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Objective:To explore the expectations and values of patients with malocclusion on participation in shared decision-making of orthognathic surgical protocols, and to provide references for further development of clinical shared decision-making models.Methods:Based on the expected value theory and descriptive qualitative research methods, using purposive sampling, 13 patients with malocclusion in the Ninth People's Hospital of Shanghai Jiao tong University School of Medicine from May to August in 2021 were selected for semi-structured interviews. The interview data were sorted, classified and refined by traditional content analysis.Results:Two themes were extracted: patients' ability beliefs about their ability to participate in shared decision making for orthognathic surgery(decision support ability, psychological coping ability and environmental adaptability), and task values for shared decision making for orthognathic surgery(interest value, acquisition value).Conclusions:Low level of patients′ ability beliefs in shared decision-making, active physician guidance facilitates patient participation, but the depth of patient participation is influenced by factors such as information support, cultural climate, and physical space for shared decision making. It is suggested that the magnetic role of physicians should be actively played, the shared decision-making team should be strengthened, at the same time, hospital manager should enhance shared decision making propaganda to increase the acceptance and participation of patients in shared decision making so as to improve the quality of shared decision-making.
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Head and neck squamous cell carcinoma of the head and neck is a very aggressive cancer with a poor prognosis in the late stages. Studies have revealed that head and neck squamous cell carcinoma is highly heterogeneous and immunosuppressive. The tumor microenvironment plays a key role in the development of head and neck squamous cell carcinoma, facilitating its evolution and resistance to treatment, thus adversely affecting patient prognosis. A comprehensive understanding of the tumor microenvironment could lead to new therapeutic interventions for head and neck squamous cell carcinoma. In this review, recent research findings on the tumor microenvironment and therapeutic strategies targeting the tumor microenvironment were reviewed, leading to the development of novel combination therapies to address head and neck squamous cell carcinoma and the tumor microenvironment, with the aim of gaining a deeper understanding of the disease and developing more accurate treatment plans for head and neck squamous cell carcinoma.
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Objective:To evaluate superb microvascular imaging used to monitor the hemodynamic changes in lower limb arteries in the treatment of diabetic foot by tibial transverse transport.Methods:From December 2019 to December 2021, 17 patients with diabetic foot were treated by tibial transverse transport at Department of Orthopedics, The Second Hospital of Shanxi Medical University. Superb microvascular imaging was used to observe the vascular index of the first dorsal metatarsal artery, the total blood flow of the anterior tibial artery and the posterior tibial artery, and the Wagner classification in the patients before surgery, one week and one month after surgery. Complications were documented.Results:After treatment, neovascularization was observed in all the 17 patients and detected on both the ipsilateral and contralateral sides of the surgery. At the last follow-up, the number of newborn collaterals was 7.0 (3.5, 9.0), significantly larger than that before surgery [1.0 (0, 1.5)] ( P<0.05). The vascular index of the first dorsal metatarsal artery at one week (9.70±10.88) and one month (9.22±5.46) after surgery was significantly higher than that before surgery (5.65±4.36) ( P<0.05). There was no significant difference in the total blood flow between the anterior tibial artery and the posterior tibial artery before surgery, one week or one month after surgery ( P>0.05). The Wagner classification at one month after surgery (grade 1 in 4, grade 2 in 11 and grade 3 in 2) was significantly better than that before surgery (grade 2 in one, grade 3 in 2 and grade 4 in 14) and one week after surgery (grade 2 in one, grade 3 in 5 and grade 1 in 11) ( P<0.05). One patient underwent amputation due to acute lower extremity arterial embolism 2 months after operation, and another patient underwent toe amputation due to blackening of the toes. Conclusion:Superb microvascular imaging is a valuable means of monitoring in tibial transverse transport because it can objectively reflect the hemodynamic changes and microcirculation in lower limb arteries and provide valuable information for prognosis of the condition in the treatment of diabetic foot by tibial transverse transport.
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Objective:To investigate the application value of modified Overlap esophago-gastric tube (MO-EG) reconstruction in totally laparoscopic radical proximal gastrectomy.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 7 patients with upper gastric cancer or adenocarcinoma of esophagogastric junction (AEG) who underwent totally laparoscopic radical proximal gastrectomy with MO-EG reconstruction in the Second Hospital of Jilin University from January 2019 to December 2020 were collected. There were 4 males and 3 females, aged 62(range, 55-72)years. The body mass index of the 7 patients was 21.5(range, 18.5-26.0)kg/m 2. Of the 7 patients, 2 cases had early upper third gastric cancer and 5 cases had Siewert Ⅱ AEG. All patients underwent totally laparoscopic radical proximal gastrectomy with MO-EG recons-truction using barbed sutures. Observation indicators: (1) surgical situations; (2) postoperative recovery situations; (3) postoperative histopathological examinations; (4) follow-up. Follow-up was conducted using outpatient examination and telephone interview to detect postoperative esophageal reflux, endoscopic classification of esophageal reflux, anastomotic complications, tumor recurrence and metastasis and survival of patients up to December 2021. Measurement data with normal distribution were represented as Mean±SD and measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers. Results:(1) Surgical situations. All the 7 patients underwent totally laparoscopic radical proximal gastrectomy and D 1+ lymph node dissection with MO-EG reconstruction through abdominal transhiatal approach. None of the 7 patients underwent conversion to open surgery or additional thoracotomy. The operation time, time of digestive reconstruction, volume of intraoperative blood loss and length of esophagus dissected of 7 patients were (271±36)minutes, (44±10)minutes, (53±26)mL and (6.4±0.3)cm, respec-tively. (2) Postoperative recovery situations. The time to postoperative initial out-of-bed activities, time to postoperative first flatus, time to postoperative initial liquid food intake and duration of hospital stay of 7 patients were (21±5)hours, (2.9±0.9)days, (5.0±0.7)days and (10.1±1.9)days, respectively. None of the 7 patients had postoperative severe complications such as bleeding, anasto-motic leakage or mortality. One patient had postoperative pulmonary infection and recovered after anti-infection treatment. Two patients had pleural effusion and were improved after conserva-tive treatment. (3) Postoperative histopathological examinations. The tumor diameter of 7 patients was (2.5±0.7)cm. Histopathological examination of upper margins of 7 patients was negative. The distance between the esophagus margin and the superior margin of the tumor of patients with AEG was (1.8±0.6)cm. The number of lymph node dissected and the number of inferior mediastinum lymph node dissected of 7 patients were 26.0±3.6 and 3.7±1.1, respectively. Pathological TNM stages of 7 patients were 2 cases of stage ⅠB, 4 cases of ⅡA, 1 case of ⅡB. (4) Follow-up. All the 7 patients were followed up for 18(range, 12?36)months. Of the 7 patients, 4 cases reported asymptomatic, 2 cases had symptoms of reflux and 1 case had chocked feeling after eating. All the 7 patients underwent barium meal examination of gastrointestinal tract without anastomotic dysfunction or anastomotic stenosis. Six of the 7 patients underwent gastroscopy at postoperative 1 year and only 1 of them reported grade B reflux esophagitis according to Los Angeles classification, while the rest of 5 patients had no evidence of obvious reflux. None of the 7 patients had postoperative gastric cancer tumor recurrence, metastasis or death. Conclusion:Application of MO-EG reconstruction in totally laparoscopic radical proximal gastrectomy is safe and feasible, with satisfactory short-term effects.
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The study aims to improve the level of fine management of medical equipments, give full play to the functions and roles for better patient service, and explore methods for evaluating the benefits of medical equipment that can take into account and reflect the needs of multiple parties. Based on objectives and key results(OKR) methods and concepts, a benefit evaluation system was developed with the goal of giving full play to the functions and roles of medical equipments, with corresponding evaluation indexes and supervision and evaluation mechanisms formulated as well. This index system could take into account the needs and concerns of hospitals, the departments in use, the management authorities and patients at large, while contributing to process supervision and continuous improvement. In the OKR practice of large medical equipments(CT, MR) from 2018 to 2019, they had performed significantly better in inspections, inspection positive coincident rates, clinical service capabilities, maintenance assurance levels, patient satisfaction, scientific research and academics among others. The use of a medical equipment benefit evaluation system based on OKR concepts and methods can provide effective evaluation indicators for the operation and management of medical equipments. In addition, the system can maintain internal improvement momentum leveraging process supervision and continuous improvement methods, in order to assure the elevation of fine management level of medical equipments of modern hospitals, thus offering better medical services for patients at large.
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Objective:To assess the urethral mobility of normal parous women in China and explore the impacts of related risk factors on it using translabial ultrasound.Methods:Females who met the inclusion criteria in 37 tertiary hospitals from February 2017 to August 2018 were included. All women underwent standardized translabial ultrasound examination and the urethral rotation angle (URA), bladder neck position at maximum Valsalva maneuver (BNP-V) and bladder neck descent (BND) were measured. Questionnaires were used to collect basic information including age, height, weight, body mass index (BMI), past medical history, maternity history, and urinary incontinence related history. Mann-Whitney U test and multiple linear regression analysis were adopted to explore the influences of age, BMI, delivery mode and parity on normal parous women′s urethral mobility. Then, the study subjects were divided into different groups and the corresponding values of URA, BNP-V and BND were compared. Results:Compared with parous women with normal BMI and no history of vaginal delivery, those who were overweight and/or had a history of vaginal delivery were more likely to gain greater URA and BND ( P<0.05). The URA and BND were not significantly different between women with different times of cesarean sections ( P>0.05); while for women with a history of vaginal delivery, these two parameters increased with the increase of the number of transvaginal deliveries ( P<0.05). Conclusions:BMI and vaginal delivery are important risk factors for the urethral mobility of normal parous women. The urethral mobility increases with the increase of BMI and the number of vaginal deliveries.
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Objective:To understand the problems and countermeasures of information support for dentofacial deformities patients, so as to provide reference for optimizing the whole process of information support for orthognathic-orthodontics treatment.Methods:Using a descriptive research method, 10 orthognathic surgery and orthodontics specialists from a tertiary level A hospital were selected for semi-structured interviews in August and September, 2019 using the method of target sampling. The QSR Nvivo 12.0 software was used for analysis by adopting traditional content analysis.Results:According to the analysis, medical experts believed that the problems of information support in the whole treatment process of orthognathic-orthodontics treatment include the following three aspects: information content problems (incomplete information content, lack of "time" dimension, patient's psychological expectation and treatment outcome information asymmetry, lack of information for main caregivers), difficulties in information support (clinical workload, professional limitations, many key time nodes), existing network information problems (poor quality of network information, lack of pertinence of information content and the existing network resources were not effectively utilized); and three suggestions were put forward: customizing the treatment schedule of patients, developing diversified information support methods, optimizing patient treatment process.Conclusion:Medical staff should pay attention to the construction and improvement of the whole treatment information support content of dentofacial deformities patients, pay attention to the diversity of information support methods, optimize the patient treatment process, encourage the health care to cooperate with the homogenization management of the whole treatment information support, and explore the information support system suitable for the situation of dentofacial deformities patients in China.
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Objective:To investigate the changes of plasma ghrelin levels and insulin(INS) sensitivity of full-term infants small for gestational age (SGA) and the effects of breast feeding on it.Methods:Full-term SGA hospitalised in the Department of Neonatology, Wuhan Children′s Hospital from October 2014 to April 2019 were re-cruited as the SGA group (120 cases), with full-term infants appropriate for gestational age (AGA) born in the same period as the AGA group (96 cases) in this study with recorded birth weight and length.The levels of fasting blood glucose (FG), triglyceride (TG), low density lipoprotein (LDL), high density lipoprotein (HDL), INS and ghrelin were measured 7 days after birth.Homeostasis model assessment-insulin resistance (HOMA-IR) was calculated.The SGA group was subdivided into breast feeding group and formula feeding group.The above indexes were tracked and mea-sured in the 3 rd and 6 th month, respectively, and their growth parameters were recorded. Results:There were no diffe-rences in serum FG, TG, LDL and HDL levels between the SGA and the AGA group (all P>0.05). Compared with the AGA group, the serum INS[(4.21±0.83) mIU/L vs.(3.54±1.10) mIU/L], ghrelin levels[(0.80±0.23) μg/L vs.(0.69±0.19) μg/L] and HOMA-IR (0.85±0.25 vs.0.72±0.25) increased in the SGA group, the differences were statistically significant (all P<0.05). Serum INS, HOMA-IR and ghrelin levels changed with the duration of breast feeding, the differences were statistically significant( F=12.394, 9.810, 5.531, all P<0.05). Conclusions:The serum ghrelin levels of SGA infants increased and INS sensitivity decreased.Breastfeeding can decrease levels of serum INS, HOMA-IR and ghrelin, and can improve INS sensitivity of SGA infants.
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Objective:To investigate the feasibility of transperineal ultrasound in quantitative assessment of posterior compartment prolapse among Chinese women.Methods:The prospective multicenter study enrolled 485 women between January 2017 and January 2019. All patients underwent a standard clinical interview, pelvic organ prolapse quantification (POP-Q) examination and transperineal ultrasound examination. Volume data of transperineal ultrasound examinations were obtained at rest and in maximal Valsalva maneuver.Results:The higher POP-Q stage of posterior compartment, the lower rectal ampulla position in maximal Valsalva maneuver (POP-Q stage=0 vs POP-Q stage=1, P<0.001; POP-Q stage=1 vs POP-Q stage≥2, P<0.001), and the greater rectal ampulla hypermobility (POP-Q stage=0 vs POP-Q stage=1, P<0.001; POP-Q stage=1 vs POP-Q stage≥ 2, P=0.007). The rectal ampulla position at rest and in maximal Valsalva maneuver and rectocele depth were correlated with prolapse symptoms ( r=-0.200, P<0.001; r=-0.252, P<0.001; r=0.086, P=0.045). The corresponding cut-off values of rectal ampulla position in maximal Valsalva in diagnosing posterior compartment prolapse (POP-Q stage ≥1) and clinical significant posterior compartment prolapse (POP-Q stage ≥2) were 7.32 mm below the symphysis pubis and 12 mm below the symphysis pubis, respectively, with the area under the ROC curve as 0.75 and 0.85, respectively. Conclusions:The ultrasonic measurements by transperineal ultrasound is significantly associated with POP-Q examination in posterior compartment, and it is demonstrated as a useful tool in quantitative assessment of the severity of posterior compartment prolapse.
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Objective:To investigate the association between levator hiatus area, pelvic organ prolapse quantification (POP-Q) examination and prolapse symptoms.Methods:The prospective multicenter study enrolled 996 female patients between January 2017 and January 2019. All enrolled patients underwent a standard clinical interview, POP-Q examination and transperineal ultrasound examination. Volume data of pelvic floor ultrasound examinations were obtained at rest, during contraction and during maximal Valsalva maneuver. The association between levator hiatus area, POP-Q examination and prolapse symptoms was analyzed. The performance of levator hiatus area on maximal Valsalva for assessing significant POP(POP-Q stage≥2) and prolapse symptoms were also evaluated.Results:There were significant differences of levator hiatus area at rest, during contraction and during maximal Valsalva among patients with different POP-Q stages (all P<0.001). Levator hiatus area during maximal Valsalva showed the highest correlation with abdominal dragging sensation ( r=0.277, P<0.001). The area under the ROC curve (AUC) of levator hiatus area during maximal Valsalva for significant POP (POP-Q stage≥2) was significantly higher than that for prolapse symptoms (AUC: 0.77 vs 0.69, P<0.001). Conclusions:Levator hiatus area on transperineal has moderate correlation with POP-Q examination and their association is stronger than the correlation between ultrasound findings and prolapse symptoms.
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Objective:To explore whether endoscopic surgery can achieve the same effect on thyroid cancer as open surgery.Method:44 cases were selected to endoscopic thyroidectomy with breast areola approach, who were prepared to accept the surgical treatment of thyroid cancer with cT1N0 stages, female, ≤60 years old, no history of neck surgery and beauty desire. Fifty patients with the same conditions undergoing thyroid open surgery were as the control group.Results:Operative time of endoscopic group[ (170.0±28.0) min] was longer than that of the open operation group[ (90.0±21.0) min ( t=15.610, P=0.000) ]. There was no significant difference between the two groups in surgical complications ( P>0.05) . There was no statistical difference between the number of paratracheal and anterior tracheal lymph nodes of endoscopic group (6.0 ±4.2) and open surgery group (5.5 ±3.7) ( t=0.692, P>0.05) . There was no statistical difference between the number of anterior laryngeal lymph nodes of endoscopic group (0.7 ±1.1) and open surgery group (0.5 ±0.9) ( t=1.186, P>0.05) . Conclusion:The breast areola approach endoscopic thyroidectomy is safe and reliable in treatment of thyroid cancer, and the central cervical lymph node dissection is sufficient, which can be used as the choice of operation mode for thyroid cancer patients in cT1N0 stage.
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At present, nucleic acid testing technology has been widely used in clinical laboratory diagnosis. Conventional detection technique such as real-time PCR is complicated, time consuming, and dependent on specific instruments. Clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR associated protein (Cas) system is an adaptive immune defense system against viruses in bacteria and archaea, which has been developed into a powerful technology for genome editing. Recently, the leading groups engaged in CRISPR have set up new tools for nucleic acid detection based on Cas13a, Cas12a and newly discovered protein-Cas14, which plays an important role in rapid diagnosis of infectious diseases, detection of gene mutations in cancer and genotyping. Since they are ultrasensitive, specific, rapid and cost-effective, it is expected to bring great potential for molecular diagnosis. In this review, the mechanism of CRISPR/Cas system and the principle, the applications of the newly-developed diagnostic platforms are introduced. What′s more, the advantages, limitations and prospects of the technologies are summarized.
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Objective To evaluate the effectiveness of computer aided design (CAD) and three bit printing in the management of orthognathic surgery.Methods A total of 5 cases of patients with jaw deformity were involved in this study;jaw teeth and CT scanning laser scanning hefore surgery,virtual surgery design of 3D reconstruction and fusion data were analyzed,according to the design scheme of double jaw surgery combined with genioplasty;design and 3D printing of maxillary Le Fort Ⅰ osteotomy,genioplasty titanium alloy resin osteotomy and positioning guide,sagittal split ramus osteotomy by 3D printing and plate technology were used in this approach.The postoperative results were compared with the surgical planning by three-dimensional measurement and statistical analysis.Results When the operation guide plate was applied smoothly,the maximum error for maxilla was 1.2 mm (0.3-1.2 mm),and the maximum error for genioplasty was 1.7 mm,(0.5-1.7 mm),and the mean error was less than 1 mm.Follow-up for 12 months showed no adverse reaction.Conclusions Three dimensional printing surgical guide plate can accurately provide the osteotomy information,effectively control the jaw movement,and improve the orthognathic surgery accuracy of patients with partial jaw deformity.
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Small nucleolar RNAs(snoRNAs) constitute a large group of non-coding RNAs. Canonical snoRNAs contain C/D box and H/ACA box types, with the length of 60-300 nucleotides. They are predominantly engaged in 2′-O-methylation or pseudouridylation of ribosomal RNAs. Mounting evidence supported that snoRNAs were a kind of detectable modulators affecting multiple cell behavior and eventually triggered tumorigenesis. The aberration of snoRNAs could regulate cancer-related signal pathways, expedite degradation of p53 protein and induce self-renewal. Herein, the snoRNAs′ structure and the latest progress of snoRNAs research in malignancy were briefly summarized, hoping to provide a new idea for the discovery of effective therapeutic targets and promising tumor prognosis markers.
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Objective:To explore the expression level of serum exosomal miR-223-3p in patients with multiple myeloma (MM) and evaluate its clinical application.Methods:A case-control study was performed. Serum samples were collected from the Department of Hematology, Affiliated Hospital of Nantong University from March 2018 to August 2019, including 68 newly diagnosed untreated MM patients (16 in stage Ⅰ, 22 in stage Ⅱ and 30 in stage Ⅲ), 56 healthy controls and 30 patients with recurrent MM in the same period, and follow-up patients who underwent chemotherapy for 3 months after initial diagnosis. Serum exosomes were purified and identified, RNA was extracted, and RT-qPCR was performed to compare the levels of miR-223-3p in serum exosomes between the groups. The correlation between exosomal miR-223-3p levels and clinical pathological data was analyzed, and the diagnostic efficacy was evaluated by ROC curve.Results:Compared with healthy controls (0.92±0.29), the expression level of serum exosomal miR-223-3p in newly diagnosed MM patients (0.52±0.23) decreased significantly ( U=565, P<0.000 1). According to the international staging system of MM, the expression level of serum exosomal miR-223-3p in patients with stage Ⅰ(0.67±0.26) was significantly higher than that in patients with stage Ⅱ (0.47±0.21) and Ⅲ (0.48±0.19) ( U values were 96.5 and 138 respectively, P were all less than 0.05). In addition, the expression level of serum exosomal miR-223-3p increased after 3 months of chemotherapy (0.69±0.19) compared with that before chemotherapy (0.50±0.22) ( U=228.5, P=0.000 8). Compared with the healthy control group (0.84±0.21), the expression level of serum exosomal miR-223-3p in recurrent MM patients (0.65±0.18) was also decreased ( U=244, P=0.002). At the same time, the expression level of serum exosomal miR-223-3p may be related to the low expression of albumin ( U=411.5, P=0.043 1) and bone damage ( U=309, P=0.001). The ROC curves showed that the AUC of serum exosomal miR-223-3p in the diagnosis of MM was 0.853, which was higher than that of β 2-microglobulin (β 2-MG) (AUC=0.805) and albumin (AUC=0.743). The AUC of the three combined detection was 0.918. Conclusions:Serum exosomal miR-223-3p can be used as a potential marker for auxiliary diagnosis of MM, and its combination with β 2-MG and albumin can improve the diagnostic efficacy of MM.
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At present, nucleic acid testing technology has been widely used in clinical laboratory diagnosis. Conventional detection technique such as real-time PCR is complicated, time consuming, and dependent on specific instruments. Clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR associated protein (Cas) system is an adaptive immune defense system against viruses in bacteria and archaea, which has been developed into a powerful technology for genome editing. Recently, the leading groups engaged in CRISPR have set up new tools for nucleic acid detection based on Cas13a, Cas12a and newly discovered protein-Cas14, which plays an important role in rapid diagnosis of infectious diseases, detection of gene mutations in cancer and genotyping. Since they are ultrasensitive, specific, rapid and cost-effective, it is expected to bring great potential for molecular diagnosis. In this review, the mechanism of CRISPR/Cas system and the principle, the applications of the newly-developed diagnostic platforms are introduced. What′s more, the advantages, limitations and prospects of the technologies are summarized.
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OBJECTIVE：To study the effects of Calpeptin inhibitor Calpeptin on the transformation and stemness markers expression induced by estradiol（E2），and to investigate its mechanism. METHODS ：Taking human mammary epithelial cells MCF-10A as research object ，transformed cells were induced by E 2 treatment. Cells were divided into control group （0.1％DMSO）， E2-transformed group （50 nmol/L），E2-transformed+Calpeptin group （50 nmol/L E 2+1 μmol/L Calpeptin），then continuously treated with corresponding drug-containing culture medium for 15 generations. Then ，MTT assay was used to determine the proliferation rate of cells （24，48 h）；plate colony test was used to detect the Clone formation rate of cells ；the number of sphere-forming cells was measured by suspension spheroidization test ；mRNA expressions of stemness marker （CD44，Nanog，OCT4）and extracellular sigal-regulated kinase （ERK）were detected by RT-qPCR ，and protein expressions of CD 44，Nanog，OCT4 ，ERK and p-ERK were detected by Western blotting assay. Another E 2-transformed cells were divided into control group （0.1％DMSO）and U0126 （ERK inhibitor ）group（10 μmol/L）. Clone formation rate ，the number of sphere-forming ，protein expressions of CD 44，Nanog， OCT4，ERK and p-ERK were determined with above methods ，and to validate the relationship of ERK inhibition with transformed cell behavior and the expression of stemness markers. RESULTS ：Compared with control group ，proliferation rate and clone formation rate of E 2 transformed group were increased significantly （P＜0.01），and the number of sphere-forming was increased significantly（P＜0.01）；mRNA expression levels of CD 44，Nanog，OCT4，ERK and protein expression levels of CD 44，Nanog， OCT4 and p-ERK in cells were increased significantly （P＜0.01）. Compared with E 2-transformed group ，proliferation rate （24，48 h）and clone formation rate of E 2-transformed + Calpeptin group were decreased significantly （P＜0.01），and the number of sphere-forming was decreased significantly （P＜0.05）；mRNA expression levels of CD 44，Nanog，OCT4 ，ERK and protein expression levels of CD 44，Nanog，OCT4，p-ERK in cells were decreased significantly （P＜0.05 or P＜0.01）. After treated with ERK inhibitor U 0126，clone formation rate of E 2-transformed cells ，the number of sphere-forming ，protein expression levels of CD44，Nanog，OCT4 and p-ERK were increased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS ：Calpeptin can inhibit the transformation and the expression of stemness markers of human mammary epithelial cells MCF- 10A，and the mechanism of it may be associated with inhibiting the activation of Calpain-ERK signaling pathway.
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Objective@#To summarize the effect of simultaneous orthognathic surgery along with mandibular ramus reconstruction using costochondral graft, for adult M3 hemifacial macrosomia.@*Methods@#From November 2015 to October 2017, 5 adults diagnosed with M3 hemifacial macrosomia were treated. There were 3 males and 2 females, aged from 19 to 26 years. Le Fort Ⅰ osteotomy and SSRO with simultaneous mandibular ramus reconstruction using contralateral sixth or seventh costochondral graft was performed to correct the facial asymmetry and occluding relation. The data of clinical examination and CTs were collected at the time point of immediately postoperative, 1, 3, 6, 12 months after surgery. The facial symmetry, joint function, occlusion and 3D measurements in CT image reconstruction were analysed to evaluate the surgery outcome.@*Results@#The length of rib and costal cartilage ranged from 47 mm to 67 mm. All the costal cartilage grafts survived, and 4 patients got primary healing. All patients were followed for 2-13 months (with the mean follow-up of 8 months). The ratio of ramus length of affected side to normal side was over 80%. The occlusion was stable. The facial structures were satisfactory after 6 months.@*Conclusions@#Orthognathic surgery with simultaneous mandibular ramus reconstruction using costochondral graft is suitable for the adult severe hemifacial macrosomia, with satisfactory cosmetic and functional results. This method is easily performed with reliable graft survival rate, aesthetic facial structure and stable occlusion.
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Exosomes are a class of extracellular vesicles that secreted by a variety of cells, with the length of 40-100 nm and a lipid bilayer membrane structure. They are often observed in multiple body fluids and are important mediators in intercellular communication. Several researches demonstrated that exosomes are closely linked to the development, invasion, metastasis, and drug resistance of colorectal cancer (CRC). In this review, the role of CRC-derived exosomes in the pathogenesis, diagnosis, prognosis and treatment of CRC were briefly summarized to provide a strategy for new therapeutic targets in CRC.
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Objective@#To evaluate the feasibility and efficacy of a self-made arborizing clinical pathway(ACP)in acute pediatric intussusceptions and appendicitis.@*Methods@#Based on the clinical pathway(CP)-node concept, an ACP electronic template with some CP branches for dealing with significant variations was made, using a doctor-advices package in the CP program of the Clinical Information System in our hospital.From February 2018 through January 2019, children inpatients diagnosed with acute intussusceptions at our hospital accepted the ACP or the conventional CP management respectively according to parity of admitted order.@*Results@#426 children diagnosed with intussusceptions and 612 children diagnosed with appendicitis were included. After excluding some unqualified samples, 216 intussusception and 302 appendicitis children were enrolled in the observation group respectively which was subject to the ACP, 210 and 310 in the control group subject to the conventional CP. There were no significant differences between the observation and control groups in both diseases about patient demographics and therapeutic approach. The CP implementation-quality differences between the two groups in both diseases were observed and compared. Significant differences were found between the two groups in both diseases about CP completion rate(97.2% versus 90.5% and 97.7% versus 90.1%), the rate of outside-CP doctor′s orders((4.6±1.3)% versus (19.3±5.3)%and(6.1±1.7)%versus (20.3±5.1)%), the hospitalized period((2.7±0.3)d versus (3.2±0.4)d and(5.6±0.4)d versus (6.2±0.5)d), the hospitalization costs and the satisfaction rate.@*Conclusions@#ACP belongs to one of compound CPs, is appropriate to use in these solitary diseases with significant variations. ACP can deal with the CP problem of significant variations rooted in the diseases or treatments, thus contributing to promotion and application of CP.