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Methyl-CpG binding protein 2 (MeCP2) is a basic nuclear protein involved in the regulation of gene expression and microRNA processing. Duplication of MECP2-containing genomic segments causes MECP2 duplication syndrome, a severe neurodevelopmental disorder characterized by intellectual disability, motor dysfunction, heightened anxiety, epilepsy, autistic phenotypes, and early death. Reversal of the abnormal phenotypes in adult mice with MECP2 duplication (MECP2-TG) by normalizing the MeCP2 levels across the whole brain has been demonstrated. However, whether different brain areas or neural circuits contribute to different aspects of the behavioral deficits is still unknown. Here, we found that MECP2-TG mice showed a significant social recognition deficit, and were prone to display aversive-like behaviors, including heightened anxiety-like behaviors and a fear generalization phenotype. In addition, reduced locomotor activity was observed in MECP2-TG mice. However, appetitive behaviors and learning and memory were comparable in MECP2-TG and wild-type mice. Functional magnetic resonance imaging illustrated that the differences between MECP2-TG and wild-type mice were mainly concentrated in brain areas regulating emotion and social behaviors. We used the CRISPR-Cas9 method to restore normal MeCP2 levels in the medial prefrontal cortex (mPFC) and bed nuclei of the stria terminalis (BST) of adult MECP2-TG mice, and found that normalization of MeCP2 levels in the mPFC but not in the BST reversed the social recognition deficit. These data indicate that the mPFC is responsible for the social recognition deficit in the transgenic mice, and provide new insight into potential therapies for MECP2 duplication syndrome.
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OBJECTIVE@#To evaluate the mid-term efficacy of radiofrequency ablation of nucleus pulposus by intervertebral foramen endoscopy BEIS technique in the treatment of lumbar spine surgery failure syndrome over 60 years old.@*METHODS@#The clinical data of 40 patients over 60 years old with lumbar spine surgery failure syndrome admitted from January 2010 to January 2015 were retrospectively analyzed. Among them, there were 34 males and 6 females, aged from 60 to 76 years old with an average of 66 years, the courses of disease ranged from 10 months to 4 years. The patients were divided into two groups (BEIS group and revision group) according to the different surgery. The intervertebral foramen endoscopy BEIS technique and the transforaminal lumbar interbody fusion (TLIF) were performed in BEIS group and revision group respectively. There was no significant difference in general data such as sex, age, course of disease, surgical segment between two groups(>0.05). The operation time, intraoperative bleeding volume, bed rest time after operation and hospitalization time were observed between two groups. At preoperative, postoperative 1 month, 1 year, 3 years, visual analogue scale(VAS) and Japanese Orthopaedic Association Score(JOA) were used to compare the efficacy.@*RESULTS@#The operation time, intraoperative bleeding volume, bed rest time after operation and hospitalization time in BEIS group were (60.2±10.3) min, (60.1±4.5) ml, (2.2±1.5) d, (4.04±1.40) d, respectively, which were significantly lower than those of revision group (<0.05). The VAS and JOA scores of the two groups at different time after operation were significantly improved (<0.05), and there was statistically significant difference between two groups (<0.05).@*CONCLUSIONS@#Radiofrequency ablation of nucleus pulposus by intervertebral foramen endoscopy BEIS technique is more effective than TLIF revision in the treatment of lumbar spine surgery failure syndrome over 60 years old. It has advantages of shorter operation time, less bleeding, shorter bed rest after operation and hospitalization time, and is worthy of clinical promotion.
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Aged , Female , Humans , Male , Middle Aged , Endoscopy , Lumbar Vertebrae , Retrospective Studies , Spinal Fusion , Treatment OutcomeABSTRACT
Objective To explore the application value of the fusiform tube stomach in the digestive tract reconstruction after thoracoscopic and laparoscopic radical resection of esophageal carcinoma.Methods The retrospective cohort study was conducted.The clinicopathological data of 96 patients with thoracic esophageal cancer who were admitted to the First Affiliated Hospital of Zhengzhou University between November 2016 and May 2017 were collected.All the patients underwent thoracoscopic and laparoscopic radical resection of esophageal carcinoma,45 using thin tubular stomach and 51 using fusiform tube stomach for digestive tract reconstruction were respectively allocated into the tubular stomach group and fusiform stomach group.Observation indicators:(1) intra-and post-operative situations;(2) postoperative complications;(3) detection of gastric hemodynamics;(4) follow-up situations.Follow-up using outpatient examination and telephone interview was performed to detect patients' survival up to November 2017.Measurement data with normal distribution were represented as-x±s and comparison between groups was analyzed using the t test.Measurement data with skewed distribution were described as M (range) and comparison between groups was analyzed using the rank sum test.Ordinal data and categorical variables were respectively done using the independent-sample Wilcoxon rank-sum test and chi-square test.Paired experimental data were analyzed by the Friedman test and Wilcoxon test.Results (1) Intra-and post-operative situations:96 patients underwent successful thoracoscopic and laparoscopic radical resection of esophageal carcinoma.The number of closers,time of postoperative mediastinal tube removal,thoracic stomach anteroposterior diameter by postoperative CT examination,number of slices at maximal width of thoracic stomach by postoperative CT examination and duration of hospital stay were respectively 4 (range,3-5),14 days (range,11-45 days),28.35 mm (range,9.96-75.70 mm),0.56 (range,0.33-2.13),16 days (range,12-62 days) in the tubular stomach group and 4 (range,2-4),12 days (range,10-16 days),45.80 mm (range,17.36-89.77 mm),1.10 (range,0.47-2.15),14 days (range,12-61 days) in the fusiform stomach group,with statistically significant differences between groups (Z=4.525,4.240,-3.796,-4.604,2.154,P＜0.05).(2) Postoperative complications:cases with postoperative cervical anastomotic fistula,thoracic gastric fistula,grading Ⅰ-Ⅱ and Ⅲ-Ⅳ of Clavien-Dindo classification were respectively 4,5,32,13 in the tubular stomach group (1 with a combination cervical anastomotic fistula and thoracic gastric fistula) and 0,0,47,4 in the fusiform stomach group,with statistically significant differences between groups (x2 =9.937,7.266,P＜0.05).Patients with complications were improved by symptomatic treatment.(3) Detection of gastric hemodynamics:hemodynamic values of gastric antrum,gastric body and gastric fundus that was detected by non-contact laser Doppler line imaging were respectively 314 PU (range,294-320 PU),252 PU (range,242-259 PU),206 PU (range,194-223 PU) in self-control status of 7 patients and 295 PU (range,277-314 PU),255 PU (range,244-267 PU),219 PU (range,199-233 PU) in tubular stomach model and 277 PU (range,263-300 PU),216 PU (range,201-235 PU),199 PU (range,176-207 PU) in fusiform stomach model,with statistically significant differences among groups (x2 =10.286,14.000,10.286,P＜0.05).There were statistically significant differences in the hemodynamic values of gastric antrum,gastric body and gastric fundus between self-control status and fusiform stomach model (Z=-2.028,-2.384,-2.197,P＜0.05),between self-control status and tubular stomach model (Z =-2.371,-2.371,-2.201,P＜0.05) and between fusiform stomach model and tubular stomach model (Z =-2.201,-2.366,-2.366,P＜0.05).(4) Follow-up situations:among 96 patients,90 were followed up for 6-12 months,with a median time of 8 months.During the follow-up,1 patient in the tubular stomach group died of tumor recurrrence,and no patient died in the fusiform stomach group,with no statistically significant difference between groups (x2 =1.264,P ＞ 0.05).Conclusion Compared with the thin tubular stomach,the fusiform tube stomach can reduce the incidences of postoperative fistula and pulmonary complications and shorten duration of hospital stay after the thoracoscopic and laparoscopic radical resection of esophageal carcinoma,and hemodynamics of the fusiform tube stomach is superior to that of thin tubular stomach.
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<p><b>OBJECTIVES</b>To investigate the mechanism of Liuwei Dihuang Pill (, LDP) in treating postmenopausal osteoporosis (PMOP) with Shen (Kidney) yin deficiency.</p><p><b>METHODS</b>In this study, 205 cases of PMOP were divided into the PMOP Shen-yin deficiency group (Group A), PMOP Shen-yang deficiency group (Group B), PMOP without Shen deficiency group (Group C), and control group (Group N). Real-time polymerase chain reaction (RT-PCR) and Western blot techniques were used to observe the effects of LDP treatment on the cardiotrophin-like cytokine factor 1 (CLCF1), ankyrin repeat and SOCS box containing 1 (ASB1), and prokineticin 2 (PROK2) genes and the Janus kinase/signal transducer and activator of transcription (JAK/STAT) signaling pathway.</p><p><b>RESULTS</b>The mRNA (P<0.05) and protein (P<0.01) expression levels of the CLCF1 gene in Group A were significantly lower than the corresponding levels in Group N. After LDP treatment for 3 months, the mRNA expression levels of the CLCF1 gene were obviously up-regulated (P<0.01). After 6-month treatment, the expression levels of CLCF1 mRNA and protein were significantly up-regulated (both P<0.01), and the average bone density of the top femur had significantly increased (P<0.05). In vitro, CLCF1 overexpression resulted in a significant increase in the total protein and phosphorylated protein levels of JAK2 and STAT3.</p><p><b>CONCLUSIONS</b>The CLCF1 gene is an important gene associated with PMOP Shen-yin deficiency and the therapeutic effects of LDP may be mediated by up-regulation of CLCF1 gene expression and activation of the JAK/STAT signaling pathway.</p>
Subject(s)
Female , Humans , Middle Aged , Cytokines , Genetics , Metabolism , Drugs, Chinese Herbal , Pharmacology , Therapeutic Uses , Gene Expression Regulation , Janus Kinases , Metabolism , Osteoporosis, Postmenopausal , Drug Therapy , Genetics , RNA, Messenger , Genetics , Metabolism , STAT Transcription Factors , Metabolism , Signal Transduction , Up-Regulation , Yin Deficiency , Drug Therapy , GeneticsABSTRACT
Objective To understand the distribution and drug resistance of pathogens from patients with anastomotic fistula infection after esophageal cancer surgery, and provide basis for clinical diagnosis and treatment.Methods Patients were admitted to a hospital due to anastomotic fistula after esophageal cancer surgery between January 2012 and December 2015, microbial culture and antimicrobial susceptibility testing results of patients were retrospectively analyzed.Results 1 986 patients underwent radical resection of esophageal cancer within 4 years, 148 of whom developed anastomotic fistula, 104 (70.27％) were with positive microbial culture.A total of 197 pathogenic strains were isolated, 52(26.40％)and 145 (73.60％)strains were isolated from intrathoracic anastomotic fistula and cervical anastomotic fistula respectively;127 (64.47％)strains were gram-negative bacteria, the major were Pseudomonas aeruginosa, Klebsiella pneumoniae, and Acinetobacter baumannii, 62(31.47％) strains were gram-positive bacteria, the major were Staphylococcus aureus, Enterococcus spp., and Streptococcus viridans, 8 strains (4.06％) were fungi.49(47.12％) cases were with mixed pathogenic infection.The resistance rates of gram-negative bacteria to imipenem were 17.86％-47.62％, to polymyxin B was 0, resistance rates of Pseudomonas aeruginosa to other antimicrobial agents were all70％, Acinetobacter baumannii to most antimicrobial agents were all>50.00％;resistance rates of gram-positive bacteria to clindamycin and tetracycline were both>50.00％, to linezolid, vancomycin, and teicoplanin were all 0, resistance rates of Staphylococcus aureus to penicillin, oxacillin, and ciprofloxacin were all>60％,resistance rate of Enterococcus spp.to quinupristin/dalfopristin was 100.00％.Conclusion Postoperative anastomotic fistula combined with infection can affect the prognosis of patients after esophageal cancer surgery, regular monitoring on distribution and drug resistance of pathogens can provide the basis for initial empirical treatment, and is conducive to the early treatment and rational use of antimicrobial agents.
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Objective To investigate the risk factors of cervical esophagogastric anastomotic fistula after esophagectomy of esophageal cancer.Methods The retrospective case-control study was conducted.The clinicopathological data of 956 patients who underwent esophagectomy and cervical esophagogastrostomy from January 2012 to December 2016 in the First Affiliated Hospital of Zhengzhou University were collected.Patients underwent Sweet or Mckeown surgery.Observation indicators:(1) intra-and post-operative situations;(2) the risk factors analysis of cervical esophagogastric anastomotic fistula after esophagectomy;(3) follow-up situations.Follow-up using outpatient examination and telephone interview was performed to detect the esophagogastric anastomotic stenosis of patients up to February 2017.Measurement data with normal distribution were represented as the (x)±-s.Univariate analysis and comparison of count data were done using the chi-square test or Fisher exact probability method.Multivariate analysis was done using the Logistic regression model.Results (1) Intra-and post-operative situations:all the 956 patients underwent successful operations,including 107 with Sweet operation and 849 with Mckeown operation.Of 956 patients,336 received thoracotomy and 620 received thoracoscopic surgery.Tumors located in upper,middle and lower esophagus were respectively detected in 143,627 and 186 patients.Operation time,volume of intraoperative blood loss and number of lymph node dissected in 956 patients were (274 ± 67) minutes,(210 ± 167) mL and 18 ± 11,respectively.Of 956 patients,117 had cervical esophagogastric anastomotic fistula,with an incidence of anastomotic fistula of 12.24％ (117/956).Of 117 patients with cervical esophagogastric anastomotic fistula,2 had early stage fistula,110 had middle stage fistula and 5 had later stage fistula;12 were cured by two-tube method (stomach tube and nutrition tube),24 were cured by three-tube method (stomach tube,nutrition tube and chest tube or mediastinal tube),43 were cured by open neck incision dressing,15 were cured by fistula cavity drainage and 17 were cured by esophageal stent implantation.Sixteen patients died in hospital postoperatively,including 6 with cervical esophagogastric anastomotic fistula and 10 without cervical esophagogastric anastomotic fistula.Duration of hospital stay of 956 patients was (16± 11)days,and durations of hospital stay of patients with and without cervical esophagogastric anastomotic fistula were (39± 19) days and (13±6) days.Postoperative pathological examinations:873,9 and 74 patients were respectively diagnosed with squamous cell carcinoma,adenocarcinoma and other types of cancer.TNM staging:stage 0,Ⅰ,Ⅱ,Ⅲ,Ⅳ and unidentified stage were respectively detected in 135,110,325,376,1 and 10 patients.(2) The risk factors analysis of cervical esophagogastric anastomotic fistula after esophagectomy:univariate analysis showed that gender,age,history of diabetes,surgical method,tubular stomach production,operation time,postoperative pulmonary infection and postoperative aspirating sputum through fiberbronchoscope were risk factors affecting cervical esophagogastric anastomotic fistula after esophagectomy,with statistically significant differences (x2 =4.179,6.174,4.427,4.377,6.266,7.057,55.036,51.806,P＜ 0.05).Multivariate analysis showed that tubular stomach production,postoperative pulmonary infection and aspirating sputum through fiberbronchoscope were independent risk factors affecting cervical esophagogastric anastomotic fistula after esophagectomy,with statistically significant differences (OR =1.922,2.907,2.323,95％ confidence interval:l.203-3.070,1.682-5.023,1.235-4.370,P＜0.05).(3) Follow-up situations:908 of 956 patients were followed up for 2-62 months,with a median follow-up time of 28 months.During the follow up,21 of 111 patients with cervical esophagogastric anastomotic fistula were complicated with cervical esophagogastric anastomotic stenosis,59 of 797 patients without cervical esophagogastric anastomotic fistula were complicated with cervical esophagogastric anastomotic stenosis,showing a statistically significant difference in cervical esophagogastric anastomotic stenosis (x2-16.803,P＜0.05).Conclusion Tubular stomach production,postoperative pulmonary infection,postoperative aspirating sputum through fiberbronchoscope are independent risk factors affecting cervical esophagogastric anastomotic fistula after esophagectomy.
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<p><b>OBJECTIVE</b>To compare the quality of life in patients with prevertebral or retrosternal reconstruction after cervical tubular gastroesophagostomy.</p><p><b>METHODS</b>A total of 167 patients enrolled in this prospective study from July 2008 to June 2012 in Shantou Central Hospital, and divided into prevertebral route group(85 cases) and retrosternal route group(82 cases) according to the random number table method. Quality of life questionnaire was investigated 1, 3, 6, 9, and 12 months after operation respectively.</p><p><b>RESULTS</b>The incidence of anastomotic stenosis was lower in the prevertebral route group (P<0.05). However, the differences in perioperative general conditions between the two groups were not statistically significant(all P>0.05). One hundred and forty-nine patients completed the postoperative quality of life questionnaire. Dysphagia and swallowing retching symptom were better, while acid reflux and heartburn symptom were more serious in prevertebral route group as compared to retrosternal route group(all P<0.05). Overall quality of life score difference between the two groups was not statistically significant(P>0.05).</p><p><b>CONCLUSIONS</b>For digestive tract reconstruction after resection of esophageal cancer, tubular gastroesophagostomy by prevertebral or retrosternal route both can obtain better quality of life after surgery. Swallowing function after surgery of the former is superior to the latter, but the reflux symptoms is more serious. Therefore the two mehods have their own advantages and disadvantages, and the choice of route should be depended on clinical experience and patient condition.</p>
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Humans , Deglutition Disorders , Digestive System Surgical Procedures , Esophageal Neoplasms , Esophagectomy , Gastrectomy , Postoperative Period , Prospective Studies , Quality of Life , Plastic Surgery ProceduresABSTRACT
Objective To investigate the expression of hypoxia-inducible factor-1?(HIF-1?) and chemokine receptor 4(CXCR4) protein in tissues of breast cancer and its association with clinicopathological features.MethodsThe expression of HIF-1? and CXCR4 protein in 60 breast cancer,30 breast fibroadenoma and 20 normal breast samples were detected by immunohistochemistry,and the relationship between the expression of HIF-1? and CXCR4 protein in the tissues of breast cancer and its association with clinicopathological factors were analysed.ResultsThere was no positive expression of HIF-1? and CXCR4 protein in normal breast tissues.The positive expression rates of HIF-1? protein in tissues of breast cancer and breast fibroadenoma were 65.0% and 26.7%,respectively(P
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The aquatic ferns of the genus Azolla are nitrogen-fixing plants that have great potentials in agricultural production and environmental conservation. Azolla in many aspects is qualified to serve as a model organism for genomic studies because of its importance in agriculture, its unique position in plant evolution, its symbiotic relationship with the N2-fixing cyanobacterium, Anabaena azollae, and its moderate-sized genome. The goals of this genome project are not only to understand the biology of the Azolla genome to promote its applications in biological research and agriculture practice but also to gain critical insights about evolution of plant genomes. Together with the strategic and technical improvement as well as cost reduction of DNA sequencing, the deciphering of their genetic code is imminent.