ABSTRACT
Objective To analyze the pulmonary perfusion defect index (PPDI) of dual-energy computed tomography (CT) and pulmonary artery obstruction index (PAOI) of conventional CT angiography, and to investigate the clinical application value of dual-energy CT perfusion imaging in the examination of patients with acute pulmonary embolism. Methods A retrospective study was conducted on 21 patients diagnosed with acute pulmonary embolism in Weifang People's Hospital from January 1, 2022 to December 31, 2022. PPDI, PAOI, and maximum plasma D-dimer concentration (mg/L) were calculated. According to the 2019 ESC Guidelines, the patients were divided into low-risk group (n = 8) and medium-risk group (n = 12). The Mann-Whitney U test was used for between-group comparisons. The Spearman’s rank correlation coefficient was used to analyze the correlations between PAOI, PPDI, and plasma D-dimer concentration. Results The PPDI, PAOI, and D-dimer values in the low-risk group were 3.33 (2.09, 4.58), 5.00 (3.13, 5.00), and 0.67 (0.52, 0.79), respectively. The PPDI, PAOI, and D-dimer values in the middle-risk group were 8.34 (5.42, 12.50), 12.50 (8.13, 15.00), and 1.18 (0.86, 2.87), respectively. The Z-values of comparison between the two groups were −3.092, −3.650, and −3.318, respectively (all P < 0.05). There were significant differences in PPDI, PAOI, and D-dimer between the low-risk and middle-risk groups (P < 0.05). Positive correlations were observed between PPDI and PAOI, between PPDI and D-dimer, and between PAOI and D-dimer (rs = 0.869, 0.918, 0.909, all P < 0.05). Conclusion Both PPDI and PAOI can be used for the clinical examination of patients with acute pulmonary embolism and evaluation of the severity of the disease. Compared with conventional CT, dual-energy CT perfusion imaging is more efficient in the diagnosis of acute pulmonary embolism, and facilitates accurate clinical treatment.
ABSTRACT
Objective To explore the application value of computed tomography (CT)-based three-dimensional digital navigation technology in microwave ablation of lung cancer. Methods A total of 92 patients with lung cancer in our hospital were retrospectively analyzed, and randomized to receive microwave ablation with the three-dimensional digital navigation technology or traditional CT-guided microwave ablation (three-dimensional navigation group and traditional group). The two groups were paired according to tumor location, size (the maximum diameter difference of less than or equal to 2 mm), and microwave ablation conditions, for a total of 46 pairs. The operation time, times of microwave ablation needle puncture, CT dose index, incidence rates of intraoperative complications, and postoperative lesion control were compared between the two groups. Results The operation time [(30.07 ± 6.36) min vs (47.20 ± 9.65) min], times of puncture [(1.72 ± 0.69) times vs (7.13 ± 3.00) times], CT dose index [(11.16 ± 2.20) mGy vs (26.67 ± 8.72) mGy], and incidence of intraoperative complications (10.87% vs 34.78%) in the three-dimensional navigation group were lower than those in the traditional group, and the response rate was higher in the three-dimensional navigation group than in the traditional group (93.48% vs 71.74%) (P < 0.05). Conclusion CT-guided three-dimensional digital navigation technology for microwave ablation of lung cancer makes the operation of interventional puncture more accurate and safe.
ABSTRACT
Objective: To compare the short-term outcomes between off-pump and on-pump coronary artery bypass graft (CABG) by experienced surgeons with similar surgical team in a single large-volume cardiac surgery center. Methods: A total of 31 075 patients with multivessel coronary disease who underwent isolated off-pump or on-pump CABG between January 1, 2009 and December 31, 2019 by experienced surgeons in Fuwai hospital were enrolled in this retrospective study. Patients was divided into on-pump CABG group and on-pump CABG group on an intention-to treat basis. Short term safety endpoints, including 30 days mortality, composite endpoint of major morbidity or mortality, prolonged postoperative length of stay (PLOS), and prolonged ICU length of stay (PICULOS), and distal anastomosis were compared between the two groups. Mortality was evaluated on 30 days post operation, other endpoints were collected before discharge. After 1∶1 propensity-score matching of baseline characteristics for on-pump and off-pump CABG, postoperative endpoints were compared with use of McNemar's test and further adjusted with the use of a logistic regression model. Results: After propensity-score matching, 10 243 matched pairs of patients were included in the final analysis, there were 4 605(22.5%) females and mean age was (60.7±8.6) years. The standardized differences were less than 5% for all baseline variables in matched cohort. Univariate analysis indicated lower risk of 30 days mortality (0.2% vs. 0.7%, P<0.001), major morbidity or mortality (5.7% vs. 8.8%, P<0.001), PLOS (3.2% vs. 4.9%, P<0.001), PICULOS (9.4% vs. 12.2, P<0.001), and lower number of distal anastomosis ((3.3±0.8) vs. (3.6±0.8), P<0.001) in off-pump CABG group than in on-pump CABG group. After adjustment of cofounders, multivariate analysis showed that off-pump CABG was still associated with a lower risk of 30 days mortality (OR=0.29, 95%CI: 0.09-0.87, P=0.027), composite endpoint of major morbidity or mortality (OR=0.60, 95%CI: 0.53-0.68, P<0.001), PLOS (OR=0.64, 95%CI 0.54-0.75, P<0.001), PICULOS (OR=0.76, 95%CI: 0.69-0.84, P<0.001). Conclusions: Off-pump CABG is related with superior short-term safety outcomes than on-pump CABG by experienced surgeons in our center.
Subject(s)
Aged , Female , Humans , Middle Aged , Coronary Artery Bypass , Coronary Artery Bypass, Off-Pump , Coronary Artery Disease/surgery , Postoperative Complications/epidemiology , Retrospective Studies , Surgeons , Treatment OutcomeABSTRACT
Objective To compare the clinical efficacy of posterior minimally invasive reconstruction plate and 3D-navigated percutaneous sacroiliac screw fixation of elderly patients with posterior pelvic ring fractures.Methods A retrospective cases control study was performed to analyze the data of 75 elderly patients with posterior pelvic ring fractures admitted from January 2014 to June 2018 in Central Hospital of the PLA.There were 32 males and 43 females,with the age range of 60-83 years (mean,67.7 years).Twenty-four patients in the plate group were treated by posterior minimally invasive reconstruction plate fixation,and 51 patients in the navigation group were treated by percutaneous sacroiliac screw internal fixation with 3 D navigation.The operation time,intraoperative blood loss,X-ray exposure time,complication rate and postoperative visual analogue scale (VAS) were compared between the two groups.Postoperative Matta radiographic criteria was used to assess fracture reduction quality,and Majeed criteria was used to assess pelvic function at the last follow-up.Results All 75 patients were followed up for 6-24 months (mean,13.5 months).The operation time,intraoperative blood loss and X-ray exposure time in the plate group were (126.1 ± 20.6) minutes,(251.6 ± 50.8) ml,and (15.7 ±4.4)s,showing significant differences in comparison with the navigation groups [(49.7 ± 17.5)minutes,(22.8 ±5.1) ml,and (112.8 ± 8.8) s] (P ＜0.05).The incidence of postoperative complications was not significantly different between the plate group (4％) and the navigation group (4％) (P ＞0.05).At day 3,one week,and one month postoperatively,the VAS in the navigation group was (3.3 ± 0.7) points,(3.2 ± 0.7) points,(2.4 ± 0.6) points,better than that in the plate group [(7.2 ± 0.7) points,(6.2 ± 0.8) points and (4.5 ± 0.7) points] (P ＜ 0.05).However,there was no significant difference between the two groups at 3 months and one year after operation (P ＞ 0.05).According to the Matta radiographic criteria,the excellent and good rate was 92％ in plate group (excellent in 14 cases,good in 8,and fair in 2),and was 82％ in the navigation group (excellent in 25 cases,good in 17 and fair in 9).There was no significant difference between the two groups (P ＞0.05).According to the Majeed criteria at the follow-up,the excellent and good rate was 96％ in the plate group (excellent in 15 cases,good in 8 and fair in 1),and was 94％ in the navigation group (excellent in 35 cases,good in 13 and fair in 3).The difference between the two groups was not statistically significant (P ＞ 0.05).Conclusion For elderly patients with osteoporotic posterior pelvic ring fractures,percutaneous sacroiliac screw fixation under 3D navigation has the advantages of shorter operation time,less bleeding,less radiation dose and less postoperative pain than minimally invasive reconstruction plate internal fixation,and hence deserves clinical application.
ABSTRACT
Objective@#To compare the clinical efficacy of posterior minimally invasive reconstruction plate and 3D-navigated percutaneous sacroiliac screw fixation of elderly patients with posterior pelvic ring fractures.@*Methods@#A retrospective cases control study was performed to analyze the data of 75 elderly patients with posterior pelvic ring fractures admitted from January 2014 to June 2018 in Central Hospital of the PLA. There were 32 males and 43 females, with the age range of 60-83 years (mean, 67.7 years). Twenty-four patients in the plate group were treated by posterior minimally invasive reconstruction plate fixation, and 51 patients in the navigation group were treated by percutaneous sacroiliac screw internal fixation with 3D navigation. The operation time, intraoperative blood loss, X-ray exposure time, complication rate and postoperative visual analogue scale (VAS) were compared between the two groups. Postoperative Matta radiographic criteria was used to assess fracture reduction quality, and Majeed criteria was used to assess pelvic function at the last follow-up.@*Results@#All 75 patients were followed up for 6-24 months (mean, 13.5 months). The operation time, intraoperative blood loss and X-ray exposure time in the plate group were (126.1±20.6)minutes, (251.6±50.8)ml, and (15.7±4.4)s, showing significant differences in comparison with the navigation groups [(49.7±17.5)minutes, (22.8±5.1)ml, and (112.8±8.8)s](P<0.05). The incidence of postoperative complications was not significantly different between the plate group (4%) and the navigation group (4%) (P>0.05). At day 3, one week, and one month postoperatively, the VAS in the navigation group was (3.3±0.7)points, (3.2±0.7)points, (2.4±0.6)points, better than that in the plate group [(7.2±0.7)points, (6.2±0.8)points and (4.5±0.7)points] (P<0.05). However, there was no significant difference between the two groups at 3 months and one year after operation (P>0.05). According to the Matta radiographic criteria, the excellent and good rate was 92% in plate group (excellent in 14 cases, good in 8, and fair in 2), and was 82% in the navigation group (excellent in 25 cases, good in 17 and fair in 9). There was no significant difference between the two groups (P>0.05). According to the Majeed criteria at the follow-up, the excellent and good rate was 96% in the plate group (excellent in 15 cases, good in 8 and fair in 1), and was 94% in the navigation group (excellent in 35 cases, good in 13 and fair in 3). The difference between the two groups was not statistically significant (P>0.05).@*Conclusion@#For elderly patients with osteoporotic posterior pelvic ring fractures, percutaneous sacroiliac screw fixation under 3D navigation has the advantages of shorter operation time, less bleeding, less radiation dose and less postoperative pain than minimally invasive reconstruction plate internal fixation, and hence deserves clinical application.
ABSTRACT
Objective:To explore the effect of miR-223-3p regulating FOXO3a-mediated autophagy in hepatic injury-reperfusion injury (LIRI).Methods:The model of hepatic ischemia-reperfusion injury (IR) was established in C57BL6 mice. According to different reperfusion timepoints, mice were randomly divided into 2 h, 6 h, 12 h and 24 h group. For sham group, there was no intraoperative clamping of hepatic pedicle. Murine hepatic AML12 cells were treated with miR-223-3p mimics, miR-223-3p inhibitor and FOXO3a interfering RNA. A hypoxic 1 h reoxygenation 6 h model was established. And miRNA-NC, miR-223-3p mimics, miR-223-3p inhibitor and siRNA-NC and FOXO3a siRNA groups were assigned. Hepatic injury and apoptosis were detected by hematoxylin eosin or TdT-mediated nick end labeling (HE/TUNEL) at different timepoints. The changes of proliferating cell nuclear antigen (PCNA) and Caspase-3 in hepatocytes were detected by immunohistochemistry. Reverse transcription-polymerase chain reaction (RT-PCR) and Western blot were employed for detecting the expressions of miR-223-3p, FOXO3a, LC3, p62 and Caspase-3 in hepatocytes.Results:The results of HE/TUNEL indicated that reperfusion injury and apoptosis of hepatic tissue were most severe in 12 h group. In hepatic ischemia-reperfusion model, RT-PCR results showed that the expressions of miR-223-3p and FOXO3a were higher in IR group than those in sham group (1.00±0), the expression level of miR-223-3p mRNA peaked at 12 h (9.13±2.12) after reperfusion and FOXO3a was the highest at 6 h (5.23±0.90, P<0.05). Western blot showed that the expression of FOXO3a peaked at 6 h post-reperfusion and the expressions of LC3 and caspase-3 were the highest at 12 h. ( P<0.05). In the model of cell hypoxia and reoxygenation, RT-PCR indicated that the expression of FOXO3a mRNA decreased in miR-223-3p mimics group (0.45±0.21) as compared with miRNA-NC group (1.00±0). In contrast, miR-223-3p inhibitor group increased (2.73±0.53, P<0.05). Western blot indicated that FOXO3a protein expression was highest in miR-223-3p inhibitor and miR-223-3p mimics groups whereas LC3 and Caspase-3 were the highest in miR-223-3p mimics group ( P<0.05). The expression of FOXO3a was higher in siRNA-NC group than that in FOXO3a siRNA group while the expressions of Caspase-3 and LC3 were the higher in FOXO3a siRNA group. Conclusions:FOXO3a has protective effect on hepatic ischemia-reperfusion injury. It may be related to its inhibition of autophagy and apoptosis and miR-223-3p promotes injury through a down-regulation of FOXO3a-mediated autophagy. It suggests that miR-223-3p and FOXO3a are negatively correlated and may be potential gene therapeutic targets for hepatic injury.
ABSTRACT
Objective To investigate the effect of nucleotide-binding oligomerization domaincontaining protein 1 (NOD1) on pyroptosis in hepatic ischemia-reperfusion injury.Methods An animal model of ischemia-reperfusion injury was established.Thirty healthy,male,and clean C57 BL mice were randomly divided into sham operation group (sham group) and ischemia-reperfusion group (IR,including 2 h,6 h,12 h,24 h subgroups),6 per group.Serum ALT and AST levels in each group were measured by blood biochemistry.HE staining and TUNEL were used to observe the pathological changes of liver and hepatocyte apoptosis.Immunohistochemistry was used to detect the expression and distribution of NOD1 in each group.Western blotting was used to detect NOD1,MM2,pro-Caspase-1 and active-Caspase-1 expression.NOD1 siRNA and empty control siRNA were transfected into AML12 cells,then the hypoxia/reoxygenation model was established and cells were collected to detect the expression of NOD1,AIM2 and active-Caspase-1.Results The ALT and AST levels in IR group were significantly higher than those in sham group,and peaked at IR 12-h subgroup (P＜0.05).HE staining showed that hepatic injury was the most severe at 12 h after reperfusion.TUNEL results showed that the number of apoptotic cells was the greated at 12 h after reperfusion.Western blotting showed that NOD1 protein expression was highest at 12 h after reperfusion.With the prolongation of reperfusion time,the expression of AIM2 and active-Caspase-1 gradually increased,and that of pro-Caspase-1 gradually decreased.The expression of NOD1,AIM2 and activeCaspase-1 decreased after transfection of NOD1 siRNA into AML12 cells.Conclusions NOD1 promotes liver ischemia-reperfusion injury,which may be related to NOD1 promoting liver injury by activating pyroptosis.
ABSTRACT
Objective To explore the clinical efficacy of lateral osteotomy via the supra-fibular-head approach combined with lateral locking plating for simple posterolateral tibial plateau fractures.Methods From January 2014 to February 2017,11 patients with simple posterolateral tibial plateau fracture were treated at Department of Orthopaedics,General Hospital of Middle Military Command of PLA.They were 8 males and 3 females,aged from 21 to 55 years (average 41.8 years).In all of them the supra-fibular-head approach was used for lateral osteotomy according to the size and orientation of the fracture block.After the fracture was reset,a full bone graft was implanted under direct visualization,followed by fixation of the posterolateral bone mass with a lateral locking plate which was placed as far as possible above the fibular head.The patients were encouraged 6 weeks after surgery to do knee functional exercise within 90°.The therapeutic efficacy was evaluated at the final follow-up according to the Rasmussen's criteria for knee functions.Results The average operative time was 74 minutes (from 55 to 90 minutes);the average intraoperative blood loss was 70 mL (from 40 to 120 mL).All the patients were followed up for 12 to 35 months (average,17.5 months).No neurovascular injury or incision infection was observed.Bony union was achieved in all patients after 10 to 15 weeks (average,12.5 weeks).Follow-ups found no implant loosening/breakage,genu valgum,genu varum,fracture redisplacement,or knee instability.According to the Rasmussen's function evaluation of the knee joint,10 cases were rated as excellent and one as good.Conclusion Lateral osteotomy via the supra-fibular-head approach combined with lateral locking plating is a preferred treatment for simple posterolateral tibial plateau fractures.
ABSTRACT
Objective To investigate the effect of miRNA-30a-3p on the proliferation,invasion and metastasis of liver cancer cells by targeting Atg3-mediated autophagy pathway.Methods The immunohistochemical staining was used to detect content of miRNA-30a-3p and Atg3 and their correlation in human hepatocellular carcinoma.Liver cancer cells were cultured in vitro and hunger environment was used to induce autophagy.RFP-GFP-LC3 double-labeled adenovirus infected hepatoma cells were used to detect autophagosomes in hepatoma cells.The expressions of autophagy-related proteins (autophagocytosis associated protein (Atg3),polyubiquitin-binding protein p62,autophagy microtubule-associated protein light chain 3 (LC3)) and EMT-related proteins (N-cadherin,vimentin,snail,ZO-1) were detected by Western blot.Platelet cloning assay and transwell assay were carried out to detect the proliferation,invasion and metastasis of carcinoma cell.CCK-8 kit was used to detect hepatocarcinoma cells' viability.Results The expression of miRNA-30a-3p was down-regulated.The expression of Atg3,E-cadherin and N-cadherin in miRNA-30a-3p high-expressed hepatocellular carcinoma was lower than that in miRNA-30a-3p low-expressed hepatocellular carcinoma.Increasing the expression of miRNA-30a-3p in hepatocellular carcinoma cells can decrease the expression of Atg3 and LC3,increase the expression of p62 and inhibit the formation of autophagosomes;otherwise,Atg3 and LC3 were increased,p62 was decreased and the formation of autophagosomes was promoted.Inhibition of Atg3 expression could decrease the expression of EMT-related proteins.When miRNA-30a-3p was inhibited,the cell viability of HCC was increased at each time point (F1 =10.314,P ＜0.05).When miRNA-30a-3p and Atg3 were inhibitor together,the cell viability of HCC was decreased at each time point(F2 =6.599,P ＜ 0.05).Conclusion miRNA-30a-3p can inhibit Atg3-mediated autophagy pathway and reduce cell autophagy activity,thus inhibiting the proliferation,invasion and metastasis of hepatocarcinoma cells.
ABSTRACT
Objective To investigate the therapeutic effects of navigation-guided hollow screw fixation on the treatment of elderly patients with the sacroiliac complex injury.Methods Twentyone older patients with sacroiliac complex injury received the three-dimensional images-guided percutaneous hollow screw fixation from March 2015 to May 2016.There were 14 males and 7 females with age of 60-73 years[average(63.5 ± 3.7) years].Traffic accident injury was found in 15 cases,falling injury in 5 cases,others in one case.The pelvic fractures were classified by tile classification:type B2 in 2 cases,type B3 in 6 cases,type C1 in 5 cases,type C2 in 6 cases,type C3 in 2 cases.Intraoperative observation data,the injury of nerve and blood vessel during the screw insertion,postoperative fracture reposition and so on were recorded.The quality of fracture reposition was evaluated by Matta radiological criteria after surgery,and the pelvic function was assessed by Majeed scoring criteria at the last follow-up.Results A total of 30 hollow screws in 21 elderly patients were placed under three-dimensional images navigation,and each screw fixation time was 36-45 min,average (40.5±4.7)min with a small amount of bleeding (10-20)ml.Postoperative examinations showed that S1 vertebral cortical bone screw wear was found in one patient,and the end of the bolt washer was internalized into the outer table of the ilium without breaking the medial iliac plate in another patient.The above two patients had no postoperative complications.Other screws positions were good,without nerve or vascular injury and other complications.Postoperative reposition quality evaluated by the Matta radiological criteria showed that 14 cases had excellent quality,five with good quality,two with fair quality,and no case with poor quality.Therefore,the excellent and good rates were 90.5 ％.Moreover,19 elderly patients were followed up for 7-13 months average(10.3± 2.1)months,and only one patient showed the bilateral sacroiliac joint screws outside the lateral sacroiliac joint 5 mm.However,this patient had good function in the later follow-up without further prolapse.The remaining 18 patients assessed by the pelvic X-ray and CT at the end of the follow-up showed a good fracture healing,no screw breakage,loosening,and prolapse.Meanwhile,pelvic function findings evaluated by the Majeed standard demonstrated that nine cases were with excellent function,ten with good function,and the excellent and good rates were 90.5％.Conclusions Three-dimensional images-guided hollow screw fixation for the treatment of elderly patients with the sacroiliac complex injury is safe and effective with less trauma and high nailing accurateness.However,the placing process should be cautious in the elderly with osteoporosis.
ABSTRACT
Objective To explore the role of miR-137 in the proliferation and migration of hepatocellular carcinoma (HCC) cells by regulating Notch1 and mediating autophagy.Methods The human SMMC7721 hepatoma cell line was transfected with miR-137 mimics,miR-137 inhibitor and Notch1 interfering RNA (siRNA),and divided into normal control group (NC group),miR-137 mimics group,miR-137 inhibitor group,Notch1 siRNA group.The expression levels of miR-137 and Notch1 mRNA after the transfection were detected by RT-PCR in SMMC7721 cells.Transwell experiments were performed to analyze the effect of miR-137 and Notch1 on the migration and invasion of SMMC7721 cells.The expression levels of β-catenin and vimentin in SMMC7721 cells were detected by immunohistochemistry.The number of autophagosomes was detected by double labeled adenovirus.Western blot was utilized to detect the expression of Notch1,E-Cadherin,N-Cadherin,vimentin,P62,and LC3.Results The results of RT-PCR showed that the relative expression level of Notch1 in miR-137 inhibitor group (5.71 ± 0.45) was significantly higher than that in miR-137 mimics group (0.21 ± 0.06) with statistical significance (P ＜ 0.05).The Transwell experiments showed that there were fewer invasive metastatic hepatoma cells in miR-137 mimics group (66.00 ± 4.55) and Notch1 siRNA group (88.00 ± 6.78) than that in the miR-137 inhibitor group (515.00 ±35.12) (P ＜0.05).The expression levels of β-catenin in miR-137 mimics group and Notch1 siRNA group were significantly increased and the expression level of vimentin was decreased (P ＜ 0.05).The results of autophagy double labeled adenovirus test showed that the number of autophagosomes in miR-137 mimics group (5.50 ± 3.70) was significantly fewer than that in miR-137 inhibitor group (32.75 ± 4.11),and the difference was statistically significant (P ＜ 0.05).The expression levels of Notch1,N-cadherin,vimentin,and LC3 protein in miR-137 mimics group were much lower than that in miR-137 inhibitor group and NC group,and the expression levels of E-Cadherin and P62 protein were greatly increased.The expression level of Notch1,N-cadherin,and LC3 protein in Notch1 siRNA group were significantly lower than that in NC group,and the expression levels of E-cadherin and P62 protein were much higher than that in NC group.Conclusion MiR-137 can inhibit the proliferation,migration and invasion of HCC cells by inhibiting the expression of Notch1 and autophagy,which may become a new target for the treatment of HCC.
ABSTRACT
Objective To evaluate the clinical outcomes of three-dimensional navigation assisted percutaneous sacroiliac screw combined with external fixator for the treatment of the Tile B and C pelvic fractures. Methods A retrospective case-control study was conducted on 43 patients with Tile B and C pelvic fractures from January 2014 to June 2017. There were 25 males and 18 females, with an average age of 44.6 years (range, 21-68 years). According to the AO typing, there were seven cases of type B1, 13 type B2, six type B3, 15 type C1, and two type C2. The duration from injury to operation ranged from 4 to 14 days (mean, 8.0 days). Based on the operation method, patients were divided into Group A (n=20) treated by three dimensional navigation assisted percutaneous sacroiliac screw combined with external fixator, and Group B (n = 23) treated by anterior open reduction and plate internal fixation. The two groups were compared in terms of operation time, blood loss, reduction quality by Matta score, Majeed pelvic fractures function score at the last follow up, and postoperative complications. Results All patients were followed up for 6-24 months (mean, 12.7 months). The operation time [(27.5 ± 1.6) minutes] and intraoperative bleeding [(26.3 ± 3.9) ml] in Group A were significantly less than those in Group B [(166.2±3.6)minutes and (128.0 ± 8.9) ml] (＜0.05). There were no significant differences between Group A and Group B in the good and excellent rate of reduction [85％ (17/20) vs.91％ (21/23)], and Majeed score [90％ (18/20) vs.91％ (21/23)](P＞0.05). The incidence of postoperative complication in Group A (10％) was significantly lower than that in Group B (39％) (P ＜0.05). Conclusion Compared with open reduction and plate internal fixation, three dimensional navigation assisted percutaneous sacroiliac screw combined with external fixator is preferable to unstable pelvic fractures due to the shorter operation time, less intraoperative bleeding, and fewer postoperative complications.
ABSTRACT
Objective To compare the clinical effect of digital orthopedic three-dimensional visualization technology combined with image-based computer navigation and simple image-based computer navigation in percutaneous screw fixation for the treatment of sacroiliac joint complex injury. Methods A retrospective case-control analysis was conducted on 49 cases of sacroiliac complex injury from January 2015 to May 2017. There were 27 males and 22 females, with an average of 39.3 years old (range, 21-66 years). According to AO typing, there were 10 cases of type B1, 19 type B2, and 20 type C1. The duration from injury to operation ranged from 5 to 11 days (mean, 6.5 days). Based on the application of three-dimensiona digital programming, the 49 cases were assigned to Group A (n =24) which used Mimics computer assisted surgery software to simulate screw placement on the healthy side of sacroilic joint before operation and Group B (n = 25) without the simulation programming. Screw placement time, intraoperative fluoroscopy frequency, and intraoperative bleeding were compared between two groups. Fracture reduction was evaluated by modified Matta standard score, and the function of hip joint by Majeed pelvic fracture function score at the last follow-up. Fracture healing and complications were observed. Results All patients were followed up for an average of 10.4 months (range, 6-24 months). The time of sacroiliac joint screw placement [(18.4 ±3.0)min] and the intraoperative fluoroscopy frequency [(12.9 ± 3.8) times] in Group A were significantly less than those [(26.4 ±3.8) min, (19.4 ±1.5) times] in Group B (P ＜ 0.05). There were no significant differences between Group A and Group B in intraoperative bleeding [(14.1 ± 3.0) ml vs. (15.1 ± 2.2) ml](P＞0.05). According to the modified Matta reduction standard, the good and excellent rate of Group A was 92％ (22/24), and that of Group B was 92％ (23/25). At the last follow up, the Majeed pelvic function score was 96％ (23/24) in Group A and 92％ (23/25) in Group B (P ＞0.05). Bone healing was seen in all patients 4 months after operation, and no complications such as wound infection, deep venous thrombosis, or screw loosening were observed. Conclusion The digital orthopedic three-dimensiona visualization technology in preoperative planning can reduce the time of sacroiliac screw placement and the intraoperative fluoroscopy frequency. It is an effective adjuvant technique for the percutaneous screw fixation under navigation in the treatment of sacroiliac joint.
ABSTRACT
Objectives: Modified extended Morrow procedure for treatment of children with hypertrophic obstructive cardiomyopathy (HOCM) is a complicated and challenging procedure. Our study sought to assess the effect and outcome of modified extended Morrow procedure in children with HOCM. Methods: From January 2010 to July 2017, 50 consecutive pediatric (age≤14 years) patients with HOCM underwent transaortic modified extended Morrow procedure in Fuwai Hospital. Clinical data of these patients were analyzed retrospectively. Pre-operative and post-operative echocardiography data were analyzed, including left atrial size, left ventricular end diastolic diameter, left ventricular ejection fraction, left ventricular outflow tract peak pressure, ventricular septal thickness, mitral systolic anterior motion and grade of mitral regurgitation. Results: Mean age at the time of operation was (84.4±57.7) month (6 month -14 year). Mean body weight at the time of surgery was (28.4±20.7) kg (4.3-92.0) kg. There were 2 deaths after the operation. Three patients had postoperative complete heart block and received permanent pacemaker implantation. After myectomy, left ventricular outflow tract gradient decreased from (74.8±25.0) mmHg to (19.6±17.3) mmHg (P<0.001); the postoperative thickness of ventricular septum decreased from (21.2±9.7) mm to (14.3±6.7) mm (P<0.001); mitral regurgitation degree reduced from 2.2±1.0 to 0.67±0.72, P<0.001). Concomitant surgical procedures were required in 22 patients (44.0%). There was no late death during a follow-up of (27.7±14.0) months. Patients' symptoms were significantly improved post operation and all surviving patients were in New York Heart Association functional class I or II during follow-up. Conclusions: Modified extended Morrow procedure is safe and effective in children with HOCM, post-procedural clinical outcome is excellent, and this procedure can significantly improve the quality of 1ife and the long-term prognosis in these patients.
ABSTRACT
Objectives:To analyze the impact of extended myectomy on reducing mitral regurgitation in patients with hypertrophic obstructive cardiomyopathy (HOCM). Methods:We retrospectively analyzed 480 consecutive HOCM patients who underwent surgical treatment by the same surgeon in our institution from October 2002 to July 2017. The efficacy of extended myectomy for reducing mitral regurgitation and left ventricular outflow tract (LVOT) obstruction were evaluated by echocardiography after surgery. Results:Among the 480 patients, 22 (4.6%) received concomitant mitral repair or replacement because of their intrinsic mitral diseases. In the remaining 458 (95.4%) patients without concomitant mitral valve surgery, 1 (0.2%) died at the 5th day after surgery because of infective shock, and another 4 (0.9%) lost to follow-up, a total of 453 (98.9%) patients underwent echocardiographic follow-up (median follow-up time:6 months [3, 12]). During follow-up, left ventricular out flow tract gradient was significantly decreased from (89.1±30.6) to (12.8±11.6) mmHg (P＜0.001); the number of patients with systolic anterior motion (SAM) of mitral leaflets decreased from 451(98.5%) to 42 (9.3%) (P＜0.001); 297 (64.8%) patients presented with moderate or severe mitral regurgitation before surgery, which decreased to 14 (3.1%) at follow-up (P＜0.001); the multivariate regression analysis showed that patients with residual SAM were significantly associated with a higher incidence of moderate to severe mitral regurgitation during follow-up (odds ratio 30.334, 95% confidence interval:5.619-163.739, P＜0.001). Conclusions:Extended myectomy, combined with dividing the anomalous links between mitral apparatus and septum, and trimming papillary muscles, yields satisfactory outcomes of relieving LVOT obstruction and reducing mitral regurgitation in most of patients with HOCM. Concomitant mitral valve surgery is rarely required unless the patient have intrinsic mitral valve disease.
ABSTRACT
Objective To investigate the role of miRNA-30a-3p on inhibiting the proliferation,invasion and metastasis of HCC cells by targeting Caspase 1 involved in pyroptosis.Methods The qRT-PCR and immunohistochemical staining were used to detect the expressions of miRNA-30a-3p and Caspase 1 in HCC cells.SMMC-7721 cells were transfected with miR-30a-3p agonists,inhibitors and Caspase 1-specific inhibitors.Western blot was obtained to detect the expression of EMT-related proteins (N-cadherin,vimentin,snail,MMP-2) and Caspase 1,IL-18 and IL-1β.Plate clone assay,CCK-8 kit and Transwell were carried out to detect the proliferation and immigration of HCC cells.Results Caspase 1 was highly expressed (t =17.54,P ＜ 0.05) in HCC tissues.Overexpression of miR-30a-3p inhibited HCC cells proliferation and metastasis,while miR-30a-3p inhibition increased the proliferation and metastasis of HCC cells.Overexpression of miR-30a-3p decreased the expression of Caspase 1 (t =12.73,P ＜ 0.05) and inhibited the induction of pyroptosis,inhibiting the expression of IL-18 (t =7.32,P ＜ 0.05) and IL-1 β (t =7.32,P ＜0.05).When miRNA-30a-3p was inhibited,the cell viability of HCC was increased (F1 =9.57,P ＜0.05).When miRNA-30a-3p and Caspase 1 were inhibited together,the cell viability of HCC decreased (F2 =10.66,P ＜ 0.05).Conclusion MiRNA-30a-3p regulate cell pyroptosis through Caspase 1 pathway,inhibiting the proliferation,invasion and metastasis of HCC cells.
ABSTRACT
In order to investigate the genetic difference on medicinal components of Scutellaria baicalensis from different provenances on the genetic difference, the S. baicalensis provenance tests were arranged by randomized block design.Excavating the crude drugs that have been growing for three years, with the same drying process, the content of baicalin, baicalein, wogonoside, wogonin and laminarin A in S. baicalensis were detected by HPLC, and then the data were analyzed. The results indicated that the content of baicalin in different provenances of S. baicalensis was significantly different (<0.05), while the variation of baicalein reached extremely significant level (<0.01). Cluster analysis showed that if the distance was divided by 5.0, the provenances in Chengde, Hebei province were divided into two independent populations, while the other two populations had large geographic spans. The results show that the significant geographical variations exist in the content of medicinal components in S. baicalensis. The study laid a theoretical foundation of provenance selection of S. baicalensis.
ABSTRACT
Objective To investigate the effect of transcription factor FOXO3a on mitophagy in hepatic ischemia-reperfusion injury in mice. Methods A total of 30 male C57BL/6 mice were randomly divided into Sham operation group (Sham) and ischemia reperfusion (IR) 2 h, 6 h, 12 h and 24 h groups, 6 mice in each group. The mouse model of liver ischemia -reperfusion injury was established. Blood biochemical methods were used to detect changes of alanine aminotransferase (ALT) and aspartate aminotransferase (AST). HE staining and TUNEL were used to observe the damages of liver tissue and apoptosis. Western blot assay and qRT-PCR were used to detect the expressions of transcription factor FOXO3a, mitochondrial autophagy-related protein Nix protein and its mRNA expression in each group. Mouse liver AML12 cells were treated with FOXO3a and Nix interfering RNA, and the model was established for 6 h after hypoxia for 1.5 h.These cells were divided into siRNA-NC group, FOXO3a siRNA group and Nix siRNA group. MTT assay was used to detect the viability of cells in each group. The number and distribution of autophagy in each group were observed by confocal microscopy. The expressions of FOXO3a, Nix, microtubule-associated protein LC3, apoptotic protein P62 and Caspase-3 were detected by Western blot assay. Results The levels of ALT and AST in all groups of IR were reduced, and reached the peak value at 6 h (P<0.05). HE and TUNEL results showed that liver injury and apoptosis were the most serious at 6 h after reperfusion. The expression of FOXO3a and Nix was higher in IR group than that in the Sham group, and the expression level of FOXO3a mRNA was the highest at 12 h after reperfusion, the expression of Nix mRNA was the highest at 6 h after reperfusion (P<0.05). Western blot assay showed the highest expression of FOXO3a in the reperfusion of 12 h, and the highest expression levels of Nix, Caspase-3 and LC3Ⅱin reperfusion 6 h. After interfering with the expression of FOXO3a, MTT showed a marked reduction in cell survival (P<0.05), Western blot assay showed that the expression level of FOXO3a was significantly higher in siRNA-NC group than that in FOXO3a siRNA group, and the expression levels of Nix, Caspase-3 and LC3Ⅱwere significantly lower than those of FOXO3a siRNA group. Confocal microscopy showed that the number and distribution of autophagosomes were significantly lower in siRNA-NC group than those in FOXO3a siRNA group. After interfering with the expression of Nix, MTT showed a marked increase in cell survival (P<0.05), Western blot assay showed that the expression levels of Nix, P62 and LC3Ⅱ were significantly higher in siRNA-NC group than those in Nix siRNA group. Conclusion FOXO3a can reduce the hepatic ischemia-reperfusion injury in mice, which may be related to the FOXO3a inhibition for liver cell mitophagy and apoptosis.
ABSTRACT
As an important herbaceous plant, Scutellaria baicalensis Georgi (Chinese skullcap) is geographically widespread and commonly used throughout the world. In the Chinese medicine market, S. baicalensis has been divided into two primary types, "Ku Qin" (WXR) and "Tiao Qin" (TST). Moreover, TST is also divided into different grades according to the diameter of roots. To explore the distribution patterns of the contents of five biologically activate ingredients (FBAI), we used six-year-old cultivated S. baicalensis and analyzed its growth characteristics as well as the quality difference among different types and diameters in roots. Throughout the entire root, we discovered that contents of the FBAI all initially increased and subsequently decreased from the top to the bottom of the roots. The baicalin content of WXR was less than that of TST. On the contrary, the contents of baicalein, wogonin, and oroxylin A in WXR were up to about two times higher than that in TST. We also found that the 0 to 40 cm part of the S. baicalensis root possessed about 87% of the root biomass and about 92% of the contents of the active ingredients.
Subject(s)
Drugs, Chinese Herbal , Chemistry , Flavanones , Flavonoids , Plant Roots , Chemistry , Scutellaria baicalensis , ChemistryABSTRACT
Objective To investigate the correlation between family cohesion and adaptability and quality of life in patients with enterostomy. Methods Using Chinese version of Family Adaptability and Cohesion Scale (FACESⅡ-CV) and Chinese version of Stoma-Quality of Life (STOMA-QOL-C) to investigate the status of family cohesion and adaptability, family type and their impact on quality of life of 110 patients with enterostomy. Results Scores of family cohesion and adaptability averaged 59.15 ± 11.94, 47.32 ± 9.40,were significantly lower than 63.90 ± 8.00 and 50.90 ± 6.20 in the norm,and the difference was statistically significant (t=-4.171,-3.990, P<0.01).The family cohesion was positively correlated with the score of quality of life, social interaction and psychological burden(r=0.274, 0.284, 0.263, P<0.05), and the family adaptability was positively correlated with the score of quality of life,social interaction and psychological burden(r=0.316, 0.338, 0.228, P<0.05 or 0.01). The balance type family was 30 cases;scores of quality of life averaged 45.10±7.26, the intermediate type family was 50 cases;scores of quality of life averaged 43.48±9.98, the extreme type family was 28 cases;scores of quality of life averaged 43.37 ± 16.68, and difference between the three was no statistically significant(F=0.442, P=0.665). Conclusions In the nursing process of patients with enterostomy, health care workers should pay attention to improve family cohesion and adaptability, as to achieve the purpose of improving the quality of life of the patients.