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The C-glycosidic bond that connects the sugar moiety with aglycone is difficult to be broken or made due to its inert nature. The knowledge of C-glycoside breakdown and synthesis is very limited. Recently, the enzyme DgpA/B/C cascade from a human intestinal bacterium PUE was identified to specifically cleave the C-glycosidic bond of puerarin (daidzein-8-C-glucoside). Here we investigated how puerarin is recognized and oxidized by DgpA based on crystal structures of DgpA with or without substrate and biochemical characterization. More strikingly, we found that apart from being a C-glycoside cleaving enzyme, DgpA/B/C is capable of efficiently converting O- to C-glycoside showing the activity as a structure isomerase. A possible mechanistic model was proposed dependently of the simulated complex structure of DgpB/C with 3″-oxo-daidzin and structure-based mutagenesis. Our findings not only shed light on understanding the enzyme-mediated C-glycosidic bond breakage and formation, but also may help to facilitate stereospecific C-glycoside synthesis in pharmaceutical industry.
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The ChatGPT, a lite and conversational variant of Generative Pretrained Transformer 4 (GPT-4) developed by OpenAI, is one of the milestone Large Language Models (LLMs) with billions of parameters. LLMs have stirred up much interest among researchers and practitioners in their impressive skills in natural language processing tasks, which profoundly impact various fields. This paper mainly discusses the future applications of LLMs in dentistry. We introduce two primary LLM deployment methods in dentistry, including automated dental diagnosis and cross-modal dental diagnosis, and examine their potential applications. Especially, equipped with a cross-modal encoder, a single LLM can manage multi-source data and conduct advanced natural language reasoning to perform complex clinical operations. We also present cases to demonstrate the potential of a fully automatic Multi-Modal LLM AI system for dentistry clinical application. While LLMs offer significant potential benefits, the challenges, such as data privacy, data quality, and model bias, need further study. Overall, LLMs have the potential to revolutionize dental diagnosis and treatment, which indicates a promising avenue for clinical application and research in dentistry.
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Dentistry , Artificial IntelligenceABSTRACT
Objective:To analyze the clinical characteristics of elderly patients with papillary thyroid cancer(PTC)by age grouping.Methods:The patients were divided into three groups according to age at diagnosis: old(≥60 years, 90 cases), middle(40-59 years, 359 cases)and young patients(<40 years, 203 cases). The clinical data of 652 patients with PTC who were admitted to the Department of Thyroid Surgery of Beijing Hospital from December 2019 to December 2021 were retrospectively analyzed.The patients were divided into elderly group(≥60 years old, 90 cases), middle-aged group(40-59 years old, 359 cases)and young group(<40 years old, 203 cases). The clinical characteristics, ultrasound characteristics and invasion-related factors of patients in different groups were analyzed by statistical methods.Results:Compared with the young and middle-aged group, the elderly patients with PTC had a higher proportion of microcarcinoma(75.6%, 75.2%, 61.4%, χ2=13.054, P=0.001), less cervical lymph node metastasis(24.4%, 34.3%, 58.1%, χ2=41.650, P<0.001), and lower proportion of metastatic lymph nodes(0.08, 0.14, 0.24, χ2=40.618, P<0.001). There was no significant difference in tumor location and extra glandular invasion among the three age groups(35.56%, 36.2%, 38.4%, χ2=0.959, P=0.545). Conclusions:Compared with the young and middle-aged groups, PTC showed low invasiveness in the elderly population.In addition to surgical treatment, for elderly patients with low-risk clinical characteristics, it is worth performing a further study on whether careful observation or palliative treatment can be selected after comprehensive evaluation.
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Objective To investigate the clinical application of multi-criteria optimization (MCO) in radiotherapy for cervical cancer. Methods A retrospective analysis was performed on the clinical data of 15 patients who received radiotherapy for cervical cancer in Shandong Cancer Hospital and Institute. A fixed field intensity-modulated radiotherapy plan was re-optimized using 9 fields on the Halcyon platform, with the goal of achieving a target coverage of > 95% and the lowest dose to organs at risk. The plan was refined until it reached the goal (Plan I) and was calculated using MCO to reach the goal (Plan MI), and the quality assurance verification was performed. The Wilcoxon rank-sum test was used to compare design time, target coverage, radiation dose to organs at risk, and number of monitor units between the plans. Results Both plans met the clinical requirements. There were no significant differences in target dose indices between Plan I and Plan MI (P > 0.05). Plan MI reduced the maximum dose to the small intestine by 0.51 Gy (P < 0.05). There was no significant difference in dose coverage between the bladder and the rectum (P > 0.05). Compared with Plan I, Plan MI saved 34.04 min in design time (P < 0.05). Conclusion MCO can improve the optimization and adjustment, significantly shorten the design time, and improve the efficiency of the plan.
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Posterior vitreous detachment (PVD), retinal breaks, and lattice degeneration are common problems in ophthalmic clinical practice, which not only cause disturbance to patients' life-quality, but also increase the risk of retinal detachment and vitreoretinal traction.In September 2019, the American Academy of Ophthalmology published Posterior Vitreous Detachment, Retinal Breaks, and Lattice Degeneration Preferred Practice Pattern (PPP). Based on clinical evidence, this PPP provides authoritative guidance for the definition, epidemiological background, diagnosis and treatment of these diseases.This PPP also gives definite solution for treatment and follow-up of different sub-types.This article provides introduction and interpretation of this PPP.
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Objective@#The purpose of our study was to investigate the predictive abilities of clinical and computed tomography (CT)features for outcome prediction in patients with coronavirus disease (COVID-19). @*Materials and Methods@#The clinical and CT data of 238 patients with laboratory-confirmed COVID-19 in our two hospitalswere retrospectively analyzed. One hundred sixty-six patients (103 males; age 43.8 ± 12.3 years) were allocated in thetraining cohort and 72 patients (38 males; age 45.1 ± 15.8 years) from another independent hospital were assigned in thevalidation cohort. The primary composite endpoint was admission to an intensive care unit, use of mechanical ventilation, ordeath. Univariate and multivariate Cox proportional hazard analyses were performed to identify independent predictors. Anomogram was constructed based on the combination of clinical and CT features, and its prognostic performance wasexternally tested in the validation group. The predictive value of the combined model was compared with models built on theclinical and radiological attributes alone. @*Results@#Overall, 35 infected patients (21.1%) in the training cohort and 10 patients (13.9%) in the validation cohortexperienced adverse outcomes. Underlying comorbidity (hazard ratio [HR], 3.35; 95% confidence interval [CI], 1.67–6.71;p < 0.001), lymphocyte count (HR, 0.12; 95% CI, 0.04–0.38; p < 0.001) and crazy-paving sign (HR, 2.15; 95% CI, 1.03–4.48;p = 0.042) were the independent factors. The nomogram displayed a concordance index (C-index) of 0.82 (95% CI, 0.76–0.88),and its prognostic value was confirmed in the validation cohort with a C-index of 0.89 (95% CI, 0.82–0.96). The combinedmodel provided the best performance over the clinical or radiological model (p < 0.050). @*Conclusion@#Underlying comorbidity, lymphocyte count and crazy-paving sign were independent predictors of adverseoutcomes. The prognostic nomogram based on the combination of clinical and CT features could be a useful tool for predictingadverse outcomes of patients with COVID-19.
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This research evaluated the clinical efficacy of three-wings rib plate in the treatment of multiple rib fractures and flail chest with mechanical analysis and clinical verification. The model of rib and three-wings rib plate was reconstructed. The contact simulation with pretension stress was applied to the plate's fixation, and it was found that the bearable stress of the rib fractures after fixation increased from the result which indicated a good fixation efficacy of the plate. Clinical data of 53 cases of rib fractures and flail chest treated with three-wings rib plate in Shanghai Pudong Hospital of Fudan University were retrospectively analyzed. After the operation, the pain of the patients was relieved. Postoperative CT reconstruction of the chest showed good restoration of the rib fractures, which verified the clinical efficacy of three-wings rib plate. The three-wings rib plate showed a high value in clinical use for treatment of rib fractures.
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Humans , China , Flail Chest/surgery , Fracture Fixation, Internal , Retrospective Studies , Rib Fractures/surgery , RibsABSTRACT
Objective: To observe the expressions of SENP1, SENP2 and SENP6 proteins in human malignant glioma tissue and cells∗ and to elucidate the their effects in the development of malignant glioma. Methods: The samples of normal human brain tissue and malignant glioma tissue were obtained and used as normal control group and malignant glioma group, respectively. The Cos7 cells and the malignant glioma LN443 and U343 cells were cultured; the Cos7 cells were used as normal cell control group, and the LN443 and U343 cells as malignant glioma cell group. Western blotting method was used to detect the expression levels of SENP1, SENP2 and SENP6 proteins in human malignant glioma tissue and cells. Results: In brain tissue, the expression levels of SENP1,SENP2 and SENP6 proteins in malignant glioma group were higher than those in normal control group ( P<0. 05). Compared with normal cell control group, the expression levels of SENP1,SENP2 and SENP6 proteins in the LN443 and U343 cells in malignant glioma cell group were significantly increased (P<0. 05). Conclusion: SENP1, SENP2 and SENP6 proteins highly express in the malignant glioma tissue and cells,and they may play an important role in promoting the occurrence of malignant glioma.
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Objective@#To investigate the effects of preoperative percutaneous transhepatic biliary drainage on surgical treatment of type Ⅲ and Ⅳ hilar cholangiocarcinoma.@*Methods@#Clinical data of 72 patients with hilar cholangiocarcinoma of the Bismuth-Corlette type Ⅲ and Ⅳ treated at Department of General Surgery,First Affiliated Hospital of Bengbu Medical College from January 2010 to December 2017 were analyzed retrospectively.Patients were divided into two groups based on whether PTBD was performed:a drained group and an undrained group.In the drained group,there were 31 patients,20 males and 11 females,aged (59.9±9.7)years (range: 39-73 years).Among them,14 patients underwent hepatectomy with half or more than half of the liver removed (extended hepatectomy)and 17 patients underwent non-anatomical hepatectomy in the hilar region (limited hepatectomy).In the undrained group,there were 41 patients, 26 males and 15 females, aged (60.8±7.8)years(range: 45-75 years).Among them, 17 patients underwent hepatectomy with half or more than half of the liver removed (extended hepatectomy)and 24 patients underwent non-anatomical hepatectomy in the hilar region (limited hepatectomy).Percutaneous transhepatic biliary drainage(PTBD)was used in the drained group.Under the guidance of ultrasound,one or more hepatobiliary ducts could be sufficiently drained,which had good effect and was not restricted by the obstruction location of hilar cholangiocarcinoma.The analysis of the measurement data was performed using t test,and the analysis of the count data was performed using χ2 test,and the survival curve was plotted using Kaplan-meier method.@*Results@#In total, 72 jaundiced patients with hilar cholangiocarcinoma underwent surgical treatment: 31 had PTBD prior to operation while 41 did not had PTBD.There were significant differences in ALT((93.2±21.4)U/L vs.(207.4±65.1)U/L),AST((87.6±18.1)U/L vs.(188.9±56.6)U/L)and total bilirubin((68.8±12.6)μmol/L vs.(227.5±87.7)μmol/L)between the patients after treatment and those before treatment(t=10.958, P=0.000; t=10.845, P=0.000; t=10.386, P=0.000).Compared with those in the undrained group, the operation time was shorter, the amount of intraoperative bleeding and the incidence of complications were lower in the drained group(t=-2.840, P=0.006; t=-3.698, P=0.000; χ2=4.108, P=0.043).There were no perioperative death cases in drained group and 2 perioperative death cases in undrained group.There was no significant difference in R0 resection rate between the two groups(χ2=0.778,P=0.378).The 1-,3-,5-year survival rate of patients in the drained group and the undrained group was 72.7%,34.2%, 13.7% and 72.8%, 31.5%, 11.8%, respectively.The difference was not statistically significant(all P>0.05).@*Conclusions@#The preoperative percutaneous transhepatic biliary drainage in patients with hilar cholangiocarcinoma of Bismuth-Corlette type Ⅲ and Ⅳ could effectively shorten operative time, reduce amount of intraoperative bleeding and incidence of postoperative complications,but have no significant effect on the R0 resection rate and survival rate.
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Objective To investigate the clinical efficacy and safety of CT-guided percutaneous microwave ablation (MWA)in elderly patients with early-stage lung cancer who were unable to underwent surgery,and to evaluate the risk factors for prognosis.Methods A total of 51 patients with early stage(stages Ⅰ and ⅡA)non-small cell lung cancer (NSCLC)who underwent MWA in Beijing hospital from January 2016 to December 2018 were collected as the MWA group.And 50 patients with similar age and gender receiving lobectomy surgery were collected as the control group.In a retrospective follow-up study,the clinical efficacy and safety of treatment were compared between the study(n=51)and control(n=50)groups.Kaplan-Meier survival analysis was used to assess the overall survival and local recurrence-free survival.COX analysis was used to evaluate the risk factors.Results Of the 101 patients,62 were male(61.4％),aged 60-85 years(average,72.3± 11.6 years).There was no significant difference in baseline characteristics,including age,gender,smoking,medical history,lung function,tumor size,pathological type and histological grading,tumor position and clinical stage between the two groups(P＞0.05).There were no serious complications in the MWA group during perioperative period,and 14 cases (27.5％)had a small amount of pneumothorax after operation,which were absorbed after special treatment.Five cases (9.8％)had a small amount of hemoptysis,7 cases(13.7％)had a small amount of pleural effusion,9 cases(17.6％)had low fever (＜ 38.5 ℃),and 9 cases (17.6 ％) had postoperative mild pain.There were no serious complications in the control group.The follow-up period was up to December 31,2018,and the median follow-up time was 11.7 months(4.5 20.3 months).During the follow-up,local recurrence occurred in 10 patients(9.9％),including 7 patients(13.7％)in the MWA group and 3 patients(6.0％)in the control group.There was no significant difference between the MWA group and the control group in the 1-year overall survival rate(92.2％ or 47 cases vs.96.0％ or 48 cases,P =0.313),tumor-specific survivalrate(100.0％ vs.100.0％,P=1.00),local recurrence free survival rate(86.3％ or 44 cases vs.94.0％ or 47 cases,P =0.156).Multivariate COX regression analysis showed age (HR =1.22,95 ％CI:1.06-1.38,P =0.004),tumor size (HR =1.75,95 ％ CI:1.14-2.36,P =0.005) and clinical stage of tumor(HR =1.53,95 ％ CI:1.17-1.89,P =0.001) were risk factors for the local recurrencefree survival.Conclusions MWA is an effective and safe treatment for elderly patients with early-stage lung cancer who are not suitable for surgery.Age,tumor diameter and clinical stage are risk factors for local recurrence-free survival.
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Objective:To observe the expressions of SENP1, SENP2and SENP6proteins in human malignant glioma tissue and cells, and to elucidate the their effects in the development of malignant glioma.Methods:The samples of normal human brain tissue and malignant glioma tissue were obtained and used as normal control group and malignant glioma group, respectively.The Cos7cells and the malignant glioma LN443and U343cells were cultured;the Cos7cells were used as normal cell control group, and the LN443and U343cells as malignant glioma cell group.Western blotting method was used to detect the expression levels of SENP1, SENP2and SENP6proteins in human malignant glioma tissue and cells.Results:In brain tissue, the expression levels of SENP1, SENP2and SENP6proteins in malignant glioma group were higher than those in normal control group (P＜0.05) .Compared with normal cell control group, the expression levels of SENP1, SENP2and SENP6proteins in the LN443and U343cells in malignant glioma cell group were significantly increased (P＜0.05) .Conclusion:SENP1, SENP2and SENP6proteins highly express in the malignant glioma tissue and cells, and they may play an important role in promoting the occurrence of malignant glioma.
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Objective To study the effect of extended hepatectomy for hilar cholangiocarcinoma (HCCA) of the Bismuth-Corlette type Ⅲ and Ⅳ.Methods The clinical data of 73 patients with HCCA of the Bismuth-Corlette type Ⅲ and Ⅳ treated in our department from January,2008 to June,2016 were analyzed retrospectively.The extended hepatectomy group of patients consisted of 29 patients who underwent hepatectomy with half or more than half of the liver removed or/and combined with hepatic caudate lobectomy.The limited hepatectomy group consisted of 44 patients who underwent non-anatomical hepatectomy around the hepatic hilar region.Results Compared with the limited hepatectomy group,patients in the extended hepatectomy group had significantly longer operations with significantly more intraoperative blood loss.However,the complication rate was significantly lower than that of the limited hepatectomy group.There was no perioperative death in the extended hepatectomy group,while 3 perioperative deaths occurred in the limited hepatectomy group.The R0 resection rate was 93.1％ (27 of 29) for the extended hepatectomy group,while it was 54.6％ (24 of 44) for the limited hepatectomy group (P＜0.05).The 1-,3-and 5-year survival rates or the extended hepatectomy group were 81.4％,51.4％ and 19.3％,respectively while the corresponding rates for the limited hepatectomy group were 70.5％,24.4％ and 8.7％,respectively (P＜0.05).Conclusions After adequate preoperative radiological assessments on tumor resectability,and the residual liver volumes,with preoperative biliary drainage to improve liver function,extended hepatectomy effectively increased R0 resection and survival rates with improved prognosis for patients with HCCA of Bismuth-Corlette type Ⅲ and Ⅳ.
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Objective:To analyze the clinical data of 2 patients with primary intracranial chondrosarcoma,and to improve its climical awareness and management. Methods:One patient admitted to the hospital because of his left eye with oculomotor palsy,and he was considered as craniopharyngioma before operation and received radiotherapy after operation.The other patient admitted to the hospital for the vision loss,and he was considered as chordoma and received subtotal resection.Results:Both two patients were confirmed as chondrosarcoma by postoperative pathological examination.One patient's clinical symptoms relieved after operation,and there was no obvious progress from the begining of follow-up to now;the other patient died of severe intracranial infection on the 10th day after operation.Conclusion:Primary intracranial chondrosarcoma is easy to be misdiagnosed before operation and needs to be confirmed by postoperative pathology. Operation is the first choice for its treatment, and the postoperative radiotherapy can achieve the good results.
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Objective To investigate the effect of dexmedetomidine combined with sufentanil on postoperative analgesia and the vascular crisis in patients undergoing free flap transplantation. Methods Forty patients with ASA physical statusⅠ-Ⅱhaving underwent free flap transplantation were divided into groupⅠand groupⅡaccording to the random digits table method with 20 cases each. The drugs of patient controlled intravenous analgesia (PCIA) in groupⅠwere sufentanil 1.0μg/(kg·d)+tropisetron 5 mg/100 ml, and the drugs of PCIA in group Ⅱ were sufentanil 1.0 μg/(kg · d) +dexmedetomidine 1.0 μg/(kg · d) + tropisetron 5 mg/100 ml. The PCIA pump was set in 2 groups as follows: continuous perfusion rate 2 ml/h, single bolus 2 ml, lockout time 15 min. The visual analogue score (VAS), Ramsay sedation score, press number of PCIA pump within 48 h after operation, satisfaction score after operation, untoward reaction and vascular crisis were recorded. Results The VAS at 6, 12, 24 and 48 h after operation in group Ⅱ were significantly lower than those in group Ⅰ: (2.18 ± 0.41) scores vs. (3.00 ± 0.63) scores, (2.64 ± 0.51) scores vs. (3.82 ± 0.60) scores, (2.55 ± 0.52) scores vs. (3.36 ± 0.51) scores and (2.27 ± 0.47) scores vs. (3.09 ± 0.70) scores, the Ramsay sedation scores were significantly higher than those in group Ⅰ: (2.42 ± 0.51) scores vs. (2.00 ± 0.58) scores, (2.74 ± 0.45) scores vs. (2.11 ± 0.57) scores, (2.58 ± 0.51) scores vs. (2.05 ± 0.52) scores and (2.53 ± 0.51) scores vs. (2.00 ± 0.47) scores, and there were statistical differences (P0.05). Conclusions Dexmedetomidine can relieve anxiety and nervousness, reduce postoperative consumption of sufentanil, and decrease the incidence of nausea and vomiting. In addition, dexmedetomidine does not affect the incidence of vascular crisis.
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OBJECTIVE:To study the distribution characteristics of germacrone from zedoary turmeric oil (ZTO) in each tis-sue of mice,and to provide reference for further application of zedoary turmeric oil. METHODS:30 KM mice were given zedoary turmeric oil 0.5 mL;6 mice were randomly selected 1,2,4,8,12 h after medication,respectively. The contents of germacrone in heart,liver,spleen,lung and kidney tissues were determined by HPLC. 15 KM mice were selected,medication and sampling method were same as above;3 mice were collected at each time point respectively. The fluorescence intensity of germacrone in above sections were observed by fluorescence. The same number of mice were selected as control in 2 trials. RESULTS:The con-centration of germacrone in each tissue 1-4 h increased gradually as time and reached the peak value at 4 h. The contents of ger-macrone in liver and spleen were significantly higher than in heart and lung. The concentrations of germacrone in each tissue were ranked as liver>spleen>kidney>heart>lung. The results of fluorescence intensity observation was same as above results. CON-CLUSIONS:Results of 2 methods show same distribution characteristics of germacrone in mice tissues,and indicate that ger-macrone is distributed more in liver,spleen and kidney tissues and less in heart and lung.
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OBJECTIVE:To optimize the technology conditions of water-soluble chitosan on Huang'e gel water extract solu-tion. METHODS:Using the comprehensive scores of transmittance ratio,impurity removal rate,naringin retention rate as indexes, Box-Behnken response surface method was used to optimize the amount of water-soluble chitosan,shocking time and temperature in clarifying technology,and verification test was conducted. RESULTS:The clarification effect was the best when the volume ra-tio of TCM extract solution with proportion ≥1.3 to amount of 0.01 g/mL water-soluble chitosan was 2.2,shocking for 100 min at 70 ℃. In the verification test,the average transmittance ratio was 87.3%,impurity removal rate was 41.5%,and naringin reten-tion rate was 131.38%. The measured values of comprehensive scores were 97.35%,98.92% and 98.04%,showing relative error of -0.87%,0.73% and -0.16% with the predicted values(98.27%),respectively. CONCLUSIONS:The method can effectively optimize the clarification technology parameters of water-soluble chitosan on Huang'e gel water extract solution.
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OBJECTIVE:To optimize the technology conditions of water-soluble chitosan on Huang'e gel water extract solu-tion. METHODS:Using the comprehensive scores of transmittance ratio,impurity removal rate,naringin retention rate as indexes, Box-Behnken response surface method was used to optimize the amount of water-soluble chitosan,shocking time and temperature in clarifying technology,and verification test was conducted. RESULTS:The clarification effect was the best when the volume ra-tio of TCM extract solution with proportion ≥1.3 to amount of 0.01 g/mL water-soluble chitosan was 2.2,shocking for 100 min at 70 ℃. In the verification test,the average transmittance ratio was 87.3%,impurity removal rate was 41.5%,and naringin reten-tion rate was 131.38%. The measured values of comprehensive scores were 97.35%,98.92% and 98.04%,showing relative error of -0.87%,0.73% and -0.16% with the predicted values(98.27%),respectively. CONCLUSIONS:The method can effectively optimize the clarification technology parameters of water-soluble chitosan on Huang'e gel water extract solution.
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Objective To explore the influence of epidural analgesia on stress,immune and survival in patients with ovarian cancer undergoing cytoreductive surgery.Methods 72 cases with ovarian cancer undergoing cytoreductive surgery were divided into group A and group B according to random number table method.Patients in group A were treated with epidural analgesia,while patients in group B were treated with intravenous analgesia.The stress index,the plasma cortisol and immune indexes,CD3+,CD4+,CD8+ and CD4+/CD8+ at 30 mins before surgery (T1),right after surgery (T2),12 h after surgery (T3),1 d after surgery (T4) and 3 d after surgery (T5) between the two groups were observed.The overall survival and free survival in the two groups were compared.Results The plasma cortisol levels was lower in group A than in group B (Fgroup=27.784,P=0.000).The plasma cortisol levels in the two groups increased first and then decreased (Ftime=109,268,P-=0.000),and the decrease ratein group A was higher than that in group B (Finteraction,=22.092,P=0.000).The levels of CD3+,CD4+ and CD4+/CD8+ werehigher in group A than in group B,while the level of CD8+ was lower in group A than in group B (Fgroup=5.893,6.110,7.283,5.593,P＜0.05).The levels of CD3+,CD4+ and CD4+/CD8+ in the two groups reduced first and then increased while the level of CD8+ increased first and then reduced (Ftime=12.220,14.430,15.592,11.102,P＜0.05).CD3+,CD4+ and CD4+/CD8+ in group A increased more while C D8+ reduced more than those in group B (Finteraction=8.251,9.792,8.092,7.103,P＜0.05).The overall survival rate and free survival rate of 3 years in group A and group B was 44.44％,22.22％ vs 38.89％,16.67％,respectivelyThedifferencehadnostatisticalsignificancebetweenthetwogroups (P＞0.05).Conclusion Epidural analgesia may reduce the stress response in patients with ovarian cancer undergoing cytoreductive surgery,and protect the immune function,but the influence on survival is not obvious.
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<p><b>OBJECTIVE</b>To observe the clinical efficacy of transcutaneous electrical acupoint stimulation (TEAS) at Hegu (LI 4) and Neiguan (PC 6) on treatment and prevention of postoperative sore throat (POST) after tracheal intubation under general anesthesia.</p><p><b>METHODS</b>One hundred patients who received elective thyroid gland lobectomy with gradeⅠand Ⅱ of American Society of Anesthesiologists criteria were randomly assigned into a TEAS group and an anesthesia group according to random number table method, 50 cases in each group. All the patients were treated with tracheal intubation under general anesthesia. Patients in the TEAS group were treated with TEAS (2 Hz/100 Hz, 8 to 12 mA) at Hegu (LI 4) and Neiguan (PC 6) from 30 min before anesthesia induction to the end of operation. Patients in the anesthesia group were treated with TEAS at the same acupoints but no electrical stimulation was given. The incidence rate, severity and visual analogue scale (VAS) of POST were recorded 1h, 6h, 12h and 24h after tracheal extubation, respectively.</p><p><b>RESULTS</b>The incidence rate of POST was 12.0% (6/50), 22.0% (11/50) and 18.0% (9/50) 1h, 6h, 12h after tracheal extubation respectively in the TEAS group, which was significantly lower than 30.0% (15/50), 42.0% (21/50) and 36.0% (18/50) in the anesthesia group (all<0.05). However, the incidence rate was not significantly different between the two groups 24h after extubation[14.0% (7/50) vs 28.0% (14/50),>0.05]. Moreover, the VAS scores of the patients with POST in the TEAS group at each time point were lower than those in the anesthesia group (all<0.05).</p><p><b>CONCLUSIONS</b>TEAS at Hegu (LI 4) and Neiguan (PC 6) can effectively reduce the incidence rate and severity of POST induced by tracheal intubation under general anesthesia.</p>
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Mesenchymal stem cells (MSC) are derived from the mesoderm, and exhibit multipotential differentiation. MSC can alleviate liver fibrosis and improve liver function through paracrine cytokines and cell-cell interactions, but their therapeutic mechanism remains unknown. MSC are derived from various tissues, such as bone marrow, umbilical cord tissue, umbilical cord blood, peripheral blood, and adipose tissue. However, there are different advances in MSC with various sources in experimental studies and clinical treatment of liver fibrosis. This paper summarizes the possible therapeutic mechanisms of MSC in alleviating liver fibrosis, as well as the advances in experimental studies and clinical application of MSC with various sources. MSC transplantation is a new therapeutic method for liver fibrosis and has a broad application prospect in this field.