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"The Expert Group on Tumor Ablation Therapy of Chinese Medical Doctor Association, The Tumor Ablation Committee of Chinese College of Interventionalists, The Society of Tumor Ablation Therapy of Chinese Anti-Cancer Association and The Ablation Expert Committee of the Chinese Society of Clinical Oncology" have organized multidisciplinary experts to formulate the consensus for thermal ablation of pulmonary subsolid nodules or ground-glass nodule (GGN). The expert consensus reviews current literatures and provides clinical practices for thermal ablation of GGN. The main contents include: (1) clinical evaluation of GGN, (2) procedures, indications, contraindications, outcomes evaluation and related complications of thermal ablation for GGN and (3) future development directions. .
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Objective To observe the effects of three treatment methods on renal anemia in maintenance hemodialysis patients with hyperparathyroidism secondary to uremia and analyze the influencing factors of erythropoietin (EPO) dosage. Methods A total of 55 maintenance hemodialysis patients with secondary hyperparathyroidism at the hemodialysis center of Huashan Hospital affiliated to Fudan University from January 2015 to December 2016 were retrospectively divided into three groups according to different treatment methods, parathyroidectomy +forearm transplantation group (surgery group, n=16), cinacalcet treatment group (n=6), and calcitriol treatment group (n=33), respectively. The hemoglobin level and erythropoietin dosage were measured before treatment and in the 3rd month, the 6th month and the 12th month after treatment. The changes of hemoglobin and erythropoietin dosage in the three groups before and after treatment were observed, and the mixed effect model was used to analyze the difference of the change of hemoglobin and erythropoietin dosage among three groups. Multiple linear regression analysis was used to analyze the influencing factors of EPO dosage after one year. Results The levels of intact parathyroid hormone (iPTH) in the surgery group and the cinacalcet group before treatment were significantly higher than that in the calcitriol group (both P<0.05). In the 12th month after treatment, the levels of iPTH decreased significantly in the patients of surgery group and the cinacalcet group compared with those before treatment (both P<0.05). The levels of serum alkaline phosphatase, serum calcium and serum phosphorus in the surgery group also decreased significantly compared with those before treatment (all P<0.05). The mixed effect model analysis showed that the hemoglobin level of surgery group was on an upward trend after the treatment, and the overall level was significantly higher than cinacalcet and calcitriol treatment group (P=0.007). There was no significant difference in the dosage change of erythropoietin (EPO) in the three groups over time. However, the intra-group comparison of the mixed effect model showed that the dosage of EPO in the 12th month was significantly lower than that of before the treatment in surgery group (P=0.007). Multiple linear regression analysis showed that dialysis vintage (B=-0.064, P=0.012) and ferritin ≥ 500 μg/L (B=0.645, P=0.032) were independent influencing factors of EPO dosage. The longer the dialysis vintage, the less EPO dosage, and more EPO dosage were observed in patients with ferritin ≥ 500 μg/L. Conclusions Parathyroidectomy and forearm transplantation is more effective in reducing EPO dosage and improving renal anemia in maintenance hemodialysis patients with secondary hyperparathyroidism. Dialysis vintage and ferritin are independent influencing factors for the dosage of EPO.
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Drug addiction is a chronic relapsing brain disease that is characterized by compulsive drug use and persistence of drug craving. Drug abuse can lead to changes in the neuron structure and function of plasticity,alterations in molecules and cells,and ultimately to individual abnormal behavior. Current studies have found that epigenetic changes leading to the sustainability of gene expression is an important mechanism of drug addiction. In this review,we will systematically summarize the latest advances in epigenetic mechanisms of drug addiction. This review is expected to provide robust evidence that repeated exposure to drugs of abuse induces changes within the brain′s reward regions in three major modes of epigenetic regulation-histone modifications such as acetylation and methylation , DNA methylation,and non-coding RNAs. It promises a new perspective from which to gain insights into the genetic and epigenetic mechanisms of drug addiction and a new area for epigenetic research on clinical drug addiction treatment.
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OBJECTIVE To investigate the effect of injection of β2-adrenergic receptor agonist clenbuterol into the infralimbic cortex(IL) on drug-seeking behavior triggered by conditioned cues. METHODS Adult male SD rats were trained to self-administer heroin under a FR1 schedule for consecutive 14 d,followed by 2-h extinction training. Cue-induced heroin seeking was measured for 2 h. Clenbuterol was microinjected bilaterally into the IL(8 ng/side)of rats 15 min prior to reinstatement test. Meanwhile,locomotor activity was detected 15 min after clenbuterol or artifial cerebrospinal fluid(mod?el group) was microinjected bilaterally into IL. Western blotting was used to detect the expression of phosphorylated cyclic AMP response element-binding protein(p-CREB)in the prelimbic cortex(PL), IL,nucleus accumbens core (NACc) and shell (NACsh) of rats immediately after reinstatement test. RESULTS After heroin administration training for 14 consecutive days,these animals exhibited reliable heroin self-administration,indicated by the increase in active nose poke responses and infusions. The rats that had received infusion of clenbuterol into the IL had significantly lower active pokes (8 ± 3)than those in model group(45±10)in cue-induced reinstatement(P<0.01),but there was no significant differ?ence between clenbuterol group and vehicle group in the locomotor activity. The expression of p-CREB in either IL or NACsh was significantly decreased in clenbuterol group compared with model group(P<0.01,P<0.05),but significantly increased in NACc(P<0.01). CONCLUSION Microinjection of clenb?uterol into the IL can attenuate the cue-induced reinstatement of heroin-seeking behavior in rats. The underlying mechanism might be related to the regulation of p-CREB expression in the NACc and NACsh.
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BACKGROUND:Except for mechanical properties and physical and chemical properties, corrosion resistance testing is necessary for a variety of biomedical materials applied in the oral environment to ensure the biocompatibility of materials. OBJECTIVE:To explore the corrosion resistance of titanium abutment and different titanium aloysin vitro. METHODS:Corrosion environment byin vitroartificial saliva was constructed with pH=6.0 at (37±0.5)℃. Potentiodynamic polarization technique, scanning electron microscope and X-ray diffraction methods were employed to assess the corrosion resistance of titanium aloy, gold aloy, nickel-chromium aloy, and titanium abutment immersed in the artificial saliva for 24 hours. RESULTS AND CONCLUSION:Different aloys had different steady-state potentials, and the range of passivation region was the largest for gold aloy, folowed by titanium abutments and titanium aloys, and the smalest for nickel-chromium aloy. After 24 hours of immersion in the artificial saliva, passivation films appeared on the surface of different materials. under the scanning electron microscope, the nickel-chromium aloy surface showed obvious traces of corrosion and there were a large number of large-diameter deep pits, but no corrosion occurred on the surface of the remaining three kinds of aloys; on the surface of nickel-chromium aloy, the contents of chromium, molybdenum and aluminum were decreased, and the contents of nickel and oxygen were increased, but there were stil no changes on the surface of the remaining aloys. Cr2O3 was found on the surfaceof nickel-chromium aloy, TiO2 was generated on the surface of titanium abutment and titanium aloy, but Au and Pt stil existed in a single phase on the surface of gold aloy. These findings indicate that titanium aloy and titanium abutment have similar corrosion resistance that is inferior to the gold aloy, but better than the nickel-chromium aloy.
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Objective To compare the efficacy of transumbilical-ultrafine gastroscope sympathectomy for severe palmar hyperhidrosis using two distinct levels of T3 and T4.Methods A total of 84 cases with severe primary hyperhidrosis were randomly allocated to undergo either T3 sympathectomy treatment (T3 group, n =42) or T4 sympathectomy treatment (T4 group, n =42) with no difference between the two groups.The operation time, postoperative hospital stay, patient's hands hyperhidrosis, axillary hyperhidrosis,complications were recorded at follow-up in 1,3,6,12 months.Results Operation on 84 patients were successful with mean operative time of T3 group being 55.02 ± 10.61 min and T4 group being 55.36 ± 10.51 min(P ＞ 0.05).The mean postoperative hospital stay were both 1.5 days.Patients were followed up for diaphragmatic hernia, umbilical hernia, Horner's syndrome and other serious complications for 12 months.No postoperative recurrence of palmar hyperhidrosis, severe compensatory sweating occurred in either group.The number of improved patients in T3 group's palmar hyperhidrosis,axillary hyperhidrosis, and foot hyperhidrosis were :42/42 cases, 10/16 cases, 21/29 cases, while those in T4 group were: 42/42 cases,16/17 cases 18/28 cases.Axillary hyperhidrosis improved to a larger extent in T4 group than in T3 group (P ＜0.05).There were 16(15 mild and 1 moderate)compensatory sweating in T3 group and 7(6 mild and 1 moderate) compensatory sweating in T4 group (P ＜ 0.05).Conclusion T3 and T4 thoracic sympathectomy using transumbilical-ultrafine gastroscope for primary palmar hyperhidrosis are safe, effective, and feasible.T4 sympathectomy is more effective in improving axillary hyperhidrosis than T3 and shows lower occurrence of postoperative compensatory hyperhidrosis.
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Objective:To collect the bioburden information in clean room to understand the bioburden status, find out weak points and risks in microbial control and improve the management efficiency in clean room. Methods: According to GB/T 16293-2010 and the standard operation practice ( SOP) in our lab, the bioburden information was obtained by the collection and identification of air-borne microbe and surface bacteria in the four main areas of clean room ( microbial limit test room, sterile room 1 and 2, positive room) and on the person entered clean room. Results:The preliminarily established bioburden information indicated that the main mi-croorganism in clean room was Micrococcus and Staphylococcus. The detection rate of fungi was about 5% in clean room. Conclusion:The movement of people and goods in clean room should be strengthened, and samples should be with thorough disinfection.
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Objective To investigate the diagnostic value of the modified esophageal capsule endoscopy (stringed esophageal capsule endoscopy,SCE) for esophageal diseases.Methods A total of 80 patients with esophageal related symptoms underwent SCE followed by esophagogastroduodenoscopy (EGD).The examination time,detection rate of esophageal lesions,complications and adverse effects were compared.Results All patients completed the study.The mean examination time of SCE and EGD was 226.18 ± 1 10.30 seconds and 21.28 ± 8.01 seconds respectively (t =-16.665,P =0.000).A total of 119 lesions were detected by SCE and EGD,and the diagnostic accordance rate of SCE and EGD was 82.4％ (98/119).Ten lesions of advanced squamous carcinoma,5 lesions of high grade intraepithelial neoplasia and 3 lesions of early squamous carcinoma were detected by both examinations,all of which were confirmed by histopathologic examination.The overall rate of complication in SCE (1.3％,1/80) was significantly lower than that of EGD (8.8％,7/80,x2 =4.238,P =0.040) and the rates of swallow difficulty (P =0.022),throat discomfort (P =0.007) and vomiting (P =0.000) of SCE were significantly lower than those of EGD.Conclusion SCE is a feasible,easy-to-operate,safe,well tolerated and accurate method for detection of esophageal diseases,and could be a non-invasive alternative for conventional EGD.
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Objective To investigate the clinical value of transumbilical endoscopic thoracic sympathectomy on women patients with palmar hyperhidrosis.Methods A total of 25 consecutive women patients with palmar hyperhidrosis underwent transumblical thoracic sympathectomy with ultra-thin endoscope.The operative data,including duration of operation,intra-operative and postoperative complications were recorded.Results The procedure was performed successfully in all 25 patients with a mean operative time of 64 min(58-113 min).No umbilical hernia,diaphragmatic hernia,Horner's syndrome or hemothorax were observed.Minor pneumothorax was found in postoperative chest X-ray in 3 patients,all of which were completely resolved with conservative treatment.All patients recovered to their normal life at 1 week after discharge.The scar was small and hidden in umbilical with no visible incisions.After a follow-up of 4 to 12 months,all patients' hands sweating symptoms completely disappeared,axillary sweat symptoms completely resolved in 6 patients,significantly improved in 4 and mildly improved in 1.Conclusion Transumbilical thoracic sympathectomy with ultrathin flexible endoscope is a safe and effective option for women patients with severe palmar hyperhidrosis,which provides excellent cosmetic outcomes.
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Objective To evaluate the safety and feasibility of endoscopic transumbilical thoracic sympathectomy.Methods The technique was performed in 4 swine models.Under general anesthesia,a newly developed long abdominal trocar (60 cm in lengths) was placed through the umbilicus,which was also used to establish pneumoperitoneum.After insertion of gastroscope through this trocar,two small incisions of diagrams were created by needle-knife,through which the gastroscope was sent into the thoracic cavity to ablate the T3 ganglia by Hot biopsy forceps under One-lung ventilation.The animals were killed at the completion of the procedure.Results This procedure was completed in four pigs.The sympathetic chain was successfully ablated in all swine,as confirmed by gross surgical pathology and histology,the mean operative time was (81.7 ±15.4) minutes.There was no major bleeding.All bilateral T3 sympathetic chains were successfully ablated in the 4 swines as confirmed by gross surgical pathology and histology.There was no severe bleeding and damage to peripheral organs during the operation in any of the cases,and no prominent pneumothorax was revealed by postoperative chest X-ray radiography.Conclusion Endoscopic transumbilical thoracic sympathectomy is safe,feasible and effective with good cosmetic result.