Clinical comparison of modified postauricular transverse incision and traditional vertical incision for microvascular decompression in the treatment of hemifacial spasm / 中国医师进修杂志

Objective:To compare the effect of modified postauricular transverse incision and traditional vertical incision for microvascular decompression in the treatment of hemifacial spasm.Methods:Prospective study method was used. A total of 116 patients with hemifacial spasm in Handan Central Hospital from January 1, 2019 to January 1, 2020 were selected, and divided into two groups according to the admission order. Both groups underwent microvascular decompression; control group (57 cases) received traditional vertical incision, while treatment group (59 cases) received modified postauricular transverse incision. The brainstem auditory evoked potential (BAEP), pain degree, surgical indicators, facial aesthetic satisfaction and complications were compared between two groups.Results:After treatment, the BAEP of latency, wave interval and wave amplitude in the two groups increased compared with that before treatment, and the BAEP of latency, wave interval and wave amplitude in the treatment group were higher than those in the control group: (1.89 ± 0.15) ms vs. (1.62 ± 0.21) ms, (7.89 ± 0.15) ms vs. (6.25 ± 0.41) ms, (1.79 ± 0.19) ms vs. (1.54 ± 0.11) ms ( P<0.05). After treatment, the visual analogue score (VAS) of patients in the two groups decreased compared with that before treatment, and the VAS of patients in the treatment group was lower than that in the control group: (1.15 ± 0.27) points vs. (2.18 ± 0.24) points ( P<0.05). The operation time, intraoperative bleeding volume and postoperative scar length of patients in the treatment group were less than those in the control group: (60.41 ± 3.81) h vs. (76.87 ± 3.87) h, (30.18 ± 4.19) ml vs. (56.87 ± 4.15) ml and (4.18 ± 1.07) cm vs. (6.87 ± 1.05) cm ( P<0.05). The satisfaction rate of patients in the treatment group was higher than that in the control group: 91.53% (54/59) vs. 71.93% (41/57) ( P<0.05). The complication rate of patients in the treatment group was lower than that in the control group: 5.08% (3/59) vs. 21.05% (12/57) ( P<0.05). Conclusions:Compared with traditional vertical incision, the modified transverse incision for microvascular decompression in the treatment of hemifacial spasm can reduce intraoperative blood loss and postoperative scar area, enhance brainstem auditory evoked potential, and improve facial aesthetics, which is worthy of recommendation.

Efficacy of first-line tyrosine kinase inhibitors plus immune checkpoint inhibitors in metastatic fumarate hydratase-deficient renal cell carcinoma / 中华泌尿外科杂志

Objective:To evaluate the efficacy of first-line tyrosine kinase inhibitors (TKI) plus immune checkpoint inhibitors (ICI) in metastatic fumarate hydratase-deficient renal cell carcinoma (FH-deficient RCC).Methods:The data of 87 metastatic FH-deficient RCC patients from West China Hospital ( n=44), Renji Hospital ( n=27) and Sun Yat-sen University Cancer Center (n=16) from Mar 2019 to Aug 2022 were retrospectively analyzed. The median age was 37(30, 47) years, the male to female ratio was 1.9∶1. The median size of tumor was 7.5(5.0, 10.0) cm. Sixty-one patients (70.1%) had germline FH mutations, and 26 patients (29.9%) had somatic FH mutations. Forty-nine patients (56.3%) metastasis disease at initial diagnosis, and 38 patients (43.7%) had metachronous metastasis. The most common site of metastasis was lymph node (41/87, 47.1%), followed by bone (33/87, 37.9%), liver (22/87, 25.3%), and lung (14/87, 16.1%). Fifteen patients (17.2%) had weak expression of FH protein and 59 patients (67.8%) had positive PD-L1 expression. The most common treatments were sintilimab plus axitinib (52/87, 59.8%), followed by pembrolizumab plus cabozantinib (7/87, 8.0%), tirelizumab plus axitinib (6/87, 6.9%), pembrolizumab plus axitinib (5/87, 5.7%), and toripalimab plus axitinib (4/87, 4.6%). Thirteen patients (13/87, 14.9%) received other ICI plus TKI combination treatments. Statistical analysis was conducted using R 4.2.3 software. Kaplan Meier survival curve was used to evaluate survival data, and log-rank test was used to compare differences between treatment groups. Results:The overall objective response rate (ORR) and disease control rate (DCR) of first-line TKI + ICI were 39.1% and 89.7%, respectively. The median progression-free survival (PFS) and overall survival (OS) were 16.5 months and 71.0 months, respectively. For first-line sintilimab plus axitinib, the ORR and DCR were 44.2% and 92.3%, respectively. The median PFS was 17.3 months and the median OS was not reached for this combination treatment. The efficacy of first-line tirelizumab plus axitinib was inferior to other treatment strategies (median PFS: 4.0 vs. 16.6 months, P<0.001; median OS: 22.0 vs. 71.0 months, P=0.043). Subgroup analyses further showed that the efficacy of ICI+ TKI combination therapy was consistent in patients with different clinicopathologic and genomic features. However, patients with liver metastasis had shorter OS than those without liver metastasis (median OS: 26.3 vs. 71.0 months, P=0.021). Conclusion:First-line TKI + ICI is effective for metastatic FH-deficient RCC and can significantly prolong the survival of the patients.

Genetic diversity of mitochondrial cytochrome b gene of Taenia asiatica in Dali Bai Autonomous Prefecture, Yunnan Province / 中华地方病学杂志

Objective:In order to investigate the genetic diversity of mitochondrial cytochrome b (Cytb) gene of Taenia asiatica ( T. asiatica) in Dali Bai Autonomous Prefecture (Dali Prefecture), Yunnan Province. Methods:From May 2019 to August 2021, a total of 131 samples of Taenia were collected from patients admitted to the Dali Prefecture Institute of Schistosomiasis Control, involving five locations (i.e., five groups), including Dali City (58 samples), Weishan Yi and Hui Autonomous County (Weishan County, 14 samples), Midu County (18 samples), Yangbi Yi Autonomous County (Yangbi County, 24 samples) and Eryuan County (17 samples). Primers were designed based on mitochondrial Cytb gene sequence, and part of the Cytb gene sequence was amplified by PCR, then sequenced and homology comparisons were performed. MEGA 7.0 and DNASP 5.10.01 were used to analyze the measured sequence, and data such as base composition, genetic distance, genetic diversity parameters, genetic differentiation index and gene flow were obtained. Results:The amplified fragments of Cytb gene in 131 samples of Taenia were 235 bp. After homology comparisons, they were all T. asiatica. The average contents of A, T, G and C bases were 23.8%, 42.3%, 24.0% and 9.9%, respectively. Of the 131 samples of T. asiatica, 12 haplotypes were defined. The haplotype diversity and nucleic acid diversity were 0.295 9 and 0.006 0, respectively. The ranges of genetic differentiation index and gene flow among the five groups were-0.053 00 to 0.050 40 and 4.710 31 to 162.087 66, respectively. The genetic distance between the five groups ranged from 0.003 5 to 0.009 0, of which the genetic distance between Midu County and Weishan County was the largest, and the genetic distance between Dali City and Yangbi County was the smallest. Conclusions:The mitochondrial Cytb gene of T. asiatica in Dali Prefecture has rich genetic diversity. There is frequent gene exchange among the five groups, and no significant genetic differentiation has been formed.

Embolic stroke of undetermined source: potential etiology and secondary prevention / 国际脑血管病杂志

The source of the emboli of embolic stroke of undetermined source (ESUS) is still unclear, and the effect of antithrombotic therapy is also different. The recurrence rate of stroke in patients with ESUS is higher, and antiplatelet therapy is still a commonly used secondary prevention scheme. This article reviews the potential causes, pathogenesis and secondary prevention of ESUS.

Effects of water extract and ethanol extract from the root of Caragana sinica on hyperuricemia in mice / 中国药房

OBJECTIVE To investigat e the effects of water extract （WCS）and ethanol extract （ECS）from the root of Caragana sinica on hyperuricemia （HUA）in mice. METHODS Kunming mice were randomly divided into normal control group ， model group ，allopurinol group （positive control ，5 mg/kg），benzbromarone group （positive control ，7.8 mg/kg），WCS low-dose ， medium-dose and high-dose groups （38，75，150 mg/kg），ECS low-dose ，medium-dose and high-dose groups （50，100，200 mg/kg）， with 10 mice in each group. Except for the normal control group ，the other mice were given potassium oxazinate intraperitoneally and hypoxanthine intragastrically for consecutive 7 d to establish HUA model. On the third day of modeling ，mice in each administration group were given corresponding drugs intragastrically ，and normal control group and model group were given equal volume of normal saline once a day for 5 consecutive days.The body weight of mice were weighted during administration ；one hour after the last administration ，the organ indexes of liver ，kidney and spleen were calculated ；the contents of serum uric acid （SUA）， blood urea nitrogen （BUN）and serum creatinine （SCR）；the activity of xanthine oxidase （XOD）in serum and liver tissue were determined. Relative mRNA and protein expressions of XOD in liver tissue ，relative expre ssions of GLUT9，URAT1 and OAT 1 in renal tissue were all detected ；and the pathological changes of renal tissue were observed. RESULTS There were no significant differences in liver index and spleen index in each group （P＞0.05）. Compared with normal control group ， except for allopurinol group ， there were no significant differences in the body weight and the contents of BUN and SCR in mice of other administration groups （P＞0.05）；the renal index and SUA content of mice in the m odel group and allopurinol group were significantly increased （P＜0.05）；in the model group ，the XOD activity in serum and liver tissue ，the relative mRNA and protein expression of XOD in liver tissue ，the relative expressions of GLUT 9 and URAT 1 protein in renal tissue were significantly increased （P＜0.05），and the relative expression of OAT 1 protein in renal tissue was significantly decreased （P＜ 0.05）. Compared with model group ，renal indexes of mice were decreased significantly in WCS and ECS groups （P＜0.05），and the pathological damage of renal tissue was significantly improved ；SUA content ，XOD activity in serum and liver tissue ，the relative mRNA and protein expression of XOD in liver tissue ，and the relative expression of URAT 1 protein in renal tissue were decreased significantly in administration groups （P＜0.05）. The relative expression of GLUT 9 protein in renal tissue of mice in benzbromarone group and ECS high-dose group decreased significantly （P＜0.05）；relative expression of OAT 1 protein in renal tissue of mice in benzbromarone group ，WCS low-dose and high-dose groups ，ECS low-dose group were increased significantly （P＜0.05）. CONCLUSIONS WCS and ECS can significantly decrease the contents of SUA in HUA model mice ，and improve pathological state of renal tissue ，the mechanism of which may be associated with inhibiting XOD activity and uric acid reabsorption，and down-regulating protein and mRNA expression of XOD.

Application of virtual reality technology in thoracoscopic anatomical segmentectomy / 中国基层医药

Objective:To explore the application value of virtual reality technology in thoracoscopic anatomical segmentectomy.Methods:Eighty-four patients with early stage non-small cell lung cancer admitted to the First Hospital of Jiaxing from December 2017 to December 2018 were enrolled in the study.They were divided into observation group and control group according to the random digital table method, with 42 cases in each group.The observation group used virtual reality technology to construct a three-dimensional digital model, and performed preoperative evaluation and simulated surgical drills and intraoperative navigation on the three-dimensional digital model, based on the preoperative evaluation and simulated surgical drill results, combined with the specific actual situation during the operation, developed and implemented individualized thoracoscopic anatomical segmentectomy.Thoracoscopy anatomical segmentectomy was routinely performed in the control group.The operation time, intraoperative blood loss, intraoperative lymph node dissection number, intraoperative lymph node dissection, postoperative hospital stay, postoperative thoracic closed drainage tube, total postoperative drainage, total hospitalization, cost and incidence of postoperative complications were compared between the two groups.Results:The operation of both two groups was successfully completed, and no intraoperative thoracic surgery was performed during the operation.There was no perioperative death.The operation time, intraoperative blood loss, intraoperative lymph node dissection number, intraoperative lymph node dissection, postoperative hospital stay, postoperative thoracic closed drainage tube, total postoperative drainage, total hospitalization cost and the incidence of postoperative complications in the observation group were (100.98±26.51)min, (67.98±32.96)mL, (7.79±1.32), (11.98±4.69), (4.60±1.43)d, (2.86±0.81)d, (437.14±193.86)mL, (3.76±0.31)million, 9.52%(4/42), respectively, which in the control group were (114.88±24.26)min, (104.52±52.37)mL, (6.45±0.3), (8.31±1.94), (6.50±2.55)d, (4.00±2.25)d, (667.26±415.01)mL, (4.20±0.65)million, 26.19%(11/42), respectively, the differences between the two groups were statistically significant ( t=-2.208, -3.328, 5.916, 4.678, -4.221, -3.993, -3.265, -3.968, χ 2=3.977, all P<0.05). No local recurrence or distant metastasis was found during the follow-up period. Conclusion:Virtual reality technology can provide preoperative evaluation and simulated surgical exercises and intraoperative navigation for thoracoscopic anatomical segmentectomy, which can reduce the difficulty of surgery and improve the accuracy and safety of the operation.

Correlation of serum level of tumor necrosis factor receptors with cervical cancer and cervical intraepithelial neoplasia / 中华老年医学杂志

Objective To investigate the correlation of cervical cancer and cervical intraepithelial neoplasia with expression level of serum soluble tumor necrosis factor receptor Ⅰ and Ⅱ.Methods A total of 915 recruited women in middle or advanced age were treated in our hospital from January 2015 to January 2017.Participants were assigned to one of five groups:group A (n=432) as control subjects;group B (n 89) diagnosed as cervical intraepithelial neoplasia Ⅰ;group C (n=94)as cervical intraepithelial neoplasia Ⅱ;group D (n=175) as cervical intraepithelial neoplasia Ⅲ;group E (n=125) as cervical cancer.The expression level of serum tumor necrosis factor receptor (sTNFR)was detected by enzyme linked immunosorbent assay.Results The level of sTNFR Ⅰ was much lower in the group A (0.869±0.243)μg/L than in the group B (1.127±0.435)μg/L,C (1.164±0.471)μg/L,D (1.206±0.693)μg/L,and E (1.836± 1.216)μg/L (t =7.782,8.741,8.860,and 15.523,all P＜0.001).The level of sTNFR Ⅰ in the group E was much higher than in the groups B,C,and D (t=5.263,5.077,and 5.684,all P＜0.001).No statistical significance was found in sTNFR Ⅰ level between B,C and D groups.The level of sTNFR Ⅱ was much lower in the group A (1.633±0.402)μg/L than in the group B (1.872±0.526)μg/L,C (1.895±0.402)μg/L,D (1.946±0.604)μg/L,and E (3.192±1.145)μg/L (t=4.824,5.254,7.446,and 23.731,all P＜0.001).The level of sTNFR Ⅱ was much higher in the group E than in the groups B,C,and D (t =10.136,10.501,and 12.216,all P＜0.001).There was no significant difference in sTNFR Ⅱ levels between the groups B,C,and D groups (all P ＞ 0.05).Conclusions Cervical cancer and cervical intraepithelial neoplasia are correlated with level of serum tumor necrosis factor receptors.

Clinical efficacy of compound methylene blue liquid local closure combined with Gegen Jiazhu decoction in the treatment of anal pruritus / 中国生化药物杂志

Objective To discuss the clinical efficacy of compound methylene blue liquid local closure combined with Gegen Jiazhu decoction in the treatment of anal pruritus.Methods 88 cases of anal pruritus patients from June 2015 to June 2016 in our hospital were randomly divided into observation group and control group,44 cases in each group,the observation group was treated with ompound methylene blue liquid local closure combined with Gegen Jiazhu decoction,patients in control group were treated with miconazole cream,the efficacy of the two groups were compared.Results The total effective rate of the observation group was significantly higher than that of the control group(P<0.05); There were no significant differences in anal eczema,skin eczema,skin licheniformis and skin pigmentation symptoms before treatment between two groups; After treatment,the anal eczema,skin eczema,skin licheniformis and skin pigmentation symptoms score of the observation group was significantly lower than the control group(P<0.05); patients in the observation group,skin itching disappeared disappeared and the improvement of sleep time was significantly shorter than the control group(P<0.05); After treatment one,three,six months,the recurrence rate of observation group was significantly lower than the control group(P<0.05).Conclusion The clinical efficacy of compound methylene blue liquid combined with Gegen Jiazhu decoction can effectively improve the clinical symptoms of patients with anal itching,the treatment effect is good,the recurrence rate is low.

Clinicopathologic characteristics and prognosis analysis of 90 young patients with gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the features of clinicopathology and prognosis in young gastric cancer patients.</p><p><b>METHODS</b>Clinicopathological data of 90 young gastric cancer patients (≤40 years old) who received radical gastrectomy in the Department of General Surgery of Zhongshan Hospital, Fudan University from January 2013 to December 2014 were retrospectively analyzed. Survival data were obtained by follow-up and the last follow-up time was October 2016. Log-rank test and Cox regression model were used to analyze the risk factors of prognosis and these factors included gender, age, tumor size, degree of differentiation, histological type, Lauren pattern, T stage, N stage, vessel carcinoma embolus, clinical symptom, anemic condition, CA19-9 level, et al.</p><p><b>RESULTS</b>The median age of 90 patients was 35 years old, of whom, 20(22.2%) patients were ≤30 years old and 70(77.8%) patients were between 31 and 40 years old. There were 70(77.8%) female patients, 38(42.2%) patients with anemia, 11(12.8%) patients with elevated CA19-9 level and 9(10.0%) patients with family history of gastrointestinal tumors. The mean time of all the patients from presence of symptom to consultation was 8.2 months. Postoperative pathology revealed 65(72.2%) patients with poorly differentiated adenocarcinoma, 6(6.7%) patients with mucinous adenocarcinoma, 9(10%) patients with signet-ring cell carcinoma, and 10(11.1%) patients with papillary-canalicular adencarcinoma. Sixty-nine (76.7%) patients were diagnosed as advanced gastric cancer and 67(74.4%) patients were involved with lymphatic metastasis when they visited our hospital. Univariate analysis showed that gender (P=0.021), tumor size (P=0.001), depth of tumor infiltration (P=0.016), lymphatic metastasis (P=0.000), vessel carcinoma embolus (P=0.001), elevated CA19-9 level (P=0.001), and anemia (0.024) were statistically related with postoperative survival. Multivariate analysis showed that lymphatic metastasis was an independent risk factor of the poor prognosis of young patients (HR:2.774, 95%CI:1.435 to 5.364, P=0.002).</p><p><b>CONCLUSIONS</b>The majority of young gastric cancer cases are female with poorly differentiated adenocarcinoma. Most patients are diagnosed as advanced gastric cancer with lymphatic metastasis when they visit hospital at the first time. The lymphatic metastasis is an independent risk factor of prognosis in young gastric cancer patients.</p>

Establishment of risk evaluation model of peritoneal metastasis in gastric cancer and its predictive value / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To establish an evaluation model of peritoneal metastasis in gastric cancer, and to assess its clinical significance.</p><p><b>METHODS</b>Clinical and pathologic data of the consecutive cases of gastric cancer admitted between April 2015 and December 2015 in Department of General Surgery, Zhongshan Hospital of Fudan University were analyzed retrospectively. A total of 710 patients were enrolled in the study after 18 patients with other distant metastasis were excluded. The correlations between peritoneal metastasis and different factors were studied through univariate (Pearson's test or Fisher's exact test) and multivariate analyses (Binary Logistic regression). Independent predictable factors for peritoneal metastasis were combined to establish a risk evaluation model (nomogram). The nomogram was created with R software using the 'rms' package. In the nomogram, each factor had different scores, and every patient could have a total score by adding all the scores of each factor. A higher total score represented higher risk of peritoneal metastasis. Receiver operating characteristic (ROC) curve analysis was used to compare the sensitivity and specificity of the established nomogram. Delong. Delong. Clarke-Pearson test was used to compare the difference of the area under the curve (AUC). The cut-off value was determined by the AUC, when the ROC curve had the biggest AUC, the model had the best sensitivity and specificity.</p><p><b>RESULTS</b>Among 710 patients, 47 patients had peritoneal metastasis (6.6%), including 30 male (30/506, 5.9%) and 17 female (17/204, 8.3%); 31 were ≥ 60 years old (31/429, 7.2%); 38 had tumor ≥ 3 cm(38/461, 8.2%). Lauren classification indicated that 2 patients were intestinal type(2/245, 0.8%), 8 patients were mixed type(8/208, 3.8%), 11 patients were diffuse type(11/142, 7.7%), and others had no associated data. CA19-9 of 13 patients was ≥ 37 kU/L(13/61, 21.3%); CA125 of 11 patients was ≥ 35 kU/L(11/36, 30.6%); CA72-4 of 11 patients was ≥ 10 kU/L(11/39, 28.2%). Neutrophil/lymphocyte ratio (NLR) of 26 patients was ≥ 2.37(26/231, 11.3%). Multivariate analysis showed that Lauren classification (HR=8.95, 95%CI:1.32-60.59, P=0.025), CA125(HR=17.45, 95%CI:5.54-54.89, P=0.001), CA72-4(HR=20.06, 95%CI:5.05-79.68, P=0.001), and NLR (HR=4.16, 95%CI:1.17-14.75, P=0.032) were independent risk factors of peritoneal metastasis in gastric cancer. In the nomogram, the highest score was 241, including diffuse or mixed Lauren classification (54 score), CA125 ≥ 35 kU/L (66 score), CA72-4 ≥ 10 kU/L (100 score), and NLR ≥ 2.37 (21 score), which represented a highest risk of peritoneal metastasis (more than 90%). The AUC of nomogram was 0.912, which was superior than any single variable (AUC of Lauren classification: 0.678; AUC of CA125: 0.720; AUC of CA72-4: 0.792; AUC of NLR: 0.613, all P=0.000). The total score of nomogram increased according to the TNM stage, and was highest in the peritoneal metastasis group (F=49.1, P=0.000). When the cut-off value calculated by ROC analysis was set at 140, the model could best balanced the sensitivity (0.79) and the specificity (0.87). Only 5% of patients had peritoneal metastasis when their nomogram scores were lower than 140, while 58% of patients had peritoneal metastasis when their scores were ≥ 140(χ=69.1, P=0.000).</p><p><b>CONCLUSION</b>The risk evaluation model established with Lauren classification, CA125, CA72-4 and NLR can effectively predict the risk of peritoneal metastasis in gastric cancer, and provide the reference to preoperative staging and choice of therapeutic strategy.</p>

Influence of different doses budesonide aerosol inhalation on serum cytokines levels in children with severe asthma / 中国基层医药

Objective To discuss the influence of different doses budesonide aerosol inhalation on serum cytokines levels in children with severe asthma.Methods 96 children with severe asthma aged 4 to 14 years old in our hospital were chosen,and they were randomly divided into the observation group and the control group,48 cases in each group.All patients were given conventional treatment, and the control group was given 1mg/time budesonide treatment on the basis of conventional treatment (3 times a day),while the observation group was given 2mg/time budesonide treatment (3 times a day).Before and 1 week after treatment,the clinical symptoms of two groups were observed and compared,as well as the changes of IL-4,IFN-gamma,IL-10 and TNF-α.Results In the obser-vation group,wheezes,coughing,wheezy sound and rales disappearance time were (2.10 ±0.77)d,(5.45 ±1.20)d, (3.46 ±1.03)d,(5.55 ±1.35),which were significantly shorter than (2.98 ±1.02)d,(7.48 ±1.19)d,(5.43 ± 1.06)d,(7.56 ±1.67)d in the control group (t=4.77,8.32,9.23 and 8.32,all P0.771).Conclusion High doses of budesonide aerosol inhalation in the treatment of children with severe asthma has obvious clinical curative effects,which could significantly improve the patients'clinical symptoms,and also has low incidence of adverse reactions,which is worthy of clinical promotion.

Efficacy of tiotropium inhalation powder for recovery of lung function after lung cancer / 中国基层医药

Objective To investigate the clinical efficacy of thiophene tiotropium powder inhaler for postop-erative lung function recovery in lung cancer patients.Methods 80 patients of thoracic surgery lobectomy who had lung cancer were selected as research subjects.The patients were randomly divided into two groups.The observation group received tiotropium bromide powder for inhalation therapy,the control group was inhaled salmeterol /fluticasone propionate powder for inhalation therapy.Before treatment,after treatment,2d,6d of CRP,absolute neutrophil ANC, tumor necrosis factor α(TNF -α) were observed.Before treatment,after treatment 4 weeks,8 weeks of forced vital capacity (FVC),within one second force expiratory volume in FEV1 ,FEV1 percent predicted (FEV1%),FEV1 /FVC, PaO2 ,PaCO3 were detected.Results Before treatment,CRP,AND,TNF -αhad no significant differences between the two groups (all P >0.05).Postoperative 2d,CRP,ANC,TNF -αof the two groups were all increased.Postopera-tive 6d,the above indicators of the two groups were declined,and the decline of the observation group was significantly lower than the control group (t =3.163 4,3.651 8,4.025 3,all P 0.05).4 weeks,8 weeks af-ter treatment,FVC,FEV1%,FEV1 /FVC,PaO2 of the observation group were significantly higher than the control group (t =2.041 8,4.116 7;2.043 1,3.722 8;3.056 2,4.138 6;3.227 6,5.161 9;all P <0.05),FEV1 ,PaCO3 were significantly lower than the control group (t =1.523 7,3.427 6;3.439 2,4.521 7;all P <0.05).Conclusion Tiotropium bromide inhalation powder agents has certain effect on lung function recovery for lung cancer patients after surgery,it is worthy of clinical application.

Genome-wide study reveals an important role of spontaneous autoimmunity, cardiomyocyte differentiation defect and anti-angiogenic activities in gender-specific gene expression in Keshan disease / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Keshan disease (KD) is an endemic cardiomyopathy in China. The etiology of KD is still under debate and there is no effective approach to preventing and curing this disease. Young women of child-bearing age are the most frequent victims in rural areas. The aim of this study was to determine the differences between molecular pathogenic mechanisms in male and female KD sufferers.</p><p><b>METHODS</b>We extracted RNA from the peripheral blood mononuclear cells of KD patients (12 women and 4 men) and controls (12 women and 4 men). Then the isolated RNA was amplified, labeled and hybridized to Agilent human 4×44k whole genome microarrays. Gene expression was examined using oligonucleotide microarray analysis. A quantitative polymerase chain reaction assay was also performed to validate our microarray results.</p><p><b>RESULTS</b>Among the genes differentially expressed in female KD patients we identified: HLA-DOA, HLA-DRA, and HLA-DQA1 associated with spontaneous autoimmunity; BMP5 and BMP7, involved in cardiomyocyte differentiation defect; and ADAMTS 8, CCL23, and TNFSF15, implicated in anti-angiogenic activities. These genes are involved in the canonical pathways and networks recognized for the female KD sufferers and might be related to the pathogenic mechanism of KD.</p><p><b>CONCLUSION</b>Our results might help to explain the higher susceptibility of women to this disease.</p>

Macrophage-derived soluble factors induce the epithelial-mesenchymal transition of HepG2 cells / 中华肝胆外科杂志

Objective This study investigates the epithelial-mesenchymal transition effects exerted on human liver cancer cells HepG2 by THP-1 derived macrophages.The roles of tumor-associated macrophages (TAMs) on liver cancer progression and its mechanisms were explored.Methods HepG2 cells were cultured with THP-1 derived macrophages to mimic the microenvironment of liver cancer.After the culture treatment,morphological changes of the liver cancer cells were observed.Decreased E-cadherin expression is a hallmark of epithelial-mesenchymal transition (EMT),and the Ecadherin protein variations in the HepG2 cells were detected by immunofluorescence (IF) and Westernblot.FlowCytomix was carried out to screen the cytokines in the supernanants of THP-1 cells and THP-1 derived macrophages.Results After culture with macrophages,HepG2 cells revealed a morphological change.These cells lacked epithelial morphology and became a spindle-like mesenchymal cell phenotype.Additionally,the E-cadherin protein expression was reduced dramatically as measured by IF and Western-blot.IL-8 and IL-1β expression in the supernatants were increased 40 and 20 times,respectively,after THP-1 cells were activated to macrophages (P＜0.01).TNF-α expression was increased 8 times (P =0.056).Conclusion THP-1 derived macrophages could induce EMT effects on HepG2 cells,which may relate to the increased secretion of IL-1β,IL-8 and TNF-α.

Summary of 1289 percutaneous nephrolithotomy cases under ultrasonic guidance for the treatment of upper urinary calculi / 中华泌尿外科杂志

Objective To evaluate the efficacy and safety of percutaneous nephrolithotomy (PCNL) under ultrasonic guidance for the treatment of upper urinary calculus. Methods From June 2004 to July 2009, 1289 patients with upper urinary tract calculi were treated with PCNL under ultrasonic guidance, 386 cases of them were upper ureteral calculi, 463 cases were single renal calculi,355 cases were multiple renal caculi, 85 cases were staghorn calculi. Calculus size was 0.8 cm× 1.2cm-9.0 cm× 5.3 cm,mean 2. 1 cm× 3.1 cm. Nine hunderd and thirty-five cases were with hydronephrosis. Results All patients were performed PCNL successfully, without conversion to open surgery or death. Mean operation time was 90(55-220)min, mean operative blood loss was 175(60-800)ml. Thirty-one cases were given blood transfusion during operation or post operation, 14 cases were given super-selective renal artery embolism for bleeding control. 1105 cases were treated with single tract, 108 cases with double tracts, 76 cases with three tracts. Calculus clearance rate of onestage PCNL was 85.03%(1096/1289);193 cases were found with residual calculi, 67 of them were given extracorporeal shock-wave lithotripsy, 126 of them were given two-stage PCNL, calculi were removed complelety in 85 cases. Total calculus clearance rate was 91.62%(1181/1289). Conclusions PCNL under ultrasonic guidance is an effective and safe method for the treatment of upper urinary calculus with advantages of accurate positioning, high calculus clearance rate, minimal trauma, and fewer complications. The key of successful PCNL is selection of patients, grasp of operation technique, and availability of other equipements.

Sex differences in the length ratios of metapodials in Macaca mulatta from the Taihang mountains / 解剖学报

Objective Sex difference of the length ratios of metacarpals and metatarsals in Macaca mulatta from the Taihang mountains was studied in our laboratory. Methods The lengths of 27 metacarpals (10 males, 17 females) and 30 metatarsals(12 males, 18 females) were measured from the skeletons of 30 adult Macaca mulatta. Length ratios were constructed for all possible pairings of the five bones in each individual hand and foot. One-Way ANOVA adopting SPSS13.0 for windows was used to study the sex differences of length ratios of metacarpals and metatarsals. Results For Macaca mulatta, several of these lengths ratios exhibited substantial differences between the sexes. The metacarpal(Mc) length ratios showing the largest sex differences were 2Mc∶5Mc and 4Mc∶5Mc in both hands (P<0.01), and the metatarsal(Mt) length ratios showing the largest sex difference was 1Mt:3Mt in both feet (P<0.05). Conclusion The sex differences of metacarpals and metatarsals remained when specimens of similar size were compared. It showed that body size was not the basis for these sex differences. Various facts suggested that the sex difference of length ratios in primate metapodials was associated with sex hormones exposure, possibly during prenatal development.

One year follow-up of living kidney donors of laparoscopic and open live donor nephrectomy / 中华泌尿外科杂志

Objective To compare the safety of laparoscopic live donor nephreetomy(LDN) and open live donor nephrectomy(ODN), evaluate the kidney function and blood pressure of living donors during 1 year follow-up. Methods Thirty cases of LDN and 30 eases of ODN were retrospectively reviewed. The operation time, warm ischemia time, operative blood loss, time to post-operative intake and time to ambulation of the 2 grouups were compared. According to the modified Clavien classifica-tion system procedure-related complications were described and compared. Serum creatinine(SCr) le-vels, blood pressure and 24-h urine protein excretion were measured before nephreetomy and 1 d, 7 d, 3 months, 6 and 12 months after nephrectomy. Glomerular filtration rate (GFR) were measured preo-pratively and at 6 and 12 months postoperatively. These data were statistically analyzed. Results The operation time was (98. 6+13. 6)rain and (96.3+19. 5)rain in the LDN and ODN groups, re- spectively. Warm ischemia time in the LDN group was (90.6±15.1)s, in the ODN group was (86.4±12.3)s. Operative blood loss was (105.2±634.8)ml and (206.3±126.4)ml in the LDN and ODN groups(P<0.01). For the time to post-operative intake and time to ambulation, LDN group was (28.5±2.9)h and (25.8±63.8)h, ODN group was (38.6±63.3)h and (36.5±65.3)h(P<0.01). Perioperative complications rates were 6.6%(2/30) and 23.3%(7/30) for LDN and ODN, respective-ly. SCr was (109.1±7.5), (105.4±69.5), (96.6±10.7), (89.4±11.5), (91.6±69.3)/zmol/L in the LDN group and (107.3±69.6), (103.3±68.4), (95.4±69.1), (90.5±13.6), (90.3±11.7)μmol/L in the ODN group 1 day, 7 days, 3 months, 6 months and 12 months after nephrectomy. The mean GFR of LDN and ODN was 64.7 and 65.8 ml/min at 6 months after nephrectomy, 65.9 and 67.5 ml/min at 12 months postoperatively, which were significantly different comparing with preoperative mean GFR in each group(P<0.05) but no significant difference was found between 6 months and 12 months after nephrectomy and between the 2 groups at the same time point respectively(P>0.05). Mean 24 h protein excretion was elevated after either LDN or ODN during 1 year followup, but was not significantly different either between predonation and 1 year after nephrectomy or between the 2 groups at the same period. Blood pressure increased or decreased slightly with the duration of follow-up,no significant blood presure changes were found before and after nephrectomy or between the two groups at the same period postoperatively. Conclusions LDN has the advantages of minimal trauma, less operative blood loss and quicker convalescence. It is safe and and has no adverse effects regarding kidney function and blood pressure during the first year after living kidney donation comparing to ODN.