Volume 87  ·   Issue 33  ·  2007

During cardiac surgery, both ischemia and reperfusion can cause myocardial damage. Therefore, practical and effective measures should be taken to reduce the damage of myocardial cells during surgery. Hypothermia and cardiac arrest are the most effective methods to reduce myocardial oxygen consumption and alleviate ischemia and reperfusion injury.

According to the report of the Ministry of Health of China, as of May 21, 2007, 5459 cases of hand-foot-mouth disease (HFMD) have been reported in China this year. Compared with the same period of last year (2488 cases), the number of reported cases has increased by 119.41%, and 2 deaths have been reported. Therefore, the disease should be highly concerned. HFMD is an infectious disease caused by enterovirus, which mostly occurs in infants under 5 years old. It can cause fever, rash and ulcer in hands, feet and mouth. The main pathogens are coxsackievirus group A 16 (CoxA16) and enterovirus 71 (EV71).

Objective to compare the protective effects of selective sodium-hydrogen ion exchange blocker Cariporide combined with different cardiac arrest solutions (St. Thomas solution and HTK solution) on immature myocardial ischemia/reperfusion injury. Methods Thirty-two New Zealand young rabbits (2-3 weeks old) were randomly divided into four groups after Langendorff isolated cardiac perfusion model, 8 in each group: control group (St group, St. Thomas solution), HTK group (HTK solution), St + C group (St. Thomas solution with Caripofide) and HTK + C group (HTK solution with Caripofide). All hearts were ischemic at 30℃ for 120 min and reperfused with KH solution at 37℃ for 60 min. Cardiac function parameters were recorded: left ventricular developmental pressure (LVDP), left ventricular maximum systolic change rate (+ dp/dtmax), left ventricular maximum diastolic change rate (-dp/dtmax) and coronary flow (CF); Results LVDP, + dp/dtmax, -dp/dtmax, CF recovery rate and ATP contents in HTK group were significantly higher than those in St group (P<0.05), while CK-MB, MDA, WC and iCa were significantly lower than those in St group (P<0.05). The indexes of St + C group and HTK + C group were better than those of St group and HTK group, respectively, and the indexes of HTK + C group were better than those of St + C group; Comparison between St + C group and HTK group showed that-DP/dtmax, recovery rate of CF and ATP in St + C group were higher than those in HTK group (P<0.05), while MDA was higher than that in HTK group (P<0.05). The difference of other indexes between the two groups was not statistically significant (P>0.05). Conclusion Cariporide can improve the protective effects of St. Thomas solution and HTK solution on immature myocardial ischemia-reperfusion injury.

Objective to investigate the myocardial protection effect of Shenfu injection added to cardioplegia on heart valve replacement surgery.Methods Forty patients undergoing cardiopulmonary bypass (CPB) valve replacement were randomly divided into Shenfu injection (SF group) and control group.The cardioplegia solution in the control group was a mixture of oxygenated blood and cold crystal solution (modified St Thormas solution) in a volume ratio of 4:1; In the SF group, 20 ml/L Shenfu injection was added to cold crystal solution, and the other treatments were the same as those of the control group. Blood were collected at different time points before operation, after aortic opening and after CPB stop, and CK, CK-MB and cTnI were measured after treatment. Results CK, CK-MB and CK-MB were significantly increased in the two groups after 30 min of aortic opening, and CK, CK-MB were still higher in the two groups until 24 h after CPB stop. Compared with the control group at 24 h after CPB stop, the increase of CK in SF group was significantly lower than that in the control group (P<0.05), and the increase of CK-MB in SF group was significantly lower than that in the control group at each time point after CPB stop. The cTnI decreased at 24 h after CPB stop, but was still higher than that before operation. The increase of cTnI in SF group was significantly lower than that in the control group at 30 min after CPB stop (P<0.05). The number of patients with automatic cardiac rebeat in SF group was significantly higher than that in the control group, while the number of patients with dopamine assisted circulation after CPB stop was significantly lower than that in the control group

Objective to observe the effect of adenosine preconditioning on myocardial injury in patients undergoing off-pump coronary artery bypass grafting (OPCAB). Methods 40 patients undergoing off-pump coronary artery bypass grafting (OPCAB) were randomly divided into control group and experimental group (20 cases in each group). Plasma concentrations of creatine kinase isoenzyme (CK-MB) and troponin Ⅰ (cTnI) were measured after anesthesia (T0), 30 min (T1), 2 h (T2), 6 h (T3), 12 h (T4) and 24 h (T5) after revascularization. Results Compared with the basic values, CK-MB increased in both groups at each time point, and T1~ T5 increased in the control group, and the difference was statistically significant (P<0.05). Only T2 increased in the experimental group, and the difference was statistically significant (P<0.05). Compared with the basic values, cTnI increased in both groups at each time point, and the difference was statistically significant (P<0.05). Conclusion Myocardial injury can still occur in off-pump coronary artery bypass grafting, and adenosine preconditioning can reduce CK-MB and cTnI

Objective to compare and observe the myocardial protective effects of propofol and midazolam on children with cyanotic congenital heart disease undergoing open heart surgery. Methods Thirty-two children with cyanotic congenital heart disease undergoing ASA Ⅰ ~ Ⅱ open heart surgery were randomly divided into two groups, 16 cases in each group, propofol combined with low-dose fentanyl group (PF group) and midazolam combined with low-dose fentanyl group (MF group). The expression of heme oxygenase-1 (HO-1) was observed in myocardial tissues at 10~20 min after aortic occlusion (T2) and 10~20 min after aortic opening (T3). The levels of troponin Ⅰ (cTnI) in plasma were detected in venous blood at T0, 2 h after aortic opening and 24 h after operation. Results the mean extubation time and ICU stay time were shorter in PF group than in MF group (14.17 h vs 23.65 h, 30.17 h vs 49.47 h, respectively); The levels of cTnI at T4 (PF: 97 ng/ml ± 33 ng/ml, MF: 138 ng/ml ± 56 ng/ml) were higher than those in both groups T0 (PF: 0.17 ng/ml ± 0.10 ng/ml, MF: 0.62 ng/ml ± 0.96 ng/ml) and T5 (PF: 23 ng/ml ± 13 ng/ml, MF: 24 ng/ml ± 6 ng/ml), T5 The level of cTnI was higher than that of T0, but there was no statistically significant difference between the two groups. Conclusion Propofol and midazolam have protective effects on myocardium in children with cyanotic congenital heart disease after cardiopulmonary bypass and open heart surgery, and propofol is superior to midazolam in stimulating myocardial protective protein HO-1.

Objective to explore the effect of tertiary rehabilitation therapy on the motor function of upper and lower limbs in hemiplegic patients with stroke. Methods A large sample, multi-center, prospective randomized controlled study was performed in this study. Patients were randomly enrolled in each sub-center, and then the patients were randomly enrolled in the rehabilitation group and the control group at the two levels of cerebral infarction and cerebral hemorrhage. 688 cases in the rehabilitation group and 677 cases in the control group, a total of 1365 cases. The rehabilitation group was given tertiary rehabilitation therapy, while the control group was not given tertiary rehabilitation therapy. However, the general neurology routine diagnosis and treatment were the same as the rehabilitation group. At the time of enrollment, the motor function status of upper and lower limbs was evaluated by simplified Fugl-Meyer motor function rating scale at the end of 1 month, 3 months and 6 months after disease, respectively. Results After enrollment, the motor function scores of upper and lower limbs in the rehabilitation group of cerebral infarction and cerebral hemorrhage were significantly better than those in the control group (all P<0.01). When enrolled in the rehabilitation group of cerebral infarction, the scores at the end of 1 month, 3 months and 6 months after disease were 28, 47, 65 and 75 points, respectively, and the scores of the control group were: When the cerebral hemorrhage rehabilitation group was enrolled, the scores at the end of 1 month, 3 months and 6 months after illness were: 23, 44, 67 and 80 points, respectively, and the scores of the control group were: 21, 32, 46 and 55 points, respectively. The comparison of the difference of limb motor function scores at each stage showed that the functional improvement degree of patients in the cerebral infarction and cerebral hemorrhage rehabilitation group was significantly better than that in the control group (all P<0.01). After 6 months of follow-up treatment, the motor function of upper and lower limbs in the cerebral infarction and cerebral hemorrhage rehabilitation group was improved by 47 points and 56 points, respectively, while that in the control group was improved by 29 points and 34 points, respectively. That is, compared with the control group, the improvement of upper and lower limbs in the cerebral infarction rehabilitation group was 18 points more, and that in the cerebral hemorrhage rehabilitation group was 22 points more.

Objective to evaluate the efficacy of percutaneous vertebroplasty in the treatment of chronic painful vertebral compression fractures in the elderly.Methods the clinical data of 98 patients with intractable low back pain and severe frustration of self-care ability treated by percutaneous vertebroplasty were retrospectively analyzed.Results 98 patients with 123 vertebral compression fractures were treated by percutaneous vertebroplasty, and the amount of bone cement injection was 3.5-7ml.The postoperative pain was completely relieved in 20 patients, 59 patients were significantly relieved, 14 patients were improved, and 5 patients had no obvious effect.The pain score and self-care life ability score were significantly decreased after operation (P<0.01). Conclusion Percutaneous vertebroplasty can significantly improve the pain symptoms and living status of elderly patients with chronic painful vertebral compression fractures.

Objective to evaluate the expression and clinical significance of cytokeratin subtypes (CK7, CK20) and thyroid transcription factor 1 (TTF-1) in bronchioloalveolar carcinoma (BAC), and to further study the predictive effects of each factor on the prognosis of BAC.Methods 81 cases of bronchioloalveolar carcinoma who underwent surgery from January 1990 to December 2000 were collected, including 68 cases of non-mucinous type and 13 cases of mucinous type. The expressions of CK7, CK20 and TTF-1 in 81 cases were detected by immunohistochemical ElivisionTM two-step method, and the predictive value of each factor on the prognosis of BAC was studied by survival analysis. Results There was no significant difference in the expression of CK7 in different age groups, clinical stages and pathological types in BAC. The positive rate of CK20 in stage Ⅰ ~ Ⅱ was higher than that in stage Ⅲ (χ 2=3.928, P<0.05), and the positive rate in mucinous type BAC was higher than that in non-mucinous type (χ 2=11.512, P<0.05). The positive rate of TTF-1 in stage Ⅲ was significantly higher than that in stage Ⅰ ~ Ⅱ (χ 2=7.840, P<0.05), and the positive rate in non-mucinous type was significantly higher than that in mucinous type (χ 2=19.497, P<0.05). The expression of TTF-1 and CK7 was positively correlated (r =0.257, P =0.021). The factors affecting the prognosis in univariate analysis were TTF-1 expression (P =0.017), clinical stage (P =0.000), tumor diameter (P =0.017) and N stage (P =0.000); Stratification analysis showed that the survival time of TTF-1-positive non-mucinous BAC patients was better than that of negative patients (P =0.009), and the survival time of TTF-1-positive stage III BAC patients was better than that of negative patients (P =0.022). COX regression multivariate analysis showed that TTF-1 (P =0.035), TNM stage (P =0.000), tumor diameter (P =0.034) and N stage (P =0.000) were independent prognostic factors. TTF-1 and CK20 provide theoretical basis for molecular pathological staging of BAC; TTF-1 expression, clinical stage, tumor diameter and N stage were all independent factors affecting the prognosis of BAC.

Objective to investigate the changes of blood motilin and gastrin levels after resection of esophageal carcinoma and their effects on thoracic gastric electrical activity and emptying functions. Methods Electrogastric examination and blood motilin and gastrin levels were measured in 52 subjects, including 20 normal subjects and 32 patients with esophageal carcinoma. The patients with esophageal carcinoma were examined before and at 1, 3, 6 and 12 months after surgery, respectively. 35 subjects, including 5 normal subjects, 7 patients with esophageal carcinoma before surgery and 23 patients with esophageal carcinoma after surgery, were examined to show gastric emptying at the same time. Results (1) The frequency of gastric emptying was lower in the preoperative group [(28.0±8.0)] than that in the normal control group [(38.0±2.0)] (t =3.515, P =0.006), and further decreased [(16.0±4.8)] (t =6.987, P =0.000) at 1 month after surgery. Although it recovered at 1 year after surgery [(16.8±4.8)], it still could not reach the level of normal control group (t =9.387, P =0.0000). (2) The frequency of electrogastric examination was lower in the preoperative group [(3.1±4.8) (3) Electrogastric amplitude: There was no significant difference between the preoperative group [(229±118) μ V] and the normal control group [(226±62) μ V] (t =0.085, P =0.933). The preoperative group [(172±46) μ V] was significantly lower than the normal control group (t =3.118, P =0.003), and then gradually recovered. The preoperative group [(488±197) ng/L] was significantly higher than the normal control group [(248±98) ng/L] (t =5.030, P =0.000). The preoperative group [(488±197) ng/L] was significantly higher than the normal control group [(248±98) ng/L] (t =5.030, P =0.000). The preoperative group [(443±129) ng/L] was still higher than the normal control group (t =3.725, P =0.001)

Objective to investigate the time limit distribution of early death from cervical spinal cord injury. Methods the general status, injury causes, spinal injury segments, severity of spinal cord injury, combined injuries, imaging manifestations of cervical spinal cord injury, treatment methods, course and results, cause of death, time from injury to admission, time from injury to death were retrospectively analyzed in a group of death cases from cervical spinal cord injury. Results the time from injury to death was within 24 h, 3 cases from 25 to 48 h, 5 cases from 49 to 72 h, 16 cases from 73 to 7 d, 16 cases from 8 to 14 d, 8 cases from 15 to 21 d, 6 cases from 22 to 28 d, 1 case from 29 to 35 d, 1 case from 36 to 42 d, 43 to 49 d There were 2 cases, 1 case was 50~56 days, 1 case was over 57 days, 63 cases died in the early stage of cervical spinal cord injury, 27 cases died within 1 week after injury, accounting for 42.8%; 43 cases died within 2 weeks after injury, accounting for 68.3%; A total of 57 cases (90.5%) died within 4 weeks after injury; Conclusion the peak of death in cervical spinal cord injury is within 1 week after injury, the main death time is within 2 weeks after injury, followed by 3~4 weeks after injury, 90.5% of the death cases died within 4 weeks after injury. Respiratory failure is the primary cause of early death in cervical spinal cord injury.

Objective to study the gene expression characteristics of insulin-like growth factor Ⅰ in osteophyte cartilage of osteoarthritis. Methods 25 osteophyte specimens of primary osteoarthritis undergoing total knee arthroplasty were studied, and 3 normal adult femoral condyle cartilage specimens were used as controls. Paraffin sections were prepared and stained with HE and toluidine blue and immunohistochemical staining with collagen Ⅰ, collagen Ⅱ (Ⅱa and Ⅱb) and collagen X. According to the cell morphology of main tissues and the expression characteristics of various collagen molecules in osteophyte, five main different types (Ⅰ-Ⅴ) of osteophyte tissues were obtained, Then immunohistochemistry and in situ hybridization staining of insulin-like growth factor Ⅰ were performed respectively.Results Quantitative analysis was followed by one-way analysis of variance.Results Both immunohistochemistry and in situ hybridization methods showed that the expression of insulin-like growth factor Ⅰ was significantly higher in class Ⅰ and Ⅱ osteophytes than in class Ⅳ and Ⅴ osteophytes (14.6±3.8 vs 7.7±3.5; 14.6±3.8 vs 6.0±1.9; 14.2±4.6 vs 5.4±2.1; 14.2±4.6 vs 2.2±1.5; P<0.05). There was no statistically significant difference between class Ⅰ and Ⅱ osteophytes and class Ⅳ and Ⅴ osteophytes. Conclusion Insulin-like growth factor Ⅰ-mRNA was mainly significantly expressed in the early stage of osteophyte formation; It may play an initiating role in the occurrence of osteophyte in osteoarthritis.

Objective to compare the Lenke classification system and the Peking Union Medical College Hospital (PUMC) classification system for idiopathic scoliosis, and compare the confidence between different observers and the repeatability within the same observer. Methods Five spinal surgeons measured the preoperative X-ray films of 62 adolescents with idiopathic scoliosis treated by surgery independently. The Lenke classification system and the PUMC classification system were used to evaluate and classify respectively. After 3 weeks, the same procedure was repeated by this physician. The X-ray films measured by each physician did not leave any marks. The results were collected, and the confidence between different observers and the repeatability within the same observer were analyzed, and the κ value was calculated, and the consistency was tested. The two types of classification systems were compared and studied. Results The overall confidence and repeatability of Lenke classification system were 69.8% (κ =0.675) and 74.2% (κ =0.690), respectively. The confidence and repeatability of bending type were 86.5% (κ =0.808) and 87.4% (κ =0.826), respectively. The average reliability and repeatability of lumbar spine correction were 95.2% (κ =0.919) and 94.5% (κ =0.908), respectively; The reliability and reproducibility of thoracic sagittal plane correction were 85.2% (κ =0.734) and 89.0% (κ =0.805), respectively. The reliability and reproducibility of PUMC classification system were 91.0% (κ =0.896) and 90.2% (κ =0.892), respectively. Conclusion The reliability and reproducibility of Lenke classification system are good, and the reliability and reproducibility of PUMC classification system are better. Both Lenke and PUMC classification systems are relatively comprehensive, but PUMC classification system is relatively simple, contains less types, and clinicians have less differences when classifying, which is of guiding significance for surgery.

Objective to investigate the status of daily anti-tethering therapy in patients with non-valvular atrial fibrillation (AF) in Beijing, and to find out the problems of stroke prevention in patients with AF. Methods Eight tertiary hospitals and seven secondary hospitals (community health service centers) were selected from 8 districts of Beijing (Dongcheng, Xicheng, Haidian, Chaoyang, Chongwen, Xuanwu, Shijingshan and Fengtai). A unified questionnaire survey was conducted by physicians on patients with non-valvular atrial fibrillation in outpatient clinics or wards. Results 75% of 583 patients were from outpatient clinics, 64.3% were from tertiary hospitals and 35.7% were from community health service centers. 18.9% of patients with AF took warfarin, of which 39.1% had international standardized measurement (INR) controlled at 2.0~3.0.68.2% of patients took warfarin within 1 year, 5.7% of patients had taken warfarin before, 59.3% of patients with AF took aspirin, 85.7% of them had a dose of 76~150 mg/d, and none of them had a dose of 325 mg/d. 18.9% of patients with atrial fibrillation did not receive any anticoagulation therapy. The main reasons for not taking warfarin in patients with atrial fibrillation came from two aspects: 78.6% of patients did not receive anticoagulation recommendations, and more than 75% of patients lacked anticoagulation knowledge. The prevalence of stroke in patients with atrial fibrillation was 22.8%, 22.0% in those who took warfarin, 24.3% in those who took aspirin, and 21.3% in those who did not take any measures. The difference in stroke prevalence was not statistically significant (χ 2=1.09, P =0.58). Conclusion The rate of anticoagulation therapy in patients with non-valvular atrial fibrillation in Beijing is lower than that of antiplatelet therapy. The rate of warfarin taking is at a high level in China, but the time of taking is short, and the effect is poor. The rate of aspirin taking in patients with high risk of stroke is too high, and the dose is on the low side.

Objective to investigate the distribution characteristics of DYT1 gene mutation in Chinese patients with primary dystonia, and to evaluate the application value of denaturing high performance liquid chromatography (DHPLC) in the analysis of DYT1 gene mutation.Methods the exon 5 fragment of DYT1 gene was amplified, and the PCR product was detected by DHPLC technique, and the mutation type was confirmed by sequencing, and the results of DHPLC were examined by PCR-digestion method.Results 904-906delGAG (3 bp) heterozygous deletion mutation was found in 5 cases of 13 patients with primary dystonia, which caused the loss of glutamate in codon 302; Conclusion DHPLC can be used to detect 3 bp deletion mutation of DYT1 gene; GAG deletion mutation of DYT1 gene may be the main cause of early-onset systemic primary dystonia in Chinese.

Objective to construct a plasmid expressing SMN1 shRNA in mammalian cells, and to investigate its inhibitory effect on full-length SMN mRNA and protein in human bone marrow mesenchymal stem cells, so as to provide experimental basis for establishing a cell model of spinal muscular atrophy. Methods Five SMN1-targeting shRNAs were designed and cloned downstream of U6 promoter in pRNAT-U6.1/Neo vector according to the SMN1 cDNA sequence in GenBank, and the recombinant plasmid pshRNA-SMN1 was formed to express SMN1-specific short hairpin RNA in cells. The recombinant plasmid pshRNA-SMN1 was transfected into human bone marrow mesenchymal stem cells (hMSC) under liposome mediation, and the expression of fl-SMN mRNA and fl-SMN protein was detected by RT-PCR and Western blot, respectively. Results The recombinant plasmid pshRNA-SMN1 was successfully constructed by agarose gel electrophoresis and DNA sequencing. The transfection of pshRNA-SMN1-1 group and pshRNA-SMN1-4 group significantly inhibited the fl Without affecting △ The expression of 7-SMN mRNA. Conclusion pshRNA-SMN1 recombinant plasmid can effectively inhibit the expression of fl-SMN mRNA and protein in human bone marrow mesenchymal stem cells.

Objective to observe the effects of basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF) on arterial blood gas and lung histopathology in rats with pulmonary emphysema, and to explore the mechanism of alveolar repair by bFGF and VEGF and the new pathogenesis of pulmonary emphysema. Methods 24 Wistar rats were randomly divided into 4 groups: bFGF group, VEGF group, control group and healthy control group. The rats in bFGF group, VEGF group and control group were injected with porcine pancreatic elastase (PPE) (250 U/kg) into the trachea to replicate the emphysema model. The healthy control group was controlled with normal saline, and the model was made after 4 weeks. The bFGF group and VEGF group were injected with bFGF (400 U/rat) and VEGF (2 μ g/rat) into the trachea, respectively. The control group and healthy control group were injected with human normal saline once a week for 3 consecutive times. After 4 weeks, the morphological changes of arterial blood gas and alveoli were compared. The number of CD34+ cells was detected by immunohistochemistry to determine the proliferation of pulmonary capillaries. Results There was no statistical difference in blood gas analysis between the groups The mean alveolar number (MAN) in bFGF group and VEGF group were [(43±8) /visual field and (44±9) /visual field], respectively, which were significantly higher than those in the control group [(30±6) /visual field] (P<0.01); The mean alveolar area (MAA) was (9856 ± 1864) μ m2 and (9804 ± 1929) μ m2, respectively, which were significantly smaller than those of the control group [(14 525 ± 3408) μ m2] (P<0.01); The mean interlining interval (MLI) was (196 ± 38) μ m2 and (194 ± 38) μ m2, respectively, which were significantly smaller than those of the control group [(288 ± 68) μ m2] (P<0.01); The relative areas of CD34+ positive cells were 3.7%4±1.3% and 2.6%4±1.2%, respectively, which were significantly more than those of the control group (0.8%±0.7%) (P<0.05). Conclusion bFGF and VEGF can promote the regeneration of pulmonary capillaries and repair the lesions of emphysema.

Objective to investigate the distribution of bone marrow mesenchymal stem cells (MSCs) in tumor tissues and whether they can differentiate into myofibroblasts induced by local microenvironment of tumor. Methods 24 New Zealand rabbits were randomly divided into experimental group and control group. After bone marrow cultured MSCs were extracted from each animal, vx-2 tumor mass was transplanted to make bladder vx-2 tumor animal model. One week after tumor transplantation, F2 generation autologous MSCs cultured in the experimental group were labeled with DAPI and then transfused into bladder tumor, while the control group was transfused with DMEM medium. B-ultrasound examination was performed once in the first, second, third and fourth weeks after vx-2 tumor mass transplantation, the maximum tumor diameter of each animal was recorded, and the mean value of the maximum tumor diameter of each group was calculated. At the third week, one animal with the closest tumor diameter was sacrificed in each group, and all animals were sacrificed at the fourth week. Another animal was sacrificed after transfusion of autologous MSCs for one week according to the treatment method of the experimental group. Distribution of MSCs in tumors.Immunofluorescence sections were used to track the distribution and transdifferentiation of reinfused autologous MSCs in tumor tissues.Immunofluorescence staining with α-SMA and vimentin double label was used to identify whether MSCs were transdifferentiated into myofibroblasts in tumor tissues.Results No tumorigenesis was found in B-ultrasound examination in both groups at the first week after tumor transplantation; At the second week, the average maximum diameter of tumor in the control group was (0.70±0.14) cm, and that in the experimental group was (0.78±0.14) cm, but the difference between the two groups was not statistically significant (t =1.308, P =0.204). At the third and fourth weeks, the growth rate of tumor in the experimental group gradually increased, and the difference in the mean value of maximum diameter of tumor in the two groups gradually increased, and the difference between the two groups was statistically significant (both P<0.05). MSC were evenly distributed in tumor tissue at the first week after transfusion into tumor tissue, and mostly distributed in tumor stroma at the third week after transfusion into tumor tissue. Dual label immunofluorescence staining showed that the expression of α-SMA and vimentin increased significantly after transfusion into tumor tissue at the third week, indicating that MSC had differentiated into myofibroblasts in tumor tissue. Conclusion MSC began to distribute evenly in tumor tissue after entering tumor tissue, and then distributed in tumor stroma, and can promote tumor growth, and can differentiate into myofibroblasts under the induction of tumor local microenvironment.

fungal keratitis (FK) is an important ocular disease causing blindness worldwide. In the past 40 years, the number of reports of FK has increased significantly [1-2], which may be related to the improvement of the understanding and diagnosis level of ophthalmologists.

The correlation between weekend effect and diseases has been studied and reported in the past, and the idea of exploring in the past is mainly to pay attention to the special atmosphere and environment of weekends or holidays, and focus on which diseases and why they are prone to suffer during this period; Recently, some scholars began to pay attention to whether the mortality rate is higher than usual after some diseases are transferred to hospital on weekends, and why it is higher.

Proband (V26), female, 30 years old, was admitted to hospital in March 2006 due to "limb stiffness and slow movement for 3 years". Three years ago, the patient gradually developed limb stiffness, obvious on the right side, and dragging on the right lower limb when walking, and the above symptoms gradually aggravated.

The patient, a 28-year-old farmer, was admitted to our hospital due to neck pain and numbness and fatigue of both lower limbs after cold. He had a history of cold and fever 1 week before the onset of the disease, and suddenly developed persistent pain in the back neck at rest 2 days before admission, accompanied by non-jet vomiting, followed by numbness and fatigue of both lower limbs and retention of urine and stool. No obvious abnormalities were found on head and neck CT in another hospital 1 day before admission, and the patient's symptoms were not improved significantly after anti-inflammatory and neurotrophic treatment.