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Fibrosis， a tumor-like lesion between benign tissue and malignant tumor， mostly occurs in the liver， kidney， heart， lung， bone marrow and other organs and tissues. It can affect almost every organ and eventually induce multiple organ failure and cancers， seriously endangering human life. It will be of great importance to prevent cancer if the disease can be opportunely blocked in the fibrotic stage. The pathogenesis of fibrosis is still not completely clear. It is of great clinical significance to study the occurrence， development， and mechanism of fibrosis as well as to screen new therapeutic targets. Enhancer of zeste homolog 2 （EZH2） is mainly located in the nucleus and involved in the formation of the polycomb repressive complex 2. EZH2 is a methyltransferase which makes the lysine on position 27 of histone H3 （H3K27me3） undergo trimethyl modification induces gene silencing through classical or nonclassical actions， so as to inhibit or activate transcription. EZH2 plays a critical role in cell growth， proliferation， differentiation， and apoptosis， which is regulated by different targets and signaling pathways. EZH2 regulates the transformation of myofibroblasts and participates in the fibrosis of multiple organs. Recent studies have shown that EZH2 plays a role in fibrosis-related pathophysiological processes such as epithelial-mesenchymal transition， oxidative stress， and inflammation. EZH2 as the target of fibrosis， EZH2 inhibitors， and EZH2-related traditional Chinese medicine （TCM） formula and active compounds have gradually become hot research directions. EZH2 may be a powerful target for organ fibrosis. Exploring the structure， function， and distribution of EZH2， the role of EZH2 in fibrosis， the EZH2 inhibitors， and TCM formulas and active components targeting EZH2 has great meanings. This paper reviews the research progress in EZH2 and fibrosis， providing new ideas for the diagnosis， treatment， and drug development of fibrosis.
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Objective:To explore the clinical application of the principle of priority of mechanics in open blepharoplasty.Methods:A retrospective analysis was performed on 96 patients with bilateral single eyelid. For patients with condylar epidermis, the modified Park method for epidermal epidermal correction was performed; for patients with mild ptosis, levator aponeurosis or levator aponeurosis was performed. Methods such as loosening adhesions, reducing tissues, reducing load, and increasing the strength of the meibomian plate through surgery can weaken the mechanical factors that affect the formation of double eyelid folds. Therefore, with less or even the use of suture force, the patient achieves a more ideal shape of the double eyelid folds when the eyes are opened.Results:The morphology of upper eyelids and skin sagging in all 96 patients were significantly improved. Among them, 2 cases had poor curvature of the double eyelid after operation, 1 had narrow double eyelid due to insufficient peeling, and 2 had bilateral asymmetry. The upper and lower eyelids of the other patients had natural morphology with open and closed eyes, scars of incisions were not obvious, and the results were satisfactory.Conclusions:During mild blepharoptosis correction combined with double eyelid surgery, The use of the principle of priority of mechanics to open the double blepharoplasty can reduce the incidence of complications such as shallowing and disappearing of double eyelid folds to a certain extent, and it is worth popularizing.
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Objective:To analyze the results in clinical application of backtracking full-thickness continuous everting suturing in primary closure of common bile duct after laparoscopic bile duct exploration.Methods:From February 2014 to November 2018 at the Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University, 82 patients with cholecystolithiasis and choledocholithiasis entered into this study. There were 45 males and 37 females, with an average age of 62.7 years. These patients underwent primary closure of common bile duct after laparoscopic bile duct exploration using backtracking full-thickness continuous everting suturing to close the incisions in common bile ducts. Clinical data on surgery, postoperative complications and follow-up were collected and analyzed retrospectively.Results:Primary closure of common bile duct was successfully carried out in all patients. The operation time ranged from 45 to 150 min (average 68.5 min). Intraoperative blood loss ranged from 5 to 150ml (average 18.4 ml). Postoperative bile leakage occurred in 2 patients (2.4%). There were no intra-abdominal or biliary bleeding, severe cholangitis, liver function derangement, abdominal infection or residual stones. Of 77 patients who were followed up (follow-up rate of 93.9%), the follow-up time ranged from 9 to 50 months (median 14 months). On follow-up, 2 patients (2.4%) developed recurrence of choledocholithiasis and 1 patient (1.2%) was diagnosed to have intrahepatic bile duct stones. There were no patients with bile duct stenosis or acute cholangitis.Conclusion:Primary closure of common bile duct with backtracking full-thickness continuous everting suturing has the advantage of reducing postoperative bile leakage in patients after laparoscopic bile duct exploration. The long-term effects of this technique still need further clinical studies.
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Objective To investigate the influencing factors for poor jaundice resolution after radical pancreaticoduodenectomy in patients with malignant obstructive jaundice.Methods The retrospective case-control study was conducted.The clinicopathological data of 121 patients with malignant obstructive jaundice who were admitted to the Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University between March 2013 and June 2018 were collected.There were 70 males and 51 females,aged (69±9)years,with a range from 39 to 85 years.Of 121 patients,112 underwent open radical pancreaticoduodenectomy,and 9 underwent totally laparoscopic radical pancreaticoduodenectomy.Observation indicators:(1) situations of jaundice resolution after pancreaticoduodenectomy;(2) influencing factors for poor jaundice resolution after pancreaticoduodenectomy.Measurement data with normal distribution were represented as Mean ± SD.Measurement data with skewed distribution were represented as M (range).Count data were described as absolute numbers.Univariate analysis was performed using the chi-square test,t test,Fisher exact probability or Mann-Whitney U test.Multivariate analysis was performed by the Logistic regression model using P＜0.10 as an inclusion criteria in the univariate analysis.Results (1) Situations of jaundice resolution after pancreaticoduodenectomy:of 121 patients,97 had good jaundice resolution after pancreaticoduodenectomy,and 24 had poor jaundice resolution after pancreaticoduodenectomy.(2) Influencing factors for poor jaundice resolution after pancreaticoduodenectomy:results of univariate analysis showd that preoperative level of serum total bilirubin,comorbidity with diabetes mellitus were influencing factors for poor jaundice resolution after pancreaticoduodenectomy (t =-2.073,x2 =10.201,P＜0.05).Postoperative pancreatic fistula was also an influencing factor for poor jaundice resolution after pancreaticoduodenectomy (P ＜ 0.05).Results of multivariate analysis showed that comorbidity with diabetes mellitus and postoperative pancreatic fistula were independent risk factors for poor jaundice resolution after pancreaticoduodenectomy (odds ratio=0.258,0.129,95％ confidence interval:0.087-0.769,0.023-0.726,P＜0.05).Conclusions Preoperative level of serum total bilirubin,diabetes mellitus,and postoperative pancreatic fistula are influencing factors for poor jaundice resolution after pancreaticoduodenectomy.Comorbidity with diabetes mellitus and postoperative pancreatic fistula are independent risk factors for poor jaundice resolution after pancreaticoduodenectomy.
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Objective@#To investigate the influencing factors for poor jaundice resolution after radical pancreaticoduodenectomy in patients with malignant obstructive jaundice.@*Methods@#The retrospective case-control study was conducted. The clinicopathological data of 121 patients with malignant obstructive jaundice who were admitted to the Affiliated Changzhou No.2 People′s Hospital of Nanjing Medical University between March 2013 and June 2018 were collected. There were 70 males and 51 females, aged (69±9)years, with a range from 39 to 85 years. Of 121 patients, 112 underwent open radical pancreaticoduodenectomy, and 9 underwent totally laparoscopic radical pancreaticoduodenectomy. Observation indicators: (1) situations of jaundice resolution after pancreaticoduodenectomy; (2) influencing factors for poor jaundice resolution after pancreaticoduodenectomy. Measurement data with normal distribution were represented as Mean±SD. Measurement data with skewed distribution were represented as M (range). Count data were described as absolute numbers. Univariate analysis was performed using the chi-square test, t test, Fisher exact probability or Mann-Whitney U test. Multivariate analysis was performed by the Logistic regression model using P<0.10 as an inclusion criteria in the univariate analysis .@*Results@#(1) Situations of jaundice resolution after pancreaticoduodenectomy: of 121 patients, 97 had good jaundice resolution after pancreaticoduodenectomy, and 24 had poor jaundice resolution after pancreaticoduodenectomy. (2) Influencing factors for poor jaundice resolution after pancreaticoduodenectomy: results of univariate analysis showd that preoperative level of serum total bilirubin, comorbidity with diabetes mellitus were influencing factors for poor jaundice resolution after pancreaticoduodenectomy (t=-2.073, χ2=10.201, P<0.05). Postoperative pancreatic fistula was also an influencing factor for poor jaundice resolution after pancreaticoduodenectomy (P<0.05). Results of multivariate analysis showed that comorbidity with diabetes mellitus and postoperative pancreatic fistula were independent risk factors for poor jaundice resolution after pancreaticoduodenectomy (odds ratio=0.258, 0.129, 95% confidence interval: 0.087-0.769, 0.023-0.726, P<0.05).@*Conclusions@#Preoperative level of serum total bilirubin, diabetes mellitus, and postoperative pancreatic fistula are influencing factors for poor jaundice resolution after pancreaticoduodenectomy. Comorbidity with diabetes mellitus and postoperative pancreatic fistula are independent risk factors for poor jaundice resolution after pancreaticoduodenectomy.
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BACKGROUND: In vitro isolation and culture of neural stem/progenitor cells will provide a good cell model for the study of neurodevelopment, neurological diseases, and neural transplantation. OBJECTIVE: To study the highly effective method for isolation and expansion of hippocampal neural stem/progenitor cells from newborn mice, and to identify the proliferation and differentiation of hippocampal neural stem/progenitor cells using improved adherent culture method. METHODS: Neural stem/progenitor cells were isolated from the hippocampus of newborn C57BL/6 mice and were expanded for several passages. Combination of polylysine and laminin were used for adherent culture to promote cell attachment. Morphological observation and immunofluorescence cytochemical staining were conducted to detect the expression of neural progenitor-specific marker protein Nestin and proliferation index Ki-67. After 7 days of induction and differentiation, the expression of GFAP, DCX, Tuj1 and S100β was detected by immunofluorescence. RESULTS AND CONCLUSION: About 82％ of the cultured neural stem/progenitor cells expressed Nestin, and about 49％ expressed Ki-67. A small number of cells were DCX-positive neurons after induction and differentiation, while most of the cells were positive for GFAP. The ratio of neurons to astrocytes was 1:1.7 identified by Tuj1 and S100β double staining. The neural stem/progenitor cells derived from the hippocampus were efficiently isolated and cultured. The cell proliferation and differentiation abilities were effectively identified after adherent culture, which can provide sufficient cell sources for further experimental research.
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BACKGROUND: In vitro isolation and culture of neural stem/progenitor cells will provide a good cell model for the study of neurodevelopment, neurological diseases, and neural transplantation. OBJECTIVE: To study the highly effective method for isolation and expansion of hippocampal neural stem/progenitor cells from newborn mice, and to identify the proliferation and differentiation of hippocampal neural stem/progenitor cells using improved adherent culture method. METHODS: Neural stem/progenitor cells were isolated from the hippocampus of newborn C57BL/6 mice and were expanded for several passages. Combination of polylysine and laminin were used for adherent culture to promote cell attachment. Morphological observation and immunofluorescence cytochemical staining were conducted to detect the expression of neural progenitor-specific marker protein Nestin and proliferation index Ki-67. After 7 days of induction and differentiation, the expression of GFAP, DCX, Tuj1 and S100β was detected by immunofluorescence. RESULTS AND CONCLUSION: About 82％ of the cultured neural stem/progenitor cells expressed Nestin, and about 49％ expressed Ki-67. A small number of cells were DCX-positive neurons after induction and differentiation, while most of the cells were positive for GFAP. The ratio of neurons to astrocytes was 1:1.7 identified by Tuj1 and S100β double staining. The neural stem/progenitor cells derived from the hippocampus were efficiently isolated and cultured. The cell proliferation and differentiation abilities were effectively identified after adherent culture, which can provide sufficient cell sources for further experimental research.
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Objective To explore the influencing factors on short -term efficacy of intravenous thrombolysis with rt -PA.Methods The clinical data of the 95 acute ischemic stroke(AIS)patients who received thrombolytic therapy were analyze.Multivariate logistic regression analysis was used to determine the possible influencing factors. Results Fifty -six(58.95%)patients had favourable outcomes after thrombolytic therapy for 24 hours.Multivariate logistic regression analysis indicated that diabetes(OR =3.933,95% CI 1.199 ~12.897)and TOAST classification (OR =1.448,95% CI 1.032 ~2.032 )were the independent predictors of short -term outcome.Conclusion Diabetes and TOAST classification are the major influencing factors of short -term efficacy after intravenous thrombolysis with rt -PA.It should pay attention screening patients for intravenous thrombolysis therapy and predicting the efficacy of thrombolysis.
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Objective The three-dimensional reconstructed images of maximum intensity projection (MIP) for membranous labyrinth and internal auditory meatus in Chinese adults were observed and measured in order to provide anatomic basis for otolosurgery and nerosurgery. Methods Thirty inner ears of 15 volunteers were scanned by using a circular temporal coil and three-dimension fast spin echo sequence with a 1