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Objective:To investigate the clinical characteristics and surgical effects of acute calculous cholecystitis (ACC) in high altitude area of Tibet.Methods:The retrospective cohort study was conducted. The clinicopathological data of 182 ACC patients who underwent surgery in the 954th Hospital of Army from January 2016 to December 2020 were collected. There were 56 males and 126 females, aged (41±13)years. Of the 182 patients, 61 cases undergoing open cholecystec-tomy were divided into the open group, and 121 cases undergoing laparoscopic cholecystectomy (LC) were divided into the laparoscopic group. Observation indicators: (1) clinical characteristics of ACC in high altitude area; (2) surgical situations; (3) postoperative complications; (4) follow-up. Follow-up was conducted using outpatient examination and telephone interview to detect postopera-tive complications of patients up to October 2021. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measure-ment data with skewed distribution were represented as M( Q1, Q3) or M(range), and comparison between groups was conducted using the Mann-Whitney U test. Count data were expressed as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test. Results:(1) Clinical characteristics of ACC in high altitude area. Of the 182 patients, cases with symptom duration as <3 days, 3 days to 1 month, >1 month and ≤12 months, >12 months were 37, 43, 57, 45, respectively. Seventy-seven of the 182 patients were combined with other diseases before surgery. (2) Surgical situations. Two cases in the open group were found common bile duct stones during the operation, and underwent choledochotomy and T-tube drainage. Nine cases in the laparoscopic group were converted to laparotomy, including 3 cases with severe abdominal adhesion and ineffective hemostasis, 6 cases with anatomical variation of Calot triangle. The conversion to laparotomy rate was 7.438%(9/121). The other patients in the open group and the laparoscopic group completed surgery successfully. The operation time, volume of intraoperative blood loss, time to postoperative first out-of-bed activities, time to postoperative first flatus, cases with indwelling drainage tube, cases with acute simple cholecystitis, acute suppurative cholecystitis, acute gangrene cholecystitis, gallbladder perforation of disease pathological type, postoperative white cell count, postoperative neutrophil percentage, duration of postoperative hospital stay were (109±42)minutes, 50(45,100)mL, (16.1±1.5)hours, (31.4±11.9)hours, 33, 25, 27, 6, 3, (6.8±1.9)×10 9/L, 72.7%±7.4%, (7.3±1.7)days for the open group. The above indicators were (98±43)minutes, 20(20,50)mL, (12.9±1.4)hours, (26.7±12.1)hours, 51, 56, 51, 9, 5, (7.1±2.4)×10 9/L, 70.5%±8.7%, (6.4±1.7)days for the laparoscopic group. There were significant differences in the volume of intraopera-tive blood loss, time to postoperative first out-of-bed activities, time to postoperative first flatus, duration of postoperative hospital stay between the two groups ( Z=?6.75, t=14.41, 2.46, 3.45, P<0.05). There was no significant difference in the operation time, cases with indwelling drainage tube, diseases pathological type, postoperative white cell count, postoperative neutrophil percentage between the two groups ( t=1.66, χ2=2.33, 0.84, t=?0.71, 1.66, P>0.05). (3) Postoperative complica-tions. Postoperative complications occurred in 7 of the 61 patients in the open group and 5 of the 121 patients in the laparoscopic group. There was no significant difference in the postoperative complications between the two groups ( χ2=2.46, P>0.05). (4) Follow-up. Of the 182 patients, 115 cases including 35 cases in the open group and 80 cases in the laparoscopic group were followed up for 12(range, 3?24)months. During the follow-up, 1 case of the 35 patients in the open group had abdominal pain and jaundice, which was diagnosed as choledocholithiasis. The patient was improved after stone removal with endoscopic retrograde cholangiopancreatography. Two cases of the 35 patients in the open group had upper abdominal pain with fever and were improved after anti-infection treatment. Of the 80 patients in the laparoscopic group, 1 case had upper abdominal pain and 1 case had dyspepsia and anorexia, respectively. The two cases were improved after symptomatic treatment. Conclusions:Patients with ACC in the high altitude area of Tibet have high ratio of preoperative complications, long diseases history and high incidence rates of pyogenic perforation of the gallbladder. Patients with ACC in the high altitude area undergoing LC is safe and effective. Compared with open cholecystectomy, LC have less volume of intraoperative blood loss, faster postoperative recovery and shorter duration of postoperative hospital stay.
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Objective@#To explore the effect of active vitamin D supplements on promoting postoperative lumbar functional rehabilitation in postmenopausal women.@*Methods@#From January 2015 to January 2017, selecting 120 postmenopausal women patients who underwent lumbar posterior surgery with age from 50 to 80 years, randomly divided into control group and observation group, control group and observation group suffer traditional nursing and treatment, meanwhile, observation group was supplied with active vitamin D, over a follow-up period of six months, using the Visual Analogue Scale(VAS)score, Japanese Orthopedic Association Scores(JOA)score, back stretch height to assess the effect of active vitamin D supplements.@*Results@#Back stretch height of patients in the observation group was (25.4 ± 2.6) cm, which was significantly better than (20.7 ± 2.1) cm of the control group after 6 months (t=-10.90, P<0.01); the observation group JOA score and VAS score were significantly better than the control group (JOA score: 25.8±2.0 vs. 24.6±1.8, t=-3.50, P<0.01; VAS score: 1.6±0.9 vs. 2.1±1.1, t=-3.10, P<0.01).@*Conclusion@#Active vitamin D supplements can improve the patient′s waist discomfort, enhance the muscle strength, improve the quality of life, and get better functional rehabilitation.
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Objective To analyze the pathologic constitution,repeated renal biopsy,treatment,prognosis and focal segmental glomerulosclerosis (FSGS) risk factors of children with steroid-resistant nephrotic syndrome (SRNS).Methods A retrospective analysis was made of 172 SRNS cases of renal biopsy in the Pediatric Nephrology Center,the First Affiliated Hospital of Sun Yat-Sen University from September 1,2006 to August 31,2016.Results The main pathological types of 172 children with SRNS were FSGS in 72 cases (41.9％),minimal change disease (MCD) in 52 cases (30.2％),and mesangial proliferative glomerulonephritis (MsPGN) in 31 cases (18.0％).There were 11 cases (6.4％) with repeated renal biopsy,5 cases of 6 children with MCD changed to FSGS;3 cases of FSGS whose repeated renal biopsy were still FSGS,but the subtype had changed;2 cases of MsPGN changed to FSGS in repeated renal biopsy.Compared to non-FSGS,the age of onset of FSGS was smaller [3.0(1.7,6.0) years old vs.5.8 (3.4,8.9) years old],the plasma albumin of FSGS was lower [18.0 (14.0,22.9) g/L vs.20.0 (15.1,29.1) g/L],the 24 hours urine protein level was higher [136.0(76.0,200.0) mg/(kg · d) vs.93.0(55.3,150.0) mg/(kg · d)],and the differences were all significant(all P ＜ 0.05).Logistic regression analysis showed that the smaller the age(P =0.007),the higher the 24-hour urine protein(P =0.028),the greater the risk of FSGS.The receiver operating characteristic (ROC) curve analysis showed that the optimal critical value of 24 hour urine protein was 131 mg/(kg · d).The effective rate of Cycloposphamide (CTX) treatment in MCD children (10/12 cases) was higher than that of FSGS (1/5 cases) and MsPGN (1/2 cases),and the differences were statistically significant (all P ＜0.05).There was no significant difference in the curative effect of Tacrolimas (TAC) and Ciclosporin A (CsA) in children with FSGS,MCD and MsPGN (all P ＞ 0.05).In 62 cases of FSGS,25 cases (56.4％) were effective,and 37 cases (84.1％) were effective in 44 cases of MCD,15 cases (60.0％) were effective in 25 cases of MsPGN,and the difference of prognosis between different pathological types was statistically significant (P ＜ 0.05).Conclusions The most common pathological types of children with SRNS are FSGS,MCD,and MsPGN,but the pathological types can be converted to each other.The smaller the age is,the higher the 24-hour urine protein level is,and the greater the risk of FSGS of the pathological type.When the quantity of 24-hours urine protein was more than 131 mg/ (kg · d),it should be alert to the possibility of pathological type of FSGS.In children with MCD,the effective rate of CTX is higher than that of children with FSGS and MsPGN.The prognosis of FSGS is the worst but the prognosis of MCD is better.
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Objective To analyze the podocyte gene mutation in children with steroid -resistant nephrotic syndrome (SRNS),and to explore the clinical manifestations and prognosis of children with gene mutation,so as to pro-vide a theoretical basis for the diagnosis and treatment of SRNS gene mutation in children. Methods Twenty-four pa-tients with SRNS diagnosis and ages less than 14 years old were selected from the Pediatric Nephrology Center of First Affiliated Hospital of Sun Yat-Sen University during August 31,2014 to September 1,2016. The gene detection was performed through PCR amplification and second DNA general sequencing,in which the target genes were detected in 23 cases with nephrotic panel,and 1 case was sequenced with the exon gene. Results There were 14 cases of male and 10 cases of female in 24 cases of genetic testing. The median age of onset was 4. 7 years old. There were 9 cases of sim-ple type,15 cases of nephritis type. And all the cases were primary steroid-resistant. Within the 20 cases of renal biop-sy,there were 5 cases of minimal change disease (MCD),11 cases of focal segmental glomerulosclerosis(FSGS),and 4 cases of mesangial proliferative glomerulonephritis (MsPGN). In the 24 cases,there were 8 cases of gene mutation. Their age was (3. 97 ± 3. 61)years old. The ratio of male and female was 1. 67:1. 00. The main clinical classification was nephritis type (6/8 cases). The major genes were NPHS2(3 cases),NPHS1(2 cases),INF2(2 cases),MYO1E(1 case). And FSGS was the main pathological type (4 cases). Most of them were no remission or end stage renal disease (ESRD)(6/8 cases),including 2 cases of renal transplantation. The 24 hour urine protein level in the gene mutation group was significantly higher than that in the non-mutation group [195. 4 (166. 0,262. 4)mg/(kg·d)vs. 85. 4 (74. 5,101. 3 ) mg/(kg·d )],and the difference was statistically significant (Z ＝ -3. 674,P ＜ 0. 001 ). Conclusion The main mutation genes of children with SRNS were NPHS2,NPHS1 and so on. FSGS was the main pathological type. Most of them were no remission or ESRD. The higher of the 24 hour urine protein level,the more pos-sibility of genetic mutation.
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BACKGROUND: Scholars have been trying to create a microenvironment similar to the human body, which can induce the directional differentiation of mesenchymal stem cells from human bone marrow, placenta and umbilical cord blood. OBJECTIVE: To compare the neuronal differentiation of human bone marrow mesenchymal stem cells, human placental mesenchymal stem cells and human umbilical cord blood mesenchymal stem cells induced by co-culture with nerve cells. METHODS: Human bone marrow mesenchymal stem cells, human placental mesenchymal stem cells and human umbilical cord blood mesenchymal stem cells cultured in vitro were co-cultured with nerve cells using the Transwell system. The morphological changes of three kinds of cells in the co-culture system were detected. After co-culture for4-5 days, immunofluorescence staining was used to measure the expression of neuron-specific enolase in cells. Mesenchymal stem cells only cultured in low glucose DMEM medium were used as controls. RESULTS AND CONCLUSION: These three kinds of mesenchymal stem cells were extended, and interconnected processes were detective. The positive expression of neuron-specific enolase was highest in the human umbilical cord blood mesenchymal stem cells followed by human placental mesenchymal stem cells and human bone marrow mesenchymal stem cells in order. In the control group, none of the three kinds of mesenchymal stem cells have neuronal morphology, and the expression of neuron specific enolase was negative for the immunofluorescence staining. To conclude, microenvironment provided by nerve cells can induce these three kinds of mesenchymal stem cells todifferentiate into neurons.
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OBJECTIVE:To strengthen application management of antibiotics in outpatients,promote rational use of antibiot-ics,and to provide reference for scientific management and decision-making in the hospital. METHODS:The proportion of outpa-tients receiving antibiotics in total outpatients was analyzed statistically during Jan. 2008-Jun. 2016. Utilization rate data of antibiot-ics in outpatients during 2008-2015 were used to establish Autoregressive integrated moving average model(ARIMA),and the data of the first half of 2016 was used to validate established model;the utilization rate trend of antibiotics in outpatients in the second half of 2016 was predicted. SPSS 20.0 statistical software was adopted for statistical analysis. RESULTS:Established ARIMA(2,1, 0)(2,1,0)12 model has higher fitting degree. There was a small difference between measured value and fitted value of utilization rate of antibiotics in outpatients in 2016. Average absolute error was 0.72%,and average relative error was 4.20%,within 95%confidence interval of fitted value. Dynamic trend of model predicted value was basically consistent with measured value. CONCLU-SIONS:ARIMA model simulates utilization rate trend of antibiotics in outpatients well,can be used for short-term prediction and dynamic analysis of utilization rate trend of antibiotics. However,for long-term prediction,various factors should be considered.
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Objective To induce the differentiation of human umbilical cord blood MSCs into osteoblasts in vitro,and to study the method of inducing MSCs to differentiate into osteoblasts under specific microenvironment.Methods MSCs was obtained from human umbilical vein,and isolated by density gradient method.The morphological changes of MSCs were observed by using dexamethasone,beta sodium phosphate and vitamin C.The proliferation and differentiation of MSC in cord blood were studied by means of optical microscope,transmission electron microscope and alkaline phosphatase staining.The expression of bone morphogenetic protein 2 mRNA in human umbilical cord blood MSCs after osteogenic was inducted by RT-PCR.Results After the umbilical cord blood MSCs were differentiated into osteoblastic cells in microenvironment,fusiform cells became polygonal,irregular shape,local cells presented overlapping growth.After 10 days,the cells gradually presented square,crystal particles of high refraction,and began to show the characteristics of osteoblasts.The expression of bone morphogenetic protein 2 mRNA was positive in alkaline phosphatase staining and alizarin red staining.Conclusion Human umbilical cord blood MSCs can be induced into osteoblasts in vitro,which is an ideal seed cell for bone tissue engineering.
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Objective To reveal the important role of aberrant splicing in cancer and to identify differential expressing isoforms and differential alternative splicing events between acute myeloid leukemia ( AML) and chronic myeloid leukemia (CML).Methods Based on whole transcriptome sequencing of CML (K562) and AML(THP1 and HL-60) cells,TopHat, MATS and Cufflinks were used to identify alternative splicing events and alternative splicing isoforms and analyze differenti -al expression of isoforms and genes .Results A total of 130 genes were identified to be highly expressed in CML and 80 genes in AML cells .Also, 337 differential expressed isoforms and 35 specific alternative splicing events between AML and CML cells were identified.Conclusion There are significant differences in alternative splicing isoforms and events between AML and CML cells.Leukemia-associated alternative splicing events can be used as potential tumor markers or drug targets.
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Aim To investigate the influence of gly-cyrrhizic acid( GA) on cell proliferation and cell cycle and secretion of extracellular matrix ( ECM) , the level of fibronection ( FN) , type Ⅳ collagen ( C-Ⅳ) in the rats′ glomerular mesangial cells ( HBZY-1 ) cultured with advanced glycation endproducts ( AGEs ) . Meth-ods HBZY-1 were incubated in culture medium con-taining AGEs in the presence of GA and treated for 48 h. At the same time, the normal and control groups were established. Methylthiazoletetrazolium ( MTT) as-say was used to measure cell proliferation;cell cycle a-nalysis was performed using a flow cytometry; FN and C-Ⅳwere analyzed by enzyme-linked immunosorbent assay ( ELISA ) . Results Cell counts increased markedly in AGEs group. Cell cycle analysis showed that cell percentage of S phase increased, G1 reduced and PI increased from 35. 01% ± 4. 21% to 44. 93%± 0. 25% ( P <0. 05 ) . FN and C-Ⅳ secretion in-creased ( P <0. 05 ) . Whereas GA was added, cell counts decreased, and the percentage of S phase also decreased and G1 increased, PI decreased from 44. 93% ± 0. 25% to 42. 16% ± 1. 04% ( P<0. 05 ) . In addition, the secretion of FN and C-Ⅳ decreased ( P<0. 05 ) . Conclusion GA could prevent AGEs-induced HBZY-1 . GA may protect HBZY-1 from in-hibiting the abnormal cell proliferation, changing the cell cycle. GA can reduce the synthesis of FN and C-Ⅳ.
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<p><b>OBJECTIVE</b>To study the effect of protein tyrosine phosphatase non-receptor type 12 (PTPN12) in regulating cardiac HERG channel currents.</p><p><b>METHODS</b>The plasmids pcDNA3.1-PTPN12-RFP and herg mutant constructed by PCR technique were transfected into HEK293 cells via Lipofectamine 2000, and the cells stably expressing PTPN12 selected with G418 were identified by Western blotting with anti-PTPN12 antibody. HERG channel current in cells expressing HERG alone (HEK293/HERG cells), cells overexpressing PTPN12 (HEK293/HERG cells transfected with pCDNA3.1-PTPN12-RFP), PAO-treated cells (PTPN12/HERG cells treated with PAO), and herg mutant cells (HEK293/HERGY327A-Y700A-Y845A cells transfected with pcDNA3.1-PTPN12-RFP) were recorded by patch-clamp technique.</p><p><b>RESULTS</b>The plasmids pcDNA3.1-PTPN12-RFP and herg mutant were successfully constructed, and the stable expressing cell lines were established. Red fluorescence was obversed in HEK293/HERG cells transfected with pcDNA3.1-PTPN12-RFP, and the protein expression of PTPN12 was detected. Overexpression of PTPN12 significantly decreased HERG current density in HEK293/HERG cells, and this change was significantly weakened in the inhibitor group and herg mutant group.</p><p><b>CONCLUSION</b>PTPN12 negatively regulates cardiac HERG channel cerrent possibly by decreasing the phosphorylation level of HERG tyrosine residues. This finding provides further insight into the regulatory mechanism of HERG channel and the pathogenesis of long QT syndrome.</p>
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Humans , Ether-A-Go-Go Potassium Channels , Physiology , HEK293 Cells , Heart , Long QT Syndrome , Patch-Clamp Techniques , Protein Tyrosine Phosphatase, Non-Receptor Type 12 , Physiology , TransfectionABSTRACT
Objective To elucidate cerebral cortical response to esophageal acid exposure in normal individuals by functional magnetic resonance imaging (fMRI) and the characteristics of activity. Methods Fifteen volunteers were received intraesophageal perfusion with either 0.9% of sodium chloride or acid (0.1 mmol/L HC1) solutions. The modified block-design model of fMRI scanning was performed simultaneously. All of 32 minutes were needed for resting (A, 8 minutes), 0.9% of sodium chloride perfusion (B,8 minutes), acid perfusion (C,8 minutes) and 0.9% of sodium chloride perfusion again (D,8 minutes). Each chunk was consisted of 160 scans and every scan contained 3 seconds. Six hundred and forty scans were collected in all. The clinical response to esophageal acid exposure was observed and the changes in the cerebral regions was statistically analyzed. Results After perfusion of 0.9% of sodium chloride or acid, 10 out of 15 volunteers had chemosensitive complaints, such as pain in pars laryngen pharyngis, heartburn and chest complaint. The initial active domains involved deutocerebrum, anterior part of callosal gyrus, left side of insula, two sides of amygdale and subiculum hippocampi, two outers of forehead cortex. The provoked regions of acid perfusion (C-A) and 0.9% of sodium chloride perfusion again (D-A) were as same as that of the activated domains by initial perfusion of 0.9% sodium chloride (B-A). The intensity and amplitude of most provoked regions increased gradually(D-A> B-A, P< 0.01). Conclusions The two different stimulations of saline and acid provoke similar cerebral regions that may act in the regulation of esophageal sensitivity. There are the evidences of the central mechanism of esophageal visceral hypersensitivity by acid perfusion.