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@#Objective To investigate the expression of α7 nicotinic acetylcholine receptor (α7 nAChR) in thymocytes of patients with myasthenia gravis (MG) and its effect on cytokine secretion and T cell proliferation. Methods Patients with MG who underwent expanded thoracoscopic thymectomy in the Comprehensive Diagnosis and Treatment Center of the Henan Provincial People’s Hospital from June 2021 to June 2022 were selected and allocated to a MG group. Patients who underwent partial thymectomy to expose the surgical field during the cardiac disease surgery from June 2021 to September 2022 in the Department of Adult Cardiac Surgery of Fuwai Huazhong Cardiovascular Hospital were selected as the control group. Thymic single cell suspensions were prepared from MG and control groups, and the expression of α7 nAChR in thymocytes of the two groups was detected by real-time polymerase chain reaction and Western blotting. Then CD3/CD28 monoclonal antibody coupled with magnetic beads was used to induce T cell activation, and the levels of cytokines interferon-gamma (IFN-γ), tumor necrosis factor-α (TNF-α), interleukin-4 (IL-4), IL-6, IL-10, IL-17, and IL-21 in thymocytes of the two groups were detected by enzyme-linked immunosorbent assay (ELISA). The activated T cells of the MG group were divided into a blank control group, an α7 nAChR antagonist group, and an α7 nAChR agonist group according to different treatment methods. After 72 hours of culture, IFN-γ, TNF-α, IL-4, IL-6, IL-10, IL-17, and IL-21 expression levels in the culture supernatant were measured by ELISA. Afterwards, CD4-PE and CD8-APC antibodies were added, and the proliferation of T cell subsets was detected by flow cytometry. Results A total of 10 MG patients were collected, including 3 males and 7 females with an average age of 19.25±6.28 years; and 15 control patients were collected, including 6 males and 9 females with an average age of 26.18±6.77 years. Compared with the control group, the mRNA and protein levels of α7 nAChR in the thymocytes of MG group were decreased, and the expression levels of IFN-γ, TNF-α, IL-4, IL-6 and IL-21 in the supernatant were increased (P<0.05), but there was no statistical difference in the expression of IL-10 and IL-17 (P>0.05). The cell-culture experiment showed that compared with the blank control group, the levels of IFN-γ, TNF-α, IL-6 and IL-21 secreted by T cells in the α7 nAChR antagonist group were increased (P<0.05), while they were decreased in the α7 nAChR agonist group (P<0.05). There was no statistical difference in the secretion levels of IL-4, IL-10 or IL-17 among the three groups (P>0.05). CD4+ T and CD8+ T cells in the α7 nAChR agonist group were significantly less than those in the blank control group and α7 nAChR antagonist group (P<0.001), while they were significantly more in the α7 nAChR antagonist group than those in the blank control group (P<0.001). Conclusion The expression of α7 nAChR in thymocytes of MG patients is decreased, and α7 nAChR may be involved in the inflammatory response in thymocytes and thus in thymic function.
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@#Objective To exploring the effectiveness of perioperative application of new surgical clinical classification and staging for myasthenia gravis (MG) in reducing the incidence of postoperative myasthenic crisis (MC). Methods The clinical data of patients with generalized MG admitted to the Comprehensive Treatment Center for Myasthenia Gravis of Henan Provincial People’s Hospital from January 2018 to June 2022 were retrospectively analyzed, who were scored with myasthenia gravis-activities of daily living (MG-ADL) score and quantification of the myasthenia gravis (QMG) score at the first visit, 1 day before surgery, and 3 days after surgery. The patients were divided into a group A (typeⅡ) and a group B (typeⅢ+Ⅳ+Ⅴ) by the new surgical clinical classification and staging of MG according to the disease progression process, and all patients underwent expanded thoracoscopic thymus (tumor) resection after medication and other interventions to control symptoms in remission or stability. The incidence of MC and the efficiency rate after surgery were analyzed. The normal distribution method and percentile method were used to calculate the unilateral 95% reference range of the QMG score and MG-ADL score. Results Finally 126 patients were enrolled, including 62 males and 64 females, aged 13-71 years, with an average age of 46.00±13.00 years. There were 95 patients in the group A and 31 patients in the group B, and the differences of the preoperative baseline data between the two groups were not statistically significant (P>0.05). The incidence of postoperative MC was 1.05% (1/95) in the group A and 3.23%(1/31) in the group B (P>0.05). The effective one-sided 95% reference range of the QMG score and MG-ADL score 1 day before surgery was 0-7.75 and 0-5.00, and there was no postoperative death in both groups. Conclusion The new surgical clinical classification and staging of MG can guide the timing of surgery, which can benefit patients undergoing surgery for MG and greatly reduce the incidence of postoperative MC.
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Objective To investigate the influence factors for immediate outcome after thymectomy for patients with myasthenia gravis (MG). Methods The clinical data of 108 patients with MG who received thymectomy in the Department of Thoracic Surgery, the Second Affiliated Hospital of Zhengzhou University from July 2009 to July 2012 were retrospectively investigated, including gender, age, duration of disease, clinical classification, pathological classification of thymus and anti-acetylcholine receptor antibodies (AChRab). The immediate outcome after thymectomy was also observed. Thirty-two cases of MG who had immediate outcome after thymectomy were enrolled into experimental group, while 76 cases who did not have immediate outcome after thymectomy were regarded as control group. Results The immediate outcome after thymectomy was associated with duration of disease (χ2=98.550, P<0.01), clinical classification (χ2=40.434, P<0.01), pathological classification of thymus (χ2=11.154, P=0.004) and AChRab (χ2=5.590, P=0.018). There were statistically significant differences between the two groups in the one-year (31.3% in the experimental group vs 14.5% in the control group, χ2=4.046, P=0.044), two-year (40.6% vs 21.1%, χ2=4.392, P=0.036) and three-year complete remission rates (46.9% vs 25.0%, χ2=4.995, P=0.025). Conclusion Duration of disease, clinical classification, pathological classification of thymus and AChRab could be influence factors for immediate outcome and complete remission for patients with MG after thymectomy.
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Objective To analyze the safety and efficacy of endovascular aortic repair (EVAR) for abdominal aortic aneurysm(AAA) with hostile aortic proximal landing anatomy. Methods The clinical and imaging data of 147 AAA patients [135 males, (68.7 ± 8.9) years old, range 43-85 years old] with hostile aortic proximal landing anatomy treated by EVAR from January 2012 to December 2014 in our center were retrospectively analyzed. The range of maximum aneurysm diameter was 45-100 mm; the length range of proximal aneurysm neck was 7-32 mm;the width range of proximal aneurysm neck was 15-30 mm, and the infrarenal angulation was 10°-90° . In addition, there were atherosclerotic changes in the proximal neck in 43 cases. Follow-up protocol consisted of evaluation of clinical symptoms and cTA at 3, 6 and 12 months and annually thereafter. Results The technical success rate was 100%. Different procedures were adopted among patients, with 113 cases of EVAR, 3 cases of fenestrated EVAR and 24 cases of chimney EVAR. The intra-operative type Ia endoleak was observed in 32 cases, in which 25 of them were successfully treated by balloon angioplasty and the other 9 patients were treated with Cuff extension. During the mean follow-up period of 18 months (6-42 months), the accumulative survival rate was 98.0%(144/147),the patency rate of stents was 99.3%(146/147), and the thrombosis rate of aneurysm was 97.3%(143/147). Two patients died because of aneurysm rupture, and another case died of unknown reason. Two patients underwent secondary intervention successfully for the treatment of thrombosis formation and lumen occlusion in unilateral iliac stent in 1 case, and type Ⅲ endoleak in another case. No other complications such as misplace of stent grafts, no bilateral limb ischemia and stent infection were observed during follow-up. Conclusions EVAR is a safe and effective option to treat AAA with hostile aortic proximal landing anatomy. Choosing the most suitable stent-graft, the combination of various interventional techniques and close postoperative follow-up are the key points for successful treatment.
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Aim To investigate the effect of metformin (Met) on connexin43(Cx43) expression in H9c2 cells cultured with high glucose and the relevant mecha-nisms.Methods Rat myocardial cells H9c2 were cul-tured with high glucose , then combined with 3μmol· L-1 and 5 μmol · L-1 of Met for 24 h respectively . The viability and toxicity of H9c2 cells were detected by MTT and LDH , respectively .The expression and distribution of Cx43 were detected by immunofluores-cence staining .The intracellular oxygen species reac-tive ( ROS) level was detected by fluorescencemicrosco-py.And the expression of Cx43, P-AMPK, AMPK and GAPDH was determined by Western blot .Results The viability of H9c2 cells was increased and the level of intracellular ROS was decreased in Met group , while there existed no significant difference in LDH release among groups.Met significantly increased the phos-phorylation of AMPK and the expression of Cx 43, and improved the distribution of Cx 43 also.Conclusion The beneficial effect of Met on cardiovascular system in diabetic patients may via up-regulating the expression of Cx43 and down-regulating of intracellular ROS through activation of AMPK .
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Objective To study the relationships of alcohol consumption to the prevalence of metabolic syndrome and its re‐lated components in Yichang professional population and provide decision making basis for lifestyle intervention to MS crowd in the city .Methods We examined baseline data from 3 640 participants (2 285 men and 1 355 women) aged 20 to 70 years who under‐went a careful drinking habits survey ,then physical examination and blood chemical examination .They were divided into three groups by average ethanol intake [non ,occasional (0 .05) .Conclusion Even moderate drinking has a significant effect to BMI ,DBP ,TG ,LDL C ,UA ,but not obvious to CRP ,GLU ,TCH ,HDL C .Excessive alcohol consumption has a very bad effect on BMI ,DBP ,SBP ,GLU ,TCH ,TG , HDL C ,LDL C ,UA .Both the prevalence of MS and the abnormal rate of its related components are proportional to the alcohol in‐take .Although moderate drinking could lower SBP and GLU ,but can not reduce the incidence of MS .
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Aim To investigate the effect of simvastatin ( Sim ) on endogenous antioxidant system after acute myocardial infarction ( AMI ) and its potential mecha-nisms. Methods The acute myocardial infarction ( AMI ) rat models were made by ligation left anterior descending of coronary artery. Then the successful models were randomly divided into myocardial infarc-tion group ( MI group) and simvastatin group ( Sim,20 mg·kg-1·d-1), another group without ligation left anterior descending of coronary artery served as sham group(Sham group). The Sim group was administered simvastatin by gavage for 7 days. MI group and Sham group received saline. Hemodynamic parameters, lipid levels, troponinI ( c-TnI ) and lactate dehydrogenase ( LDH) concentrations were examined after 7days, and the levels of superoxide dismutase ( SOD) and glutathi-one peroxidase ( GP) of myocardial antioxidant system were detected by ELISA. The expression of cardiac p-Akt and p-eNOS protein were detected by Western blot. Results Acute myocardial infarction significant-ly lowered cardiac hemodynamic parameters, increased serum c-TnI and LDH levels, lowered levels of SOD and GP, and lowered the expression of p-Akt and p-eNOS protein. However, Sim could effectively prevent the deterioration of cardiac function, reduce serum c-TnI and LDH levels, increase levels of SOD and GP, and increase p-Akt and p-eNOS protein expression. Conclusion Early using Sim can effectively improve heart function after acute myocardial infarction, acti-vate myocardial antioxidant system,and reduce myocar-dial necrosis, which may be related to increasing the expression of p-Akt and p-eNOS.
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Objective To investigate and compare the applications of white blood cell count (WBC),neutrophil percentage (N%),C reactive protein (CRP)and procalcitonin (PCT)in the detection of bacterial infections.Methods Patients were randomly recruited in the study,70 patients with bacterial infection disease were recruited in the study as bacterial infection group,81 patients without bacterial infection were enrolled as no infection group.WBC,N%,CRP and PCT were detected,then comparative analysis of test results performed.Results Compared with no bacterial infection group,WBC,N%,CRP and PCT were increased in bacterial infection group(P <0.05),CRP and PCT increased obviously.The positive rate of WBC,N%,CRP and PCT in bacterial infection group was significantly higher than that of no bacterial infection group(P <0.05).In the bacterial infection group,the positive rate of N%,CRP and PCT was significantly higher than that of WBC(P <0.05),the positive rate of CRP was higher than PCT(P <0.05).But the positive rate of CRP was relatively high,and PCT was low in no bacterial infection group,suggesting that the false positive rate of CRP was higher,while that of PCT was lower,which had higher specificity.Conclusion WBC,N%,CRP and PCT all have clinical value for bacterial infections diagnosis.For the diagnosis of bacterial infections,N%,CRP and PCT is superior to WBC.CRP is more sensitive,but less specific,therefore,PCT with higher specificity was more suitable in the diagnosis of bacterial infections.
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Objective To explore the expressions and clinical significance of epidermal growth factor receptor (EGFR),COOH-terminus tensin-like molecule (CTEN)and epithelial cadherin (E-cad)in non-small cell lung cancer (NSCLC).Methods The expressions of EGFR,CTEN and E-cad in 36 cases of normal lung tissue and 82 cases of NSCLC tissues were observed with immunohistochemical SP method and their correlation with NSCLC invasion,metastasis and prognosis was analyzed.Results The positive rate of EGFR,CTEN and E-cad was 58.5% (48/82),69.5% (57/82)and 28.1% (23/82)in 82 cases of lung cancer,while 13.9% (5/36),0.0% (0/36)and 100% (36/36)in normal tissues;the differences were all significant (P<0.05).EGFR,CTEN and E-cad expressions in NSCLC tissues were significantly correlated with tumor differentiation,TNM stage and lymph node metastasis (P<0 .0 5 ).The expressions of EGFR and CTEN were correlated with each other in NSCLC (r=0 .5 3 0 , P<0.001),while the expressions of EGFR and CTEN were correlated with that of E-cad (r=0.499,P<0.001;r=0.333,P=0.001 ).Multivariate Cox regression analysis showed that CTEN expression in NSCLC was an independent prognostic factor (P<0.05 ).Conclusion EGFR,CTEN and E-cad may play a role in the development,invasion and metastasis of NSCLC and have some significance in predicting the prognosis of NSCLC.
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BACKGROUND: T cells are believed to play an important role in anti-infection, anti-tumor and immune function. However, the mechanism underlying the differentiation and development remains poorly understood. OBJECTIVE: To investigate the distribution of T cells in nude mice that are jointly transplanted human thymus and cord blood and the reconstruction of the immune function. METHODS: Thirty Balb/c nu/nu nude mice were randomly divided into two groups: an experimental group and a control group. In the experimental group, human thymus tissue was transplanted into the renal capsule of nude mice. Two weeks later, freshly isolated human cord blood CD34+ cells suspension was back perfused into the nude mice via the vein. In the control group, CD34+ cells transplantation was performed directly without thymus transplantation. After 60 days of breeding, the immune function of nude mice was detected in two groups. RESULTS AND CONCLUSION: Human thymus tissue in the renal capsule of nude mice survived and expressed CD3 and HLA-DR molecule. In the experimental group, CD3+ cells which distributed in the form of dots were observed in the mouse spleen. The proportion of CD3+, CD4+, CD8+, and CD4+CD25+ cells were significantly higher in the experimental group than in the control group. The nude mice from the experimental group rejected human gastric cancer BGC823 cells, while those from the control group did not. These findings demonstrated that combined human thymus and CD34+ cell transplantation allow nude mice to acquire T cell-mediated cellular immune function and possess the ability of anti-tumor.
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Objective To explore the clinical significance of preserving the intercostobrachial nerve (ICBN) in the radical resection of breast cancer. Method All of 140 cases of breast cancer with Ⅰ - Ⅲ a stage operable eligible,were randomly divided into the experimental group with 79 cases (7 cases were rejected, 1 case was lost) that patients received radical resection of breast cancer with preservation of ICBN,and the control group with 61 cases (2 cases were lost) that patients received routine radical resection of breast cancer based on the time of admission. Analyzed postoperative local recurrence and compared to sensory dysfunction of the two groups. Results There was no significant difference between the two groups of patients in the rate of postoperative local recurrence [0-4.2% ( 3/71 ) vs. 0-3.4% (2/59)] ( P ＞ 0.05 ). The local sensory disturbance of the experimental group [2.8% (2/71 )-11.3% (8/71)] was significantly lower than the control group [54.2%(32/59)-71.2%(42/59)], there was significant difference between the two groups (P ＜ 0.01 ). Conclusion Radical resection of breast cancer with preservation of ICBN is an ideal operation in breast cancer.
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Objective To compare the effects of different doses of adenosine(AD)on the left coronary blood flow(CBF)and left coronary flow reserve(CFR)in mini-swine.Methods By using Doppler flow wire and intracoronary ultrasound imaging catheter at the middle segment of LAD,coronary average peak flow velocity(APV)and lumen area were measured in 10 healthy mini-swines.CBF was calculated from the equation of 0.6 APV times 0.5 lumen area.Intracoronary bolus injection of different dose AD(12μg,18μg,24 μg and 36μg,separately)was used to induce maximal coronary hyperemic reaction.CFR was defined as the ratio of hyperemic CBF to resting CBF.Results Intracoronary bolus injection of 18μg AD level induced a maximal coronary vasodilation.Significant difference in the hyperemic CBF existed between 12 μg AD dose and 24μg or 36μg AD dose(P＜0.05).No significant difference in heart rate,blood pressure,rCBF and CFR was found among three different AD dose groups(18μg,24μg,and 36μg).Conclusion CBF and CFR in mini-swine can be effectively assessed by bolus injection of AD with the dose of(18～24)μg.
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Objective By using percutaneous endovascular microcatheter technique to establish an animal model of coronary microembolization in mini-swine which is suitable for long-term observation.Methods Coronary microembolization was established in 10 mini-swine by infusing 15 × 10~4 microspheres (φ45μm) selectively into the left anterior descending artery (n = 10). Coronary flow reserve (CFR) was measured by Doppler wire and left ventricular eject fraction (EF) was assessed by echocardiography.Hematoxylin and eosin (HE) staining and nitroblue tetrazolium (NBT) dye were used to demonstrate the presence of microembolization after the procedure of coronary microembolization. The ultra-structures of cardiomyocyte were observed by transmission electron microscopy (TEM). Before sacrifice, the CFR measurement and coronary angiography were performed again in survival animals. Results The coronary microvascular integrity (CFR < 2.0) and left ventricular function (EF < 50% ) were damaged by coronary microembolization. One month after the procedure, all the 10 animals survived and were able to receive the angiography and CFR measurement again. HE staining and NBT dye could demonstrate the presence of microembolization. The edema and fibrosis of cardiomyocytes could be revealed with TEM. Conclusion The animal model of coronary microembolization can be established in mini-swine by using percutaneous endovascular microcatheter technique. The model is suitable for long-term observation, the preparation is technically-simple and minimally-invasive with very low mortality. Therefore, this kind of animal model is an ideal experimental form for studying the mechanism of coronary microembolization.
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Objective To investigate the result of McBride operation for treatment of hallux valgus with more than 5 years follow-up. Methods There were totally fifity patients who underwent McBride operation in this study. The follow-up period varied from 5 years to 10 years and 2 months (average 7 years and 1 month). The symptoms and deformity before and after operation were compared statisticly. Results The angle between first phalanx and metatarsal is strongly correlated with the angle between first and second metatarsal.The coefficience of pre- and post-operation is 0.84 and 0.71 respectively.There were 64 feet whose symptoms were eliminated and the deformity were corrected basically. The effective rate was 71.1% according to the assessment criteria discribed by doctor ZHU Lihua. The common complications were pain residue, local numbness, hallux valgus recurrence, hallux varus and claw toes. The measurment showed the angle between first phalanx and metatarsal significantly decreased after operation and the angle between first and second metatarsal also decreased following the hallux valgus correction. Conclusion McBride operation is a good and reliable method to treat young patients with mild to moderate hallux valgus. Complications are related to congenital foot deformity, severe valgus deformity and normal structure injuries during the operation.