of capsule endoscopy for the diagnosis of intestinal diseases in children.Methods:Clinical data of 113 pediatric patients who received capsule endoscopy in Xi'an Children's Hospital from October 2018 to September 2020 were retrospectively analyzed. The completion rate, passage time of stomach and small intestine, lesion detection rate, adverse reactions and complications of capsule endoscopy were analyzed.Results:Among 113 pediatric patients, 78 (69.03%) were male and 35 (30.97%) were female. The age was (99.8±44.7) months (9-195 months), and 31 (27.43%) were under 7 years old. The minimum weight was 9 kg and the minimum height was 70 cm. Eighty-seven pediatric patients (76.99%) swallowed capsules orally (the oral group) with the minimum age of 4 years and 3 months. Capsules were implanted in 26 pediatric patients (23.01%) under gastroscopy (the gastroscopic group), with the maximum age of 9 years and 2 months. Unexplained abdominal pain (47.79%) and unexplained gastrointestinal bleeding (31.89%) were common in the pediatric patients. The completion rate of capsule endoscopy was 97.35% (110/113), and the detection rate of lesions in small intestine was 31.81% (35/110). The passage time of small intestine in the gastroscopic group was significantly longer than that of the oral group (461.04±129.27 min VS 288.23±107.84 min, t=5.646, P<0.01). There was no significant difference in the passage time of stomach or small intestine among different genders, different ages or different endoscopic examination results ( P>0.05). The positive results of capsule were not correlated with the method of ingestion ( P=0.401, OR=2.562, 95% CI:0.284-23.077), gender ( P=0.154, OR=2.352, 95% CI:0.726-7.616), age ( P=0.949, OR=1.007, 95% CI:0.816-1.242), examination reason ( P=0.246) or small intestine passage time ( P=0.219, OR=1.003, 95% CI:0.998-1.008). No complications such as capsule retention occurred in any pediatric patient. Conclusion:Capsule endoscopy in children is noninvasive, rapid and simple, which can improve the diagnostic rate of small intestinal diseases in children, and can be further promoted in pediatric patients.
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Centralized drug procurement in large quantities is a major step to deepen the medical and healthcare system reform, to improve the mechanism of drug price formation, and to give full play to the role of medical insurance in guiding drug prices in China. Combined with the practice of centralized drug purchasing in public hospitals, the authors sorted out the practical problems and causes from four aspects which affected the implementation of centralized drug purchasing policy in public hospitals: selection on centrally purchased drugs, procurement and supply, clinical use, and hospital financial operation. On this basis, suggestions were put forward to provide reference for the normalization of centralized drug procurement work, such as coordinating national and regional drug collection policies, reasonably setting distribution costs, extending the agreed procurement period, and carrying out special evaluation for drug collection.
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Objective:To evaluate high resolution esophageal manometry (HREM) in peroral endoscopic myotomy (POEM) for pediatric achalasia of cardia (AC).Methods:Data of 30 AC children who received POEM in Xi′an Children′s Hospital from January 2013 to September 2019 were reviewed. HREM was performed before and 6 months after POEM. Preoperative and postoperative lower esophageal sphincter pressure (LESP), 4-second integrated relaxation pressure (4sIRP), Eckardt scores and nutritional status were compared.Results:Children with AC aged between 4-14 years. Postoperative LESP was 5.50±1.13 mmHg (1 mmHg=0.133 kPa), which was significantly lower than that before operation (26.23±4.47 mmHg) with significant difference ( t=-24.623, P<0.001). Postoperative median 4sIRP was 5 mmHg, which was 20 mmHg lower than that before operation (25 mmHg) with significant difference ( Z=-4.786, P<0.001). Postoperative median Eckardt symptom score decreased significantly compared with that before (1 VS 8, Z=-4.796, P<0.001). Severe malnutrition of the AC children improved evidently to normal( Z=-5.166, P<0.001). Conclusion:POEM can significantly improve the characteristics of esophageal dynamics in children with AC, and HREM can be an important indicator for follow-up evaluation of POEM.
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The laterodorsal tegmentum (LDT) is a brain structure involved in distinct behaviors including arousal, reward, and innate fear. How environmental stimuli and top-down control from high-order sensory and limbic cortical areas converge and coordinate in this region to modulate diverse behavioral outputs remains unclear. Using a modified rabies virus, we applied monosynaptic retrograde tracing to the whole brain to examine the LDT cell type specific upstream nuclei. The LDT received very strong midbrain and hindbrain afferents and moderate cortical and hypothalamic innervation but weak connections to the thalamus. The main projection neurons from cortical areas were restricted to the limbic lobe, including the ventral orbital cortex (VO), prelimbic, and cingulate cortices. Although different cell populations received qualitatively similar inputs, primarily via afferents from the periaqueductal gray area, superior colliculus, and the LDT itself, parvalbumin-positive (PV) GABAergic cells received preferential projections from local LDT neurons. With regard to the different subtypes of GABAergic cells, a considerable number of nuclei, including those of the ventral tegmental area, central amygdaloid nucleus, and VO, made significantly greater inputs to somatostatin-positive cells than to PV cells. Diverse inputs to the LDT on a system-wide level were revealed.
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Objective To evaluate the efficacy and safety of endoscopic radial incision ( ERI) for treatment of benign esophageal stenosis in children. Methods A retrospective analysis was performed on clinical data of 20 children with benign esophageal stenosis who underwent ERI from January 2013 to May 2018 in Xi′an Children′s Hospital. The procedure, improvement of clinical symptoms, and complications related to the operation were analyzed. Results All 20 patients were successfully treated with ERI, with median operation time of 10 min (5-25 min), and median number of narrow ring incision of 4 times (1-8 times) . No fever, poststernal pain, bleeding or perforation was found in any child after operation. The hospital stay was 4-7 days, with a median of 4. 5 days. The postoperative follow-up was 3-24 months, with an average of 7. 9 months. At one month after operation, the stenosis diameter of 20 cases was enlarged[ 1. 0 cm ( 0. 6-1. 5 cm) VS 0. 3 cm ( 0. 1-0. 5 cm) , t=11. 018, P<0. 001] , and dysphagia score was lower[ 0 ( 0-2) VS 2. 5 (2-4), Z=4. 027, P<0. 001] compared with that before. The median weight of 19 children increased by 2 kg ( 1-4 kg ) three months after operation. There was no significant correlation between improvement of dysphagia after ERI and sex, age, times of preoperative treatment and diameter of stenosis ( all P>0. 05) , but there was a negative correlation between improvement of dysphagia after ERI and the length of stenosis ( r=-0. 514, P=0. 020) . Conclusion ERI is safe and effective for treatment of benign esophageal stenosis in children, which can be recommended in clinic.
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Objective To evaluate the anatomic relationships between the portals and radial nerve of three different operations of antrolateral approach elbow arthroscopy.Methods The dissections were pedormed in 10 formalin soaked adult cadaver elbows.The distances from the three different antrolateral portals to the radial nerve in extension and flexion 90° position were measured.The portal A was located at 3 cm distal and 1 cm anterior to the lateral epicondyle;the portal B was located at 2 cm distal and 2 cm anterior to the lateral epicondyle;the portal C,1 cm distal and 1 cm anterior to the lateral epicondyle.Results The nearest distances from the anterolateral portal A,B,and C to the radial nerve in extension position were (2.30 ± 0.95) mm,(3.00 ± 1.56) mm,and (3.60 ± 1.65) mm,with significant differences (F =11.097,P =0.001).Statistical difference in distances from the anterolateral portal to the radial nerve between portal A and C was found (P =0.006).No statistically significant difference was seen between A and B or B and C (PA-B =0.134,PB-c =0.072).The distances from the anterolateral portal A,B,and C to the radial nerve in flexion 90° position were (4.40 ± 2.01) mm,(6.10 ± 1.79) mm,and (7.90 ± 1.85) mm,with significant differences (F =54.775,P =0.000).There were statistically significant difference among the three approaches (PA-B =0.000,PA-c =0.000,PB-c =0.002).The distances increased when the position changed from extension to flexion 90° for portal A (t =-5.161,P =0.001),portal B (t=-8.188,P=0.000),and portal C (t =-10.167,P =0.000).Conclusion The anterolateral portal 1 cm distal and 1 cm anterior to the lateral epicondyle is the safest apporach.
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Objective To investigate the influencing factors related to the complications of esophageal foreign body in children. Methods Data of 150 children with esophageal foreign bodies admitted to Xi'an Children' s Hospital from January 2012 to June 2015 were included in the retrospective analysis. Related clinical variables ( gender, age, location, time, size, sharpness, quality, and severity of complications) were statistically analyzed. Results Spearman correlation analysis showed that the age of children was negatively correlated with esophageal foreign body complications (r=-0. 187, P=0. 022), incarceration time ( r=0. 456, P<0. 001) , sharpness ( r=0. 384, P<0. 001) and quality ( r=0. 234, P=0. 004) was positively correlated with the incidence of complications. Non?conditional Logistic regression analysis for polytomous ordinal response showed that incarceration longer than 8 h yielded complication risks 9. 507 times as much as that less than 8 h ( 95%CI:2. 982?30. 309) . Obtuse or sharp foreign body yielded risk 142. 751 times as smooth foreign body did (95%CI:13. 736?1483. 562). Conclusion Incidence and severity of complications of esophageal foreign body in children are closely related to the age of the children, incarceration time and the degree of sharpness. For patients of less than 1 year old, incarceration for more than 8 hours, with an obtuse or sharp foreign body, early diagnosis and treatment is essential.
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Objective:To establish an algorithm on the turnover ratio of drug inventory. Methods: According to the employed method in the commercial field on calculating the inventory turnover and the requirements in the review of three level hospitals by the National Health and Family Planning Commission, an appropriate method for calculating the turnover rate of drug inventory was de-duced. Meanwhile, a corresponding program was performed for the verification. Results:Only the day turnover could be obtained ac-cording to the algorithms on the inventory turnover in commercial field, and the circumstances of the sales could be replaced by the cur-rent sales to obtain the statistics at any given time, while there was remarkable difference between the calculated results and the actual results of some species. If the time in store was chosen as the statistical index, the problem could be avoided. Conclusion:The meth-od with drug storage time as the statistical index can calculate the inventory turnover ratio at any time precisely, which also can be pro-grammed automatically, and the proportion of available varieties meets the inspection requirements.
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Objective:To establish an HPLC method for the determination of isomeric impurity in fasudil hydrochloride. Meth-ods:The chromatographic method was carried out on a Kromasil 100-5 Phenyl C18 column with phenyl bonded silica as the filler (250 mm × 4. 6 mm, 5 μm), and phosphate buffer (10 mmol· L-1 ammonium dihydrogen phosphate, adjusting pH to 4. 0 with 1% phos-phoric acid) -acetonitrile (80∶ 20) was used as the mobile phase. The detection wavelength was 275nm and the column temperature was 40℃. The flow rate was 1. 0 ml· min-1 , and the injection volume was 10 μl. Results:Fasudil hydrochloride and its derivative was linear within the range of 0. 148-2. 960 μg·ml-1(r=1. 0000) and 0. 101-2. 014μg·ml-1(r=0. 999 9), respectively. The av-erage recovery of isomer impurity in fasudil hydrochloride was 101. 9% with RSD of 0. 98%(n=9). Conclusion:The method is sim-ple,accurate and reproducible,which can be used for the quality control of fasudil hydrochloride and its isomer.
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The permeability of most drugs through the eyes is very limited, so finding safe and effective penetration enhancers is of high importance in current ophthalmology research. In this paper, we use a new approach that integrates Chinese and Western medicine to improve the corneal permeability of baicalin, a water- and fat-insoluble target drug, in vitro. Rabbits were divided into three groups. The first group was dosed with borneol [0.05%, 0.1%]. menthol [0.1%, 0.2%], or Labrasol [1%, 2%] individually, the second was dosed with a combination of Labrasol with either borneol or menthol, and the third group received a control treatment. Compared with the control treatment, borneol, menthol, or Labrasol alone clearly improved the permeability of baicalin in vitro. Furthermore, the penetrating effects were significantly increased by combining the application of Labrasol with menthol or borneol. Among the various combined penetration enhancers, 0.1% borneol with 2% Labrasol achieved the best apparent permeability, approximately 16.35 times that of the control. Additionally, the calculation of corneal hydration level and the Draize test demonstrated the safety of these penetration enhancers to the rabbit corneas in vivo. This study confirms that the combined use of borneol or menthol, compounds both derived from Chinese herbs, with Labrasol can improve the corneal permeability of waterand fat-insoluble drugs
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Animals, Laboratory , Drug Combinations , Camphanes/pharmacology , Menthol/pharmacology , Menthol , Flavonoids/pharmacokinetics , Rabbits , Cornea/drug effectsABSTRACT
BACKGROUND:Legacy posterior stabilized prosthesis has advantages in theoretic design,in vitro kinematics and abrasion, but it remains unclear whether its clinical outcomes for vaglus knee deformity are better than Legacy constrained condylar knee prosthesis. OBJECTIVE:To explore the midterm folow-up effect of Legacy posterior stabilized prosthesis in total knee arthroplasty in patients with valgus knee deformity. METHODS: From February 2006 to November 2013 in Department of Bone and Joint Surgery, Affiliated Hospital of Luzhou Medical Colege, total knee arthroplasty was used to treat valgus knee deformity in 33 cases (35 knees). Parapatelar medial approach was used. Precise osteotomy was utilized to correct limb alignment. Lateral soft tissue received selective release. Finaly, an equal type of Legacy posterior stabilized prosthesis (Zimmer, USA) was implanted and fixed with antibiotic bone cement. The differences in hospital for special surgery knee score, range of motion of knee, femoral tibial angle, and maximum flexion and extension angle, as wel as X-ray film results were compared and analyzed before and after replacement. The complications including deep vein thrombosis, peri-prosthetic infection, patelar clicking, unstable knee, and common peroneal nerve injury were recorded after surgery. RESULTS AND CONCLUSION: Al patients were folowed up for 24-50 months. The incision was healed in one-stage. No complications such as peri-prosthetic infection appeared. Three patients suffered from common peroneal nerve palsy, which was cured at half a year after surgery by expectant treatment such as trophic nerve. Two cases suffered from knee instability after replacement, which was improved at 1 month after external fixation with a brace. One case experienced deep vein thrombosis in the lower extremity, which was improved after treatment with low molecular weight heparin anticoagulation. During final folow-up, hospital for special surgery knee score increased from (51.85±4.15) preoperatively to (85.77±2.50) postoperatively (P < 0.01). There were excelent in 20 knees, good in 11 knees, with an excelent and good rate of 89%. X-ray films showed that hindlimb alignment was apparently corrected, prosthetic position was good, no loosening occurred. These data indicate that total knee arthroplasty, using parapatelar medial approach, obtained good correction outcomes through the accurate amputation to correct hindlimb alignment and selective release of the soft tissue with Legacy posterior stabilized prosthesis in the treatment of valgus knee deformity.
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Objective To explore the feasibility, safety and the efficacy of peroral endoscopic myotomy (POEM) for pediatric patients with achalasia.Methods A total of 21 patients (mean age 2 years, range 11 months-7 years) with AC were enrolled and underwent POEM from January 2012 to December 2014.Procedure-related complications, reflux esophagitis were observed.Eckardt score and the pressure of the lower esophageal sphincter (LES) were analysed.Results All patients underwent POEM successfully.No serious POEM-related complications were observed.During a mean follow-up period of 20.4 months (range 9-36 months), mean Eckardt score decreased from 8.1 to 0.8 after treatment (P ＜ 0.01).Mean LES treatment also decreased from 30.2 mmHg to 11.5 mmHg after the operation (1 mmHg =0.133 kPa, P ＜ 0.01).Reflux esophagitis developed in four patients (19.0％ ,4/21).Conclusion POEM is safe and effective treatment for pediatric patients with achalasia.
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OBJECTIVE@#The aim of this study is to investigate the effects of inhibitor HNP1 transfection on proliferation and tumor growth of human nasopharyngeal carcinoma cell line HNE1.@*METHOD@#HNE1 cells were transfected with HNP1 by liposome, and the cytotoxic effect was detected by MTT, In vivo tumor growth test was performed in nude mice inoculated with transfected HNE1 cells. The therapeutic effect of HNP1 was evaluated in the inoculated tumors, alpha-defensin 1 expression was detected in implanted tumor tissues by immunohistochemical stain.@*RESULT@#HNP1 transfection significantly inhibited the proliferation of HNE1 cells. MTT assay confirmed cytotoxic effect. In vivo study showed tumor volume was significantly smaller in HNP1 transfection group than that in control group (P < 0.01). Immunohistochemical stain showed alpha-defensin expression was increased in HNP1 transfection group.@*CONCLUSION@#HNP1 transfection can inhibit the proliferation of HNE1 cells, as well as tumor growth.
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Animals , Female , Humans , Mice , Apoptosis , Cell Line, Tumor , Cell Proliferation , Mice, Inbred BALB C , Mice, Nude , Nasopharyngeal Neoplasms , Genetics , Pathology , Transfection , Tumor Burden , alpha-Defensins , GeneticsABSTRACT
BACKGROUND: Although bone tissue engineering has been developed rapidly, ideal scaffold materials are deficient and the ability of tissue engineered bone constructed in vitro was reported inconsistently.OBJECTIVE: To study the ectopic osteogenesis of the implantation in vitro with composite fully deproteinized bone(CFDB) compounded by autologous red marrow.DESIGN: A randomized controlled study.SETTING: Department of Orthopaedics, the 152 Hospital of Jinan Military Area Command of Chinese PLA; Ward for Retired Cadres, First People's Hospital of Pingdingshan City; Department of Orthopaedics, Chaochuan Mine Hospital of Pingdingshan Coal Industrial Group.MATERIALS: The study was completed in the Department of Orthopaedics,the 152 Hospital of Jinan Militatry Area Command of Chinese PLA. Totally 40 Japanese flap-eared white rabbits of 4 months old of either gender with a body mass from 2.0 kg to 2.5 kg were involved (provided by the Laboratory for Experimental Animals of the 152 Hospital in Pingdingshan city).INTERVENTION: Calf CFDB scaffold materials were compounded by rabbit autologous red marrow after physical and chemical managements, which were then implanted into the thigh muscles of 40 rabbits. The osteogenetic abilities of the materials compounded by autologous red marrow were analyzed at 4 weeks and 8 weeks after operations respectively.ysis of the implanted bone.RESULTS: ALP activities were(63.48 ± 0. 873) and (69. 527 ± 0. 635) IU/L respectively, and the results of osteogenetic quantitative analysis were (2.50 ±0.38) and(4.70 ±0.67) points of rabbits in the study group at week 4 and week 8 respectively. ALP activities were(2.50±0.38) and (4.70 ± 0. 67) IU/L and the results of osteogenetic quantitative analysis were( 1.90 ± 0.54 ) and(3.40 ± 0.54) points of rabbits in the control group at week 4 and week 8 respectively. The results indicated that the osteogenetic ability of the study group was significantly higher than that of the control group at the same time point, and the neogenetic bone increased along with the prolongation of the implantation time.CONCLUSION: CFDB could be applied as scaffold materials for bone tissue engineering, and its osteogenesis increases significantly after being compounded by autologous red marrow.
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0.05).Conclusion The upper limit threshold of fasting U-Ca/Cr ratios in healthy premenopausal women is established,which can provide a reference for the bone metabolism of patients on the high-turnover status.