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Objective:To compare the effects of thoracoscopic anatomical segmentectomy and thoracoscopic lobectomy on patients' respiratory function.Methods:Retrospective analysis of 326 patients who underwent thoracoscopic surgery from July 2016 to July 2019(209 patients underwent anatomical segmentectomy, 117 patients underwent lobectomy). According to variables including gender, age, tumor location, smoking history and BMI, two propensity score-matched cohorts including 89 patients respectively were constructed. The patients’ baseline data and respiratory function date of the patients pre-operation and post-operation were analyzed. The measurement data that obey the normal distribution were described by mean±standard deviation, and the t-test was used for comparison between groups; the measurement data of non-normal distribution was described by the median value( P25, P75), and the Wilcoxon rank sum test was used for the comparison between groups; The data was described by frequency, and the chi-square test or Fisher's exact probability method was used for comparison between groups. Results:At the first-month follow-up after surgery, there was no significant difference in the variation of FVC[(0.48±0.40)L vs.(0.34±0.37)L, P=0.215)and FEV1[(0.52±0.46)L vs.(0.43±0.77)L, P=0.364), and in the change rate of FVC(%)[15.23(8.74, 21.25) vs. 14.58(7.75, 19.40), P=0.122], FEV1(%)[17.25(9.56, 22.78) vs. 16.42(9.15, 20.28), P=0.154]and DLCO(%)[18.54(10.88, 25.68)vs. 17.45(9.58, 23.75) P=0.245]. Between the segmentectomy group and lobectomy group, there was a significant difference in the alteration of FVC[(0.50±0.47)L vs. (0.29±0.31)L, P=0.031] and FEV1[(0.44±0.34)L vs.(0.24±0.23)L, P<0.001], the change rate of FVC(%)[14.27(7.87, 22.32) vs. 9.95(5.56, 17.24), P=0.008]、FEV1(%)[15.23(8.36, 22.17)vs. 10.05(5.15, 18.54), P<0.001]and DLCO(%)[13.74(6.24, 19.78) vs. 4.45(-2.32, 13.75), P=0.023]in the 6th month after surgery. The lobectomy group had a higher variation of FEV1[(0.34±0.49)L vs.(0.18±0.26)L, P=0.006] and change rate of FVC(%)[9.28(2.15, 18.94) vs. 5.24(0.52, 11.45), P=0.0032] and FEV1(%)[10.45(3.15, 21.32) vs. 6.50(1.55, 14.24), P<0.001] in the first year after surgery. However, the variation of FVC[(0.29±0.36)L vs.(0.21±0.24)L, P=0.176) and the change rate of DLCO(%)[8.35(2.15, 16.45) vs. 6.23(2.12, 14.54), P=0.143] didn't show a significant difference between the two groups. Conclusion:Whether in the short or the middle postoperative period, segmentectomy can preserve postoperative respiratory function than lobectomy.
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Objective:To evaluate the effect of preoperative cognitive behavioral therapy (CBT) on pain catastrophizing in the patients with orthopedic trauma.Methods:A total of 120 patients with lower extremity bone trauma, aged 18-64 yr, of American Society of Anesthesiologists physical status Ⅰor Ⅱ, with body mass index of 18-28 kg/m 2, with Pain Catastrophic Scale (PCS) score on admission >16, scheduled for surgical treatment, were enrolled.The patients were divided into 2 groups ( n=60 each) by the stratified randomization method based on the type of fracture: CBT group and routine group (group R). Group CBT received CBT for pain through the internet on the day of admission and one day before operation.The patients in both groups underwent reduction and internal fixation of lower extremity fractures under combined spinal-epidural anesthesia.The PCS scores were recorded immediately after admission and on the morning of the operation day.The effective pressing times of the patient-controlled analgesia pump, consumption of analgesics for rescue analgesia, and occurrence of nausea and vomiting within 48 h after operation were recorded.The visual analogue scale score of the surgical site during activity and occurrence of the score >3 at 3 months after operation and use of opioids within 3 months after operation were recorded. Results:Compared with group R, the PCS score was significantly decreased on the morning of the operation day, the pressing times of the patient-controlled analgesia pump, consumption of analgesics for rescue analgesia and incidence of nausea and vomiting within 48 h after operation were decreased, the requirement for opioids within 3 months after operation was decreased ( P<0.05), and no significant change was found in VAS score during activity and occurrence of the score >3 at 3 months after operation in group CBT ( P>0.05). Conclusions:Preoperative CBT can reduce the degree of pain catastrophizing and is helpful in increasing the quality of postoperative analgesia in the patients with orthopedic trauma.
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Objective:To explore the optimal labeling conditions of 177Lu-1, 4, 7-triazacyclononane-1, 4, 7-triacetic acid (NOTA)- D-Phe1-Tyr3-Thr8-octreotide (TATE), and evaluate its biodistribution and imaging characteristics in mice. Methods:The reaction temperature, pH, reaction time and other labeling conditions were changed to realize the rapid labeling of NOTATATE by 177Lu. The optimal labeling conditions, radiochemical purity, in vitro stability, plasma protein binding rate, and lipid-water partition coefficient were determined. Twenty-four normal KM mice were divided into 6 groups by random number table method. After injected with 3.7 MBq 177Lu-NOTATATE through tail vein, they were sacrificed at 0.5, 1, 4, 24 h and 4, 6 d respectively to research the biological distribution (injection dose rate per gram of tissue percentage, %ID/g). Six normal mice were randomly divided into 2 groups and injected with 11.1 MBq 177Lu-NOTATATE and 177Lu-1, 4, 7, 10-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid (DOTA)TATE, respectively. SPECT planar imaging was performed at 1, 2, 3 h after injection. Another 8 mice were divided into 4 groups, injected with 3.7, 7.4, 18.5 MBq 177Lu-NOTATATE and saline respectively for an acute toxicity test. Results:At pH 5 and reaction temperature between 95 ℃ and 100 ℃ for 15 min, the labeling rate could reach more than 98%. After being placed in human serum for 24 h, the radiochemical purity was still higher than 95%. The plasma protein binding rate of 177Lu-NOTATATE was (58.6±1.9)% and the lipid-water partition coefficient was 0.048±0.014. In normal mice, the concentration of radioactivity is mainly in the liver, kidney and spleen, especially in the kidney (up to (29.120±1.204) %ID/g after 0.5 h of injection), which is less distributed in the blood and excreted rapidly. Compared with 177Lu-DOTATATE, 177Lu-NOTATATE was excreted faster by the kidney. The toxicity study results revealed that no damage was observed in mice of each group, and no obvious damage or inflammatory changes were observed in organ tissue sections. Conclusions:The optimal labeling condition of 177Lu-NOTATATE were determined in this study. The physical, chemical, and biological properties of 177Lu-NOTATATE were proved to be good and safe, and it was excreted faster by the kidney than 177Lu-DOTATATE. The results of this study lay a foundation for further clinical transformation research.
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Objective:To evaluate the quantitative diagnostic value of controlled attenuation parameter (CAP) in health checkup groups with asymptomatic nonalcoholic fatty liver disease.Methods:A multicenter prospective study was conducted among Chinese individuals undergoing regular health checkups; a total of 173 subjects were investigated. Human body indexes such as height, weight, and blood pressure were measured, and complete blood count, liver function, blood lipid, FibroScan, and MRI-PDFF examinations were performed. Correlation between MRI-PDFF and CAP was described using Spearman′s and Pearson′s coefficients. Diagnostic efficacy of the CAP was evaluated using the subject work characteristic curve and the area under this curve, and the optimal cut-off value was determined according to the Youden index.Results:The average age and body mass index of the subjects were 45.0±10.5 years and 25.8±4.0 kg/m 2, respectively. A linear correlation was found between CAP and lg transformed magnetic resonance imaging-based proton density fat fraction results (Pearson′s coefficient 0.772, P<0.001). When optimized for ≥90% sensitivity, the CAP cutoff for staging ≥S1 steatosis was 244 dB/m. Conclusions:The CAP result was significantly correlated with the liver fat fraction measured by MRI-PDFF, and capable of differentiating steatosis grades. CAP can be used as a tool for screening fatty liver in health checkup groups.
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Objective@#To investigate the effect and possible mechanism of berberine (Ber) on myocardial injury induced by exhaustion exercise (Ee).@*Methods@#Forty healthy male SPF Sprague-Dawley rats were randomly divided into 5 groups using the random unit group design method: control group, Ee group and Ee plus Ber group (low: 50 mg·kg-1·d-1, medium: 100 mg·kg-1·d-1 and high dose: 150 mg·kg-1·d-1, n=8 each). Ber (1.5 ml) or equal volume saline was given per gavage for 14 days. Rats assigned to Ee groups underwent Ee swimming once daily and rats in control group remain sedentary. After 14 days, echocardiographic measurements were performed and left ventricular ejection fraction (LVEF) and fractional shortening (LVFS), left ventricular diastolic diameter (LVIDd) and left ventricular systolic diameter (LVIDs) were obtained. The morphological structure of heart was detected by HE and Masson staining. Serum superoxide dismutase (SOD) and malondialdehyde (MDA) were measured by enzyme-linked immunosorbent assay. Cardiomyocytes apoptosis was detected by TUNEL method. The protein expression of myocardial hypertrophy marker protein B-type natriuretic peptide (BNP) and apoptotic marker protein (Bcl-2, Bax) in rat myocardial tissue was detected by Western blot.@*Results@#(1) Both LVFS and LVEF were significantly lower, and LVIDs and LVIDd were significantly larger in Ee group than those in control group (all P<0.01). The LVFS and LVEF in medium dose of Ber and high-dose Ber groups were significantly higher, and the LVIDs and LVIDd were significantly smaller than those in Ee group (all P<0.01). (2) The results of HE staining showed that the myocardial cells in control group were closely arranged, regular, normal in morphology, clear in structure, and uniform in staining. The myocardial cells of rats in Ee group were disarranged, cell staining was uneven, and vacuoles appeared in the cytoplasm. The disorder of myocardial cell arrangement and unequal staining in the medium dose of Ber were attenuated than in Ee group. The Masson staining results showed that the myocardial cells in control group were closely arranged, regular, normal in shape, clear in structure, and rarely blue-stained (fibrosis). Myocardial cells in rats in Ee group showed obvious fibrosis. The myocardial cell fibrosis in rats with medium dose of Ber was significantly reduced than exercise group. (3) MDA content in myocardial tissue of rats in Ee group was significantly higher than that of control group, and MDA content in myocardial tissue of rats in medium dose of Ber group was significantly lower than in Ee group (P<0.01). The SOD activity of myocardial tissue in rats was significantly lower than that of control group, while that of rats with medium dose of Ber was significantly higher than that of rats in Ee group (P<0.01). (4) TUNEL staining results showed that only a small amount of apoptosis myocardial cells were seen in control group, and a large number of apoptosis myocardial cells were seen in rats in Ee group. However, the number of apoptotic cardiomyocytes in medium dose of Ber was significantly lower than that in Ee group. The AI of rat cardiomyocytes was significantly higher than that of control group (P<0.01), and the AI of rat cardiomyocytes in median dose of Ber group was significantly lower than in Ee group (P<0.01). (5) BNP and Bax protein expression in the myocardial tissues of rats in Ee group were significantly higher than in control group (P<0.01). BNP and Bax protein expression in the myocardial tissues in median dose of Ber group were significantly lower than that of Ee group (P<0.01). The myocardial protein expression level of Bax was significantly higher, and the myocardial protein level of Bcl-2 was significantly lower in Ee group than in control group (both P<0.01), treatment with median dose of Ber could partly reverse above changes (both P<0.01).@*Conclusion@#Ber can attenuate exhaustion exercise induced myocardial injury and remodeling in rats, and the beneficial effects of Ber might possibly be mediated by reducing free radical release and cardiomyocytes apoptosis.
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Objective To evaluate the accuracy of different anatomic landmark methods in determining the size of nasopharyngeal airway.Methods Fifty-two patients of both sexes,aged 16-60 yr,of American Society of Anesthesiologists physical status Ⅰ to Ⅲ,with body mass index of 18-30 kg/m2,scheduled for elective awake craniotomy for supratentorial tumors under sedation-awake-sedation anesthesia,were included.For each patient,the distance from the apex of nose to the right tragus (NT),distance from apex of nose to the right mandibular angle (NM),and thyro-mental distance (TM) were measured and marked on a transnasal tube correspondingly.The patients were placed in supine position without pillow,topical anesthesia (nasal mucosal surface) was performed with 2％ lidocaine,and patients were sedated with midazo1am,propofol and dexmedetomidine.When Observer's Assessment of Alertness/Sedation Scale score was 2 or 3 points,the tube was transnasally inserted to each marked depth.When the three marked depths mentioned above were reached,the positions of the tube's tip were checked using a fiberoptic bronchoscope and recorded as:above epiglottis (the tip of the tube was placed between the epiglottis and the free edge of soft palate) or below epiglottis (the tip of the tube placed at or beyond the epiglottis).Results When the depth reached the NT mark,the tube's tip was above epiglottis in 14 cases (27％),and the tube's tip was below epiglottis in 38 cases (73％).When the depth reached the NM mark,the tube's tip was above epiglottis in 31 cases (60％),and the tube's tip was below epiglottis in 21 cases (40％).When the depth reached the TM mark,the tube's tip was above epiglottis in 52 cases (100％).Compared with the NM and NT methods,the TM method had a higher probability with the tube's tip above epiglottis when used to determine the depth of insertion (P＜0.01).Conclusion TM anatomic landmark method provides higher accuracy in determining the size of nasopharyngeal airway.
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Objective This study explored the expression of polyclonal protein SUZ12 in patients with intrahepatic cholangiocarcinoma(ICC),and its role in predicting the survival and treatment of ICC patients.Methods The expression of SUZ12 and p16INK4a was detected by immunohistochemical assay in 207 liver tissue samples including ICC patients,BilIN-1,-2,-3 and non-tumor-like cholangiocarcinoma.The expression of these proteins was assessed to be related to the pathological characteristics of the ICC patients receiving chemotherapy and the outcome of survival as well as the subsequent chemotherapy response.Results The expression level of SUZ12 was gradually increased from non-neoplastic bile duct tissue to BilIN-1,-2,-3 and ICC.The expression of p16INK4a protein was expressed in non-neoplastic-like cholangiocarcinoma,but it decreased gradually in BilIN-1,-2,-3 and ICC tissues.SUZ12 expression was associated with undifferentiated ICC,lymph node metastasis and advanced cancer.Kaplan-Meier curve analysis showed that ICC patients with high expression of SUZ12 had a significant reduction in overall survival and disease-free survival in comparison with ICC patients with the low expression of SUZ12.SUZ12 expression was significantly associated with overall survival of patients receiving adjuvant gemcitabine-based chemotherapy(AGC).Conclusion SUZ12 expression is able to predict the overall survival and disease-free survival of ICC patients with adjuvant gemcitabine-based chemotherapy.
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Objective To explore the CT and MRI manifestations and clinical features of juxtaglomerular cell tumor (JGCT). Methods A retrospective analysis the data of eight JGCT patients who resected by surgery and comfirmed by histopathology. Seven cases were examined by CT before operation, five of whom underwent CT scan and dynamic enhanced scan, two of whom underwent CT scan, and all of the eight underwent MRI scan and dynamic enhanced scan. The clinical manifestations of patients were also observed, whether they have hypertension and reduced blood potassium, recorded the results of lying and standing test, and collected the segmental renal vein blood to detect the renin levels. Meanwhile, the CT and MRI manifestations were also recorded. Results (1) We found that all of the eight patients appeared hypertension, and hypokalemia were found among five cases. Seven patients proceeded the lying and standing test, six of whom the plasma renin activity (PRA) were elevate in erect position, and the levels of angiotensin Ⅱand aldosterone (ALD) were rised among all of the seven cases in erect position. Four patients were collected the segmental renal vein blood, and one of whom has positive result of the renin activity. (2) The tumors of all the eight cases were single, the border was clear, and the average size was 2.7 cm (range 1.9 to 3.8 cm). The CT scan results showed there's no calcification or pseudocapsule were detected, four cases showed homogeneous iso-density, one case with slightly high density, another one showed low density with dotty high density and one case with low density. The dynamic enhanced CT scan showed that four cases performed continuous enhancement from cortical to medullary phase, and no obvious enhancement was found in one case. The T2WI results of MRI scan showed six cases had pseudocapsule, 6 cases had heterogeneous signal (4 cases with patchy low signal and 2 cases with patchy high signal), and 2 cases had homogeneous signal (one case with iso-high signal and another with high signal). The T1WI results showed two cases performed low signal, anther two cases showed iso-signal, and four cases with heterogeneous signal. The DWI results showed all of the 8 lesions with homo-or peripheral high signal. The dynamic enhanced MRI scan results showed seven cases performed gradual enhancement, and the border of another case became clear on delay phase. Conclusions JGCT has specific clinical and imaging features, and the combination will help make a correct diagnosis.
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Objective To explore diagnostic value of multi-slice spiral CT imaging features with respect to pancreatic neuroendocrine tumors (pNET) of different histological grades. Methods A retrospective analysis of preoperative abdominal plain CT and dual-phased contrast-enhanced CT was performed in 21 patients (median age, 47 years;12 males and 9 females) with pathologically proven pNET. age, gender, endocrine function, location and size of lesion, cystic change or necrosis, completeness of capsule, calcification, dilation of pancreatic duct were evaluated.CT attenuation-related parameters (plain CT value, relative density index, and CT value, CT value difference, enhanced percentage and enhancement index on arterial and portal phase) of each tumor were measured or calculated. All tumors were pathologically classified into three histological grades (G1, G2 and G3) based on mitotic count and ki-67 index. Kruskal-Wallis test was performed to compare differences of age, gender, endocrine function, morphological features among different grades. CT attenuation-related parameters were evaluated using Kruskal-Wallis or one-way analysis of variance (ANOVA). Results Twenty four pNET foci [grade G1 (n=13), G2 (n=7) and G3 (n=4)] were seen in the 21 patients. The difference of age, gender among different grades demonstrated no statistical significance (P>0.05). Nine lesions of G1 and 1 lesion of G2 demonstrated endocrine function, and the difference of endocrine function among three grades was statistically significant (χ2=8.355,P=0.012). For G1, G2 and G3, 11, 5 and 2 lesions were seen in uncinate process, pancreatic head and neck, respectively while 2, 2 and 2 lesions in pancreatic body and tail, respectively. The median maximum diameter of pNET of G1, G2 and G3 was 1.5, 2.5 and 6.7 cm, respectively;For G1, G2 and G3, 13, 4 and 0 lesions demonstrated intact capsule, respectively while 2, 3, and 3 lesions cystic degeneration and necrosis, respectivel; 0, 2 and 2 lesions calcification,respectively, 0, 1 and 2 lesions dilation of pancreaticobiliary duct, respectively, 0, 1 and 4 lesions sign of malignancy, respectively. The difference of size of lesion, completeness of capsule, calcification, and dilation of pancreatic duct showed statistical significance (P0.05). In addition, pNET of different grades demonstrated similar density and relative density index on plain CT. Regarding CT value, CT value difference, enhanced percentage and enhancement index on arterial and portal phase, the pNET of G2 showed highest value, while pNET of G3 lowest value, however, the difference about CT attenuation-related parameters among three grades showed no significant difference (P>0.05). Conclusion pNET of different histologic grades have some specific CT imaging features, which can facilitate an accurate diagnosis of pNET prior to therapy.
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Objective To estimate the arterial-to-end-tidal carbon dioxide tension difference (Pa-ET CO 2 )in children with cyanotic or acyanotic congenital heart diseases;evaluate whether hyper-ventilation can reduce the tension difference or not;analyze the effect of sevofleurane on Pa-ET CO 2 . Methods One hundred and twenty patients (male 60 cases,female 60 cases,aged 1 month-6 years, ASA class Ⅱ or Ⅲ)undergoing selective cardiac surgery were randomly divided into 6 groups (n =20 each)based on right-to-left or left-to-right intracardic shunts:group A1,cyanotic with sevoflurane of 0.5 MAC;group A2,cyanotic with sevoflurane of 1.0 MAC;group B1,acyanotic with sevoflurane of 0.5 MAC;group B2,acyanotic with sevoflurane of 1.0 MAC;group C1,cyanotic with no inter-vention factors;group C2,acyanotic with no intervention factors.All the children received general an-aesthesia after placing an intravenous and arterial catheter.The value of PET CO 2 ,SpO 2 ,PaCO 2 , SaO 2 ,Hct and temperature(nasopharyngeal temperature and rectal temperature)were obtained before operation,after hyperventilation(the control groups without hyperventilation)and five minutes before surture sternum.Results The values of Pa-ET CO 2 were more than the normal one in six groups before operation.The value of Pa-ET CO 2 in group B1 was less than that in group A1,that in group B2 was less than that in group A2 and that in group C2 was less than that in group C1 before operation (P <0.01).Compared with the time point before operation,the values of Pa-ET CO 2 in groups A1,A2,B1 and B2 decreased significantly after hyperventilation (P < 0.05 or P < 0.01 ).Moreover, this reduction was more significant in groups B1 and B2.Compared with the time point before operation, the values of Pa-ET CO 2 in groups B1,B2,C2 increased significantly (P <0.01)and that in groups A1, A2,C1 decreased significantly (P <0.05)at 5 minutes before surture sternum.There was no statisti-cal difference at three different time points between group A1 and A2,B1 and B2.Conclusion The value of Pa-ET CO 2 in cyanotic children increased more significantly than that in acyanotic children.Hy-perventilation can reduce the value of Pa-ET CO 2 especially in acynanotic children with pulmonary con-gestion.The concentration (from 0.5 MAC to 1.0 MAC)of sevoflurane had little effect on the value of Pa-ET CO 2 .
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BACKGROUND:In recent years, a lot of studies have reported the feasibility and efficacy of transplanting seed celsvia tissue-engineered cardiac patches into specific infarcted myocardial area, helping regeneration of damaged heart tissue and improving heart functions. OBJECTIVE:To review the methods and strategies of fabricating tissue-engineered cardiac patches and to analyze the structure and functional characteristics of cardiac patches prepared by different methods. METHODS: The first author retrieved relevant articles about the fabrication methods of tissue engineered cardiac patches by searching PubMed and Web of science data bases. The key words were “cardiac infarction, cel death”. RESULTS AND CONCLUSION:The fabrication methods and strategies of tissue-engineered cardiac patches are as folows: (1) obtaining multi-layer cel sheets by overlapping monolayer cel sheets; (2) combing gelatin with cels to construct multi-layer cel sheets; (3) seeding cels on scaffolds; (4) homogeneous arrangement of cels. Recent studies about tissue-engineered cardiac patches have demonstrated that the biological activities of seed cels, such as retention, survival and paracrine effects, greatly influence the effect of cardiac patches on the repair and regeneration of infarcted myocardial tissues. Temperature-sensitive method is the most mature and wide-spread used constructing technique; besides, other strategies also successfuly improve the biological activities of seed cels to different extents, and they also increase the mechanical strength and thickness of cel sheets in order to have better operability. Tissue-engineered cardiac patches are usualy prepared by different combined strategies on purpose to obtain better biological and mechanical properties.
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Objective To compare the effect of different needle-retaining time on post-stroke hypermyotonia in acupuncture treatment.Method Ninety patients with post-stoke hypermyotonia were randomized into group A, group B, and group C, 30 in each group. The three groups were all treated by the twelve hand-foot needling method from the thirteen therapies invented by acupuncture master WANG Le-ting, once a day, 5 times a week, 20 times in total. For group A, needles were removed right after needling qi arrived; for group B, needles were retained for 30 min after needling qi arrived; for group C, needles were retained for 60 min after needling qi arrived. The modified Ashworth Scale (MAS), Clinical Spasticity Index (CSI), and Fugl-Meyer assessment scale (FAS) were adopted for observation before and after intervention.Result After treatment, the MAS was significantly changed in all three groups (P<0.05). The CSI score and FAS score of the affected limb were significantly changed in all three groups after intervention (P<0.05). Both group A and B were significantly different from group C in comparing the CSI and FAS scores (P<0.05).Conclusion Compared to retaining needles for 60 min, acupuncture without retaining needles or retaining needles for 30 min can produce better effect in improving post-stroke hypermyotonia, spasticity, and motions of limbs.
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Objective Hyalinizing trabecular tumor ( HTT) is often mistaken as thyroid papillary carcino-ma( TPC) ,which shares some morphological features with TPC .The aim of this study is to investigate HTT and TPC with immunohistochemical methods .Methods we detected the expression of the three Immunohistochemical index((CK19,HBME-1,MIB-1)in thirteen cases HTT and twenty cases TPC.Results In HTT samples, CK19:three of the thirteen were positive and focal positivity (1+);HBME-1:None of the thirteen samples was stained.MIB-1:ten in thirteen cases were stained in nucleus .In TPC samples,CK19:all of the twenty samples were intensely stained;HBME-1:nineteen of twenty samples were intensely stained;MIB-1:all of the twenty samples were stained in nucleus .The sensitivity and specific degrees of CK 19 and HBME-1 combination to diag-nosis HTT and TPC were 90.0%and 69.2%.Conclusion Our research could provide potent aid to differential diagnosis of HTT and TPC .The combination of CK19 and HBME-1 are adequate to identify HTT and TPC .
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Pancreatic neuroendocrine neoplasms (pNENs) are rare tumors with malignant potential.The pNENs could be classified into functional or nonfunctional according to associated clinical symptoms.Magnetic resonance imaging (MRI) is helpful for preoperative diagnosis of nonfunctional pNENs.The clinical data of 22 patients with nonfunctional pNENs who were admitted to the Chinese PLA General Hospital from March 2010 to February 2014 were analyzed retrospectively.Nonfunctional pNENs were characterized by moderate to marked,consistent or progressive enhancement with capsule-like enhancement on dynamic contrast MRI,which is very important for the diagnosis and differential diagnosis of pNENs.
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Objective To evaluate the role of the beta3 subunit of the voltage-gated sodium channel (Scn3b) in neuropathic pain in mice.Methods The target gene Scn3b was embedded in the vector pBROAD-mcs and pBROAD3-mcs-Scn3b plasmid was then obtained.The primary mice were bred.The primary mice mated with C57/B6 mice and the transgenic mice were then generated.DNA,RT-PCR and Western blot experiments were performed to confirm the mice in which Scn3b was over-expressed.The mice with Scn3b over-expression multiplied rapidly to carry out the follow-up experiment.Ten transgenic mice (Scn3b group) and 10 control mice in the same litter (Con group) of both sexes,aged 2 months,weighing 25-30 g,were randomly chosen to establish the model of neuropathic pain.The mechanical pain threshold was measured before operation and on 3,5,7 and 14 days after operation.Results There was no significant difference in the mechanical pain threshold at each time point between the two groups (P ＞ 0.05).Conclusion Scn3b is not involved in the development and maintenance of neuropathic pain in mice.
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Objective To investigate the effect of sevoflurane anesthesia on DNA methyltransferase (DNMT) mRNA expression in neonatal rat amygdala. Methods Forty-two 8-day-old SD rats were randomly divided into 2 groups ( n = 21 each): control group and experimental group. 5% sevoflurane was inhaled for 1 min, and then the inhaled concentration of sevoflurane was decreased to 3 % and maintained for 4 h. The rats were sacrificed at the end of sevoflurane inhalation and 24 h after the end of sevoflurane inhalation, and amygdala was removed for determination of DNMT, mRNA, DNMT3, mRNA and DNMT3b mRNA expression by RT-PCR. Blood samples were taken at the end of sevoflurane inhalation for blood gas analysis. Results Compared with control group, the DNMT, mRNA and DNMT3, mRNA expression was down-regulated (P ＜ 0.05). There were no significant differences in DNMT3b mRNA expression and parameters of blood gas analysis between the two groups (P ＞ 0.05). Conclusion Sevoflurane anesthesia can down-regulate DNMT, mRNA and DNMT,, mRNA expression in neonatal rat amygdala, which may result in functional deficits during the development of central nervous system.
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Long-term or even permanent neuronal injury can follow administration of general anesthetics.It has been confirmed that some elderly patients may experience a decline in cognitive function after general anesthesia.However,the effects of general anesthetics on the central nervous system have not been determined yet.Here we summarize the effects of general anesthetics on the central nervous system in pediatric patients and immature animals.
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Objective To investigate the effects of caudal block with lidocaine plus drugs on postoperative analgesia in children. Methods Eighty children aged 1 to 4 years old received caudal block with 1% lidocaine 1 ml/kg and were randomly allocated to 4 groups with 20 cases each. The local anesthetic solution was added fentanyl 2 μg/kg in group Ⅱ , neostigmine 2 μg/kg in group Ⅲ, tramadol 2 mg/kg in group Ⅳ or nothing in group Ⅰ. Postoperative analgesia with fentanyl (nurse controlled analgesia, NCA) was given in all patients. Pain and sedation scores were evaluated at 1, 2, 4, 6 and 24 h after surgery. The duration of caudal analgesia, fentanyl requirements, sicle effects,and discharge time were recorded. Results Duration of caudal analgesia in group Ⅳ was (510. 7±64. 9)rain, which was longer than (174.5±39. 3) rain in roup Ⅰ , (291.7 ± 50. 8) min in group Ⅱ , or (242.0±62. 8) min in group Ⅲ. The incidence of postoperative nausea and vomiting was more [requent in group Ⅳ than that in the other groups(P<0. 05). Conclusion Combined 1 % lidocaine 1 ml/kg with tramadol 2 mg/kg for caudal block can provide better and longer postoperative analgesia, but with a higher incidence of postoperative nausea and vomiting.
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Objective To explore the CT and MR features of cystic nephroma. Methods CT and MRI findings of 8 patients with cystic nephroma comfirmed surgically and pathologically were analyzed retrospectively. Results In all 8 patients, cystic nephromas were unilateral and solitary, and diameter of lesions was 2.92-7.81 cm. The CT and MR scans showed multilocular cystic lesion with clear border. These locules did not communicate with each other. The septa were intact and smooth, and showed slight to moderate and gradual enhancement. The interlocular septa were demonstrated clearly on coronal T2WI, and showed hypointensity signals. The intracapsular liquids were heterogenous in 4 patients on MR images. The CT scanning showed a patchy calcification in 1 case. Histopathology proved that the capsule and septa of the lesions were lined by cuboidal or flattened epitheial cells, of which hemosiderin depositions were presented in 4 patients. Conclusion CT and MR are valuable in the diagnosis of cystic nephroma, and MRI can reflect the pathology of cystic nephroma more clearly, and supply the accurate reference information for diagnosis.
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By participating in the research practice of basic medicine,the innovative consciousness,the scientific thinking and researching ability of seven-year program medical students can be improved. Meanwhile,the generalization of Open Experimental Teaching and further development of self-design experiment also improve the innovation and research ability of medical students,which can serve as a new approach to the quality education of higher medical talents.