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BACKGROUND:The dura mater and skull are physically and functionally related,although there have been few investigations on primary extraction of dura mater and cranial cells,as well as co-culture of the two.The use of primary cells to investigate the influence of the dura mater on the skull is novel,and it is hoped that it may give a theoretical foundation for therapeutic therapy. OBJECTIVE:Rat dura mater and cranial bone cells were retrieved in situ to observe the influence of dura mater on cranial bone proliferation and differentiation,as well as to get a basic knowledge of the involvement of Twist1 in this process. METHODS:The enzyme digestion method was used in conjunction with the tissue block method to extract dural cells and cranial osteoblasts from rats within three days of birth.Immunofluorescence staining was used to identify the extracted cells,and alizarin red staining was used to identify and evaluate cranial osteoblasts and their mineralization ability.After co-culturing dural cells and cranial osteoblasts,real-time PCR was utilized to identify the expression of genes associated to cranial osteoblast proliferation and osteogenesis,as well as Twist1. RESULTS AND CONCLUSION:(1)Morphology:The retrieved dural cells had morphological traits similar to fibroblasts,while the osteoblasts were spindle-shaped.(2)Cell identification:immunofluorescence staining revealed that extracted dural cells expressed high levels of vimentin and cranial osteoblasts expressed high levels of alkaline phosphatase;cranial osteoblasts were stained with alizarin red 28 days after osteogenic induction,and obvious mineralized nodules were observed.(3)Real time PCR detection showed that the co-culture group had higher levels of PCNA,alkaline phosphatase,and RUNX2 mRNA expression than the control group(P＜0.01);however,Twist1 mRNA expression was lower(P＜0.01).(4)The findings showed that the primary extracted cranial osteoblasts had a high mineralization capacity,and that the dura mater was a key factor in promoting cranial growth and development and osteogenic differentiation,with Twist1 playing a key role in this process.
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The hippocampus and its circuits play crucial roles in human learning, memory, and emotional regulation. Whether it is vascular cognitive impairment (VCI) or Alzheimer's disease (AD), damage to the hippocampus is a prominent pathological feature. This review summarizes the recent advance in multimodal magnetic resonance imaging in anatomy, blood supply, structure and function of the hippocampus and the circuits related to VCI and AD in recent years, aiming to provide help in early recognizing and differentially diagnosing VCI and AD.
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Objective To investigate the HIV-1 genotype and distribution of newly diagnosed HIV-1 cases in Fujian Province in 2020, so as to provide insights into formulation of the precise AIDS control strategy in the province. Methods Newly diagnosed HIV-1 cases without antiretroviral therapy (excluding AIDS patients) were randomly sampled from each city of Fujian Province in 2020 at a proportion of 50% of the mean number of HIV-infected cases reported across 9 cities of Fujian Province during the past three years. Subjects’ demographic and epidemiological data were collected and blood samples were collected. The HIV-1 pol gene was amplified using nested reverse-transcription PCR assay, and the gene sequences were used for HIV-1 genotyping and phylogenetic analysis. The gene sequences were uploaded to the HIV Drug Resistance Database (http://hivdb.stanford.edu) for genotypic drug resistance assays, and the scores and level of HIV drug resistance were estimated using the HIVDB Algorithm version 9.5. Results A total of 1 043 newly diagnosed HIV-1 cases were reported in Fujian Province in 2020, and 936 gene sequences were successfully obtained following sequencing of blood samples. There were 9 HIV-1 genotypes characterized in blood samples from 936 newly diagnosed HIV-1 cases, with CRF07_BC (52.1%) and CRF01_AE (30.4%) as predominant subtypes, followed by CRF08_BC (4.9%), CRF55_01B (3.0%), subtype C (2.5%), subtype B (2.1%), CRF85_BC (1.7%), CRF59_01B (0.3%) and CRF65_CPX (0.1%), and unidentified subtypes were found in 26 blood samples. HIV-1 drug resistance was detected in 43 out of the 936 newly diagnosed HIV-1 cases, with 4.6% prevalence of HIV-1 drug resistance prior to therapy, and the highest drug resistance was found in the HIV CRF59_01B subtype, followed by in CRF08_BC, B, C, CRF01_AE, CRF07_BC and other subtypes, with a significant difference in the genotype-specific prevalence of HIV-1 drug resistance (χ2 = 45.002, P < 0.05). Conclusions There was a HIV-1 genotype diversity in Fujian Province in 2020, and emerging recombinant and drug-resistant HIV-1 strains were detected and spread across patients and regions. Monitoring of HIV-1 genotypes is recommended to be reinforced for timely understanding of the transmission and spread of novel recombinant and drug-resistant HIV-1 strains.
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Objective@#To investigate the function of FAK / Twist1 signaling pathway during craniosynostosis closure.@*Methods@#Ten days old rats were divided into a control group (n = 50) and a rotation group (n = 50) . Both of them were made a approximately 0. 5 cm circle bone window at the midpoint of the lambdoid suture of the rat.The bone flaps were left free without damaging the dura mater. The bone flaps in the control group were repositioned in situ , and the bone flaps in the rotation group were rotated 180 ° and repositioned 3 weeks later. Then the experiments were performance as followed :open field test , measurement of body weight , head circumference , bone flap area , and thickness of bone flap in the two groups , observation of cranial suture closure by microscopy and HE staining , FAK / Twist1 expression determined by Western blot , real⁃time PCR , and immunohistochemical staining in the bone flap and dure , respectively. @*Results@#The cranial sutures was completely closed in the rotation groupand that was open in the control group through detecting by microscopic examination and HE staining. The thickness of the bone flap in the derotation group was greater than that in the control group , with statistical significance (P < 0. 01) . There were no significant differences between two groups in head circumference , weight , bone flap area , and operative area. The results of behavioral test showed that after the closure of cranial suture , the acsion of FAK was significantly increased in the calvaria and dura as well as Twsit1 was significantly decreased in the dura in rotating group measuring by Western blot , real⁃time PCR , and immunohistochemical staining (P < 0. 05) .@*Conclusion@#FAK/Twist1 may play an important role in craniosynostosis after rotation.
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Objective@#To explore the growth characteristics of rat calvaria by detecting the calvaria of SD rats in different periods.@*Methods@#The calvaria of SD rats at 1 , 4 , 7 , 10 , and 12 weeks from the same littermate were selected (3 rats per week) . Real⁃time PCR and Western blot techniques were used to detect the expression of focal adhesion kinase ( FAK) Ⅳ phosphatidylinositol 3 kinase/protein kinase B ( PI3K/AKT ) signal pathway in the calvaria , and the role of FAK⁃PI3K/AKT in the growth and development of the calvaria was analyzed by correlation.@*Results@#The increase of brain volume and the thickness of calvaria increased synchronously , the expression of FAK was positively correlated with the changes of meridians , and the expression of FAK was positively correlated with the expression of PI3K/AKT.@*Conclusion@#The expression of FAK is related to the growth and development of rat skull. FAK plays a role in calvaria by activating PI3K/AKT signal pathway. FAK may be used as a marker of rapid skull growth and development , which provides a basic theoretical basis for the timing of clinical skull defect repair and treatment.
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Preeclampsia is a unique complication in the second and third trimesters of pregnancy, but its pathogenesis remains unclear and the early diagnosis and treatment methods are yet to be perfect. Termination of pregnancy at the right time is the only way to prevent its deterioration and avoid adverse pregnancy outcomes. In recent years, with the in-depth research, non-coding RNAs has been found to be involved in many important physiological and pathological processes such as proliferation and apoptosis of trophoblast cells and these non-coding RNAs can regulate each other to form an intricate and competitive endogenous RNA regulatory network. This article will introduce the biological roles of non-coding RNAs in regulating the invasion and proliferation of trophoblast cells in patients with preeclampsia and possible regulatory relationship between non-coding RNAs. Furthermore, the potential clinical value of non-coding RNAs as diagnostic biomarkers for preeclampsia and therapeutic targets are also elaborated.
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Helicobacter pylori (Hp) infection is closely related to the occurrence and development of chronic gastritis, peptic ulcer, and gastric cancer. At present, the treatment of Hp is mainly the bismuth-containing quadruple therapy as the first-line treatment to eradicate Hp infection. However, the eradication treatment still faces the challenges related to the rising antibiotic resistance, the decrease in eradication rate year by year, the adverse events, the poor patient's compliance and the dysregulation of gastrointestinal microbiome. Therefore, more and more researches are focusing on finding an effective treatment with the use of natural therapy. This article reviewed the research progress of pathogenic mechanism and treatment of Hp infection.
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@#Objective To explore the risk factors of hemorrhagic transformation and prognosis of acute ischemic stroke (AIS) after intravenous thrombolysis. Methods From June 2017 to June 2019,211 patients with AIS undergoing intravenous thrombolysis were selected as the research object. Among them,34 patients with hemorrhagic tromsformation (HT) were recorded as HT group,and 177 patients without hemorrhagic transformation The patient was recorded as a non-HT group,with a bleeding conversion rate of 16.11%. The relationship between intensive blood pressure reduction and bleeding conversion and prognosis in patients with AIS intravenous thrombolysis was analyzed during intravenous thrombolysis. Results Univariate analysis revealed gender,age,time interval between onset to start of treatment (OTT),blood glucose at admission,baseline blood pressure,and baseline from the onset to start of treatment (reombinant tissue plasminogen activator,rt-PA) The National Institute of Health stroke scale (NIHSS) score,type 2 diabetes,atrial fibrillation,and venous thrombolysis have statistically significant differences (P<0.05 or P<0.01),which is a vein Risk factors related to HT after thrombolysis;binary logistic analysis showed that the baseline NIHSS score of 17.5 was divided into independent risk factors for the transformation of venous thrombolysis hemorrhage in AIS patients (OR=1.639,P=0.013). Atrial fibrillation (OR=9.129,P<0.01) is an independent risk factor for the prognosis of patients with intravenous thrombolysis. Conclusion The baseline NIHSS score of 17.5 is divided into independent risk factors for HT after intravenous thrombolysis in AIS patients,and intensive blood pressure reduction during intravenous thrombolysis is a related risk factor for HT;atrial fibrillation is an independent risk factor for the prognosis of patients with intravenous thrombolysis.
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Objective@#To explore the influencing factors of rapid postoperative recovery in young(≤40 years old) lung cancer patients.@*Methods@#Retrospective analysis was performed on 82 young patients with lung cancer diagnosed by postoperative pathology admitted to the department of thoracic surgery of the first affiliated hospital of Zhengzhou University from March 2013 to March 2019, the patients were divided into two groups according to their postoperative hospitalization time(hospitalization time≤7d, hospitalization time >7d). The preoperative medical history and examination data, intraoperative(operative method, embedding materials), postoperative complications and postoperative treatment and other data of the enrolled patients were collected to analyze the relationship between various factors and postoperative hospitalization time.Univariate analysis used t test or Fisher exact probability method, multivariate analysis used logistic regression model to analyze the data .@*Results@#All 82 patients successfully completed the operation, and no death occurred during the perioperative period. There were no significant differences(P>0.05)according to the two groups of patients in the preoperative pulmonary function(FEV1) operation history, history of hypertension, diabetes, history of preoperative chemotherapy and surgery in the patients' position, blood transfusion, pleural adhesion, Czech, nai d, the use of xanthan gum, operation time, the maximum diameter and postoperative tumor thermal perfusion, fever, vomiting, choking cough, abdominal distension, etc.And it has significant differences(P<0.05). In the preoperative antibiotic use(P=0.002), the improvement of lung function(P=0.018), smoking history(P=0.024), medical reasons(P=0.011) and the operation(P<0.001), the lymph node excision scope(P<0.001), the lymph node dissection(P=0.017), hemostatic material use(P=0.023), blood loss(P=0.001) and postoperative average white blood cell count(P=0.033).@*Conclusion@#Preoperative and postoperative prophylactic use of antibiotics and drugs to improve pulmonary function were beneficial to postoperative recovery.Smoking was an independent risk factor for prolonged postoperative hospital stay.Minimally invasive operation and application of hemostatic materials can effectively shorten the postoperative hospitalization time of patients.
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Objective:To analyze the spatial-temporal distribution characteristics of gonorrhea in Fujian province from 2010 to 2019, and to provide scientific evidence for developing prevention and control strategies.Methods:Data on gonorrhea cases reported in counties and districts in Fujian province from 2010 to 2019 were collected from the National Notifiable Disease Report System of the Chinese Center for Disease Control and Prevention. OpenGeoda 1.12 software was used for global and local spatial autocorrelation analysis with Moran′s I as the statistic, and SaTScan 9.6 software was used for spatial-temporal cluster analysis to explore high-risk areas.Results:A total of 56 053 cases of gonorrhea were reported in Fujian province from 2010 to 2019. The reported incidence of gonorrhea slightly increased from 2010 to 2013, decreased from 2013 to 2014, and markedly increased from 2014 to 2018 with an average annual increase rate of 8.36%. However, the reported incidence sharply dropped again in 2019. Global autocorrelation analysis showed that the global Moran′s I index ranged from 0.48 to 0.65 between 2010 and 2019 (all P < 0.05), and there was global spatial autocorrelation of gonorrhea cases in counties and districts in Fujian province. Local autocorrelation analysis showed that the main spatial clustering patterns of gonorrhea cases in Fujian province were high-high, low-low and high-low clusters. In recent years, high-high clustering areas had shown an expanding trend, and were mainly distributed in Siming and Huli districts in Xiamen city, as well as in Licheng and Fengze districts, Jinjiang, Shishi and Nan′an county-level cities in Quanzhou city. Spatial-temporal clustering analysis revealed that the first-level spatial-temporal clustering areas were counties and districts in Xiamen city, as well as central urban areas, Jinjiang, Shishi and Nan′an county-level cities in Quanzhou city from January 2015 to December 2019. Conclusions:There was a spatial and temporal clustering of gonorrhea cases in Fujian province. High-high clustering areas were mainly distributed in the economically developed areas along the southeast coast of Fujian province, and had shown a gradually expanding trend in recent years. Counties and districts in Xiamen city, central urban areas and their surrounding county-level cities in Quanzhou city should be regarded as key areas for gonorrhea prevention and control.
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Objective:To explore the influencing factors of rapid postoperative recovery in young(≤40 years old) lung cancer patients.Methods:Retrospective analysis was performed on 82 young patients with lung cancer diagnosed by postoperative pathology admitted to the department of thoracic surgery of the first affiliated hospital of Zhengzhou University from March 2013 to March 2019, the patients were divided into two groups according to their postoperative hospitalization time(hospitalization time≤7d, hospitalization time >7d). The preoperative medical history and examination data, intraoperative(operative method, embedding materials), postoperative complications and postoperative treatment and other data of the enrolled patients were collected to analyze the relationship between various factors and postoperative hospitalization time.Univariate analysis used t test or Fisher exact probability method, multivariate analysis used logistic regression model to analyze the data . Results:All 82 patients successfully completed the operation, and no death occurred during the perioperative period. There were no significant differences( P>0.05)according to the two groups of patients in the preoperative pulmonary function(FEV1) operation history, history of hypertension, diabetes, history of preoperative chemotherapy and surgery in the patients' position, blood transfusion, pleural adhesion, Czech, nai d, the use of xanthan gum, operation time, the maximum diameter and postoperative tumor thermal perfusion, fever, vomiting, choking cough, abdominal distension, etc.And it has significant differences( P<0.05). In the preoperative antibiotic use( P=0.002), the improvement of lung function( P=0.018), smoking history( P=0.024), medical reasons( P=0.011) and the operation( P<0.001), the lymph node excision scope( P<0.001), the lymph node dissection( P=0.017), hemostatic material use( P=0.023), blood loss( P=0.001) and postoperative average white blood cell count( P=0.033). Conclusion:Preoperative and postoperative prophylactic use of antibiotics and drugs to improve pulmonary function were beneficial to postoperative recovery.Smoking was an independent risk factor for prolonged postoperative hospital stay.Minimally invasive operation and application of hemostatic materials can effectively shorten the postoperative hospitalization time of patients.
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Objective@#To explore the internal mechanism of short-term mindfulness intervention in reducing individual anxiety and stress perception.@*Methods@#Totally 134 subjects were recruited and randomized into attention group (n=53), acceptance group (n=41) and control group (n=40). Attention group received observation of breathing intervention program, acceptance group received acceptance of negative emotions intervention program and the control group did not intervene mindfulness and read the social science materials of history. Before and after intervention, cancelled tasks were used to stimulate anxiety and stress perception, and self-rating anxiety scale and Chinese perceived stress scale (CPSS) were used to measure anxiety and stress perception level, and the results of cancelled tasks were recorded. Variance analysis and multiple linear regression were used for data statistics.@*Results@#The changes of anxiety in attention group and acceptance group((-1.44±2.42)and(-1.06±2.58)) were significantly higher than that in control group(0.08±2.56)(both P<0.01). On the basis of controlling the changes of gender, age, number of cancellations and pre-test anxiety, the differences between groups had no significantly predictive effect on pre-cancellative anxiety(P>0.05). The attention group had significant predictive effect on anxiety in post-projected cancellative task compared with the control group (t=-2.84, P<0.01), while the acceptance group had no significant predictive effect on anxiety in post-projected cancellative task compared with the control group(P>0.05).@*Conclusion@#Attention and acceptance play different roles in short-term mindfulness training. Attention factor in mindfulness plays a key role in reducing anxiety level in individual tasks.
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Objective To explore the internal mechanism of short-term mindfulness intervention in reducing individual anxiety and stress perception. Methods Totally 134 subjects were recruited and ran-domized into attention group ( n=53),acceptance group ( n=41) and control group ( n=40). Attention group received observation of breathing intervention program,acceptance group received acceptance of nega-tive emotions intervention program and the control group did not intervene mindfulness and read the social science materials of history. Before and after intervention,cancelled tasks were used to stimulate anxiety and stress perception,and self-rating anxiety scale and Chinese perceived stress scale ( CPSS) were used to measure anxiety and stress perception level,and the results of cancelled tasks were recorded. Variance analy-sis and multiple linear regression were used for data statistics. Results The changes of anxiety in attention group and acceptance group((-1. 44±2. 42)and(-1. 06±2. 58)) were significantly higher than that in con-trol group(0. 08±2. 56) (both P<0. 01). On the basis of controlling the changes of gender,age,number of cancellations and pre-test anxiety,the differences between groups had no significantly predictive effect on pre-cancellative anxiety(P>0. 05). The attention group had significant predictive effect on anxiety in post-projec-ted cancellative task compared with the control group (t=-2. 84,P<0. 01),while the acceptance group had no significant predictive effect on anxiety in post-projected cancellative task compared with the control group (P>0. 05). Conclusion Attention and acceptance play different roles in short-term mindfulness training. Attention factor in mindfulness plays a key role in reducing anxiety level in individual tasks.
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Objective To explore the impact of glucocorticoid on coagulation through administrating on rats with smoke inhalation.Methods Totally 150 male S-D rats were randomly (random number) divided into 5 groups:control group (ambient air inhalation),smoke group (smoke inhalation for 30 min),smoke+high dosage methyl prednisolone group(MP 40 mg/kg,intraperitoneal injection,s+HMP group),smoke+medium dosage MP (4 mg/kg) group (s+MMP group),smoke+low dosage MP (0.4 mg/kg) group (s+LMP group) (all n=30).Survival rates were calculated 24 h after smoke inhalation.Lung tissues were collected for histopathology and wet to dry (W/D) ratio.Arterial blood was collected for blood gas test.Coagulation factors in lung and plasma were tested.Results Survival rates of three MP groups were markedly improved compared with the smoke group (all P＜0.05),and was significantly higher in the medium dosage group(85.17％) than those in the low and high dosage groups (65.73％ and 60.07％,all P＜0.05).The W/D ratio and blood gas test were markedly improved in the high and medium groups (all P＜0.05).Tissue factor (TF) and thrombin-antithrombin complex (TAT-c) in bronchoalveolar lavage fluid (BALF) increased dramatically after SI (P＜0.01,P=0.005) with a remarkable drop of factor Ⅱ (F Ⅱ) (P=0.007),all of which were attenuated by MP with dosage dependence.The mRNA expression of TF increased dramatically after SI and recovered significantly with MP administration,while the expression of thrombomodulin (TM) recovered in the opposite direction with MP,all of which were in a dosage dependent manner.TF,fibrinogen (FIB),TAT-c increased significantly in plasma after smoke inhalation (P＜0.01,P=0.027,P=0.005).F Ⅷ ％ increased with MP administration and TF was raised by high dosage MP compared with the smoke group.FIB and TAT-c were decreased in all MP groups,which were significant higher in the high and middle dosage groups.The change of TM and endothelial cell protein C receptor (EPCR) in circulation were similar with FIB or TAT-c with or without MP.Protein C (PC％) and antithrombin (AT Ⅲ ％) dropped dramatically after SI,high and middle dosages of MP could restore the activity significantly,while low dosage would restore AT Ⅲ ％ but not PC％.Conclusions Glucocorticoid can significantly improve local and systemical coagulation disorder caused by smoke inhalation,and high-and medium-dosage hormones are effective.The regulation of hormones on the coagulation system is an important mechanism in the treatment of smoke inhalation induced lung injury.
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Objective To explore the interaction between tryptophan hydroxylase 2(TPH2) gene polymorphisms (rs4570625,rs11178997) and serotonin 1A receptor (5-HT1A) gene polymorpbisms (rs878567,rs1364043,rs6265) and the association with major depressive disorder (MDD) in a Chinese Han population.Methods The DNA isolated from peripheral blood samples of 288 MDD patients 288 healthy subjects was detected by single base primer extension assay (Snapshot).The generalized multifactor dimensionality reduction (GMDR) method was used to analyze the gene-gene interaction.Results Significant differences were found in the genotype (patients (TT:27,TA:152,AA:109),controls (TT:82,TA:105,AA:101),P＜0.01) and allele(patients (T:206,A:370),controls (T:269,A:307),P＜0.01) frequencies of rs1 1178997 within TPH2 between MDD patients and controls.Statistically,a greater risk of developing MDD was found in individuals with an rs1 1178997 A-allele(OR=1.574,95％CI=1.243-1.993).The interaction between TPH2 (rs4570625,rs1 1178997) and 5-HT1A (rs878567,rs1364043,rs6265) was considered as the best multi-locus model,and this showed a testing accuracy of 57.67％ and a CV consistency of 10/10.And this interaction had a significant effect on the risk of MDD (P=0.0107).Conclusion There may be an association between the interaction of TPH2 and 5-HT1A polymorphisms and MDD.
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Objective To verify the interaction between single nucleotide polymorphism of trypto-phan hydroxylase 2 (TPH2) (rs4570625,rs11178997,rs120074175) and negative life events and the asso-ciation with major depressive disorder (MDD) in a Chinese population.Methods Totally 300 cases of pa-tients with major depressive disorder and 300 healthy controls in northern China were enrolled and the ge-nomic DNA were extracted. PCR was used to detect the polymorphisms of rs4570625, rs11178997, rs120074175.Questionnaire survey was conducted on the case group and the control group.Chi-square test was used to compare the differences in the frequency distribution of alleles and genotype between two groups. The generalized multifactor dimensionality reduction ( GMDR) method was used to analyze the interaction between gene and environment.Binary logistic regression was used to verify the optimal model.Results After adjusting the factors of sex and age,the GMDR analysis showed rs4570625,rs11178997,rs120074175 and negative life events were the optimal model.In this model, the testing balanced accuracy was 0.7838 and cross-validation consistency value was 10/10.There was statistically significant effect on the risk of major de-pressive disorder ( P ＝ 0.001 ). Binary logistic regression analysis showed that individuals, who had rs11178997 A+ genotype (AA,AT),rs120074175 A+genotype (AA,AG) and negative life events,had sig-nificant OR values of 24.307(95%CI＝13.007-45.427) and 38.2502(95%CI＝1.148-69.181),showing a higher risk of depression.Conclusion The interaction between TPH2 gene (rs11178997,rs120074175) and negative life events plays an important role in depression.
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Objective To investigate the application value of root seeking method and suspension method in lymph nodes dissection of recurrent laryngeal nerve (RLN) during minimally invasive McKeown surgery of thoracic esophageal cancer.Methods The retrospective cohort study was conducted.The clinical data of 120 patients with thoracic esophageal cancer who were admitted to the First Affiliated Hospital of Zhengzhou University from March 2015 to May 2016 were collected.Sixty patients using root seeking method and suspension method in lymph nodes dissection of RLN were allocated into the study group,and 60 using unexposed lymph nodes dissection of RLN were allocated into the control group.All the patients underwent minimally invasive McKeown surgeries.Observation indicators:(1) intraoperative situations;(2) postoperative situations;(3) follow-up.Follow-up using outpatient examination and telephone interview was performed to detect the postoperative tumor recurrence or metastasis and injury of RLN up to January 2017.Measurement data with normal distribution were represented as-x±s.Comparisons between groups were evaluated with the independent-sample t test.Count data were analyzed using the chi-square test.Results (1) Intraoperative situations:patients between groups underwent successful minimally invasive McKeown surgery,without conversion to open surgery.The operation time and volume of intraoperative blood loss were respectively (250± 19)minutes,(484±80)mL in the study group and (248±22) minutes,(493±60)mL in the control group,with no statistically significant difference between groups (t =0.532,-0.697,P＞0.05).The number of lymph nodes dissection,successful dissection rate and metastasis rate in the left RLN and metastasis rate in the right RLN were respectively 5.0±4.1,86.7％ (52/60),23.3％ (14/60),16.7％ (10/60) in the study group and 1.0±0.9,60.0％ (36/60),1.7％ (1/60),5.0％ (3/60) in the control group,with statistically significant differences between groups (t =5.170,x2=10.909,12.876,4.227,P＜0.05).The number of lymph nodes dissection,successful dissection rate and metastasis degree in the right RLN and metastasis degree in the left RLN were respectively 3.5±3.6,93.3％(56/60),8.55％(20/234),7.69％ (20/260) in the study group and 1.5± 1.0,83.3％ (50/60),4.00％ (4/100),1.72％ (1/58) in the control group,with no statistically significant difference between groups (t=1.075,x2 =2.911,2.172,1.856,P＞0.05).(2) Postoperative situations:time to initial anal exsufflation,time of initial defecation and time for initial fluid diet intake were respectively (2.0±0.6)days,(3.1 ± 0.6)days,(7.2± 0.3)days in the study group and (2.2±0.8) days,(3.2±0.5) days,(6.9±0.5) days in the control group,with no statistically significant difference between groups (t=2.618,-0.991,3.985,P＞0.05).Comparisons of injury degree of RLN:5 and 1 patients in the study and control groups had mild injury,respectively,showing no statistically significant difference between groups (x2=1.581,P＞0.05);1 and 8 patients in the study and control groups had respectively moderate injury,showing a statistically significant difference between groups (x2 =4.323,P＜0.05);there was no severe injury between groups.Duration of hospital stay in the study and control groups were respectively (14.8±2.5)days and (14.5±2.8) days,showing no statistically significant difference between groups (t =0.619,P＞ 0.05).(3)Follow-up:120 patients were followed up for 4-22 months,with a median time of 13 months.During the follow-up,3 and 2 patients in the study and control groups had cervical lymph node metastases and received postoperative assisted chemotherapy and local radiotherapy of neck,without death between groups.There was no hoarseness in 6 patients with mild injury of RLN during the follow-up;voices in 9 patients with moderate injury of RLN were improved at 1-2 months postoperatively,and no bucking symptom was detected after fluid diet intake.Conclusion The root seeking method and suspension method in lymph nodes dissection of RLN is safe and effective during minimally invasive McKeown surgery of thoracic esophageal cancer,especially conducive to lymph nodes exposure and dissection of the left RLN,and reduce the incidence of moderate injury of RLN.
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Objective To investigate the protective effect of retigabine (a M-type potassium channel opener) on brains and its mechanism in male mice after acute cerebral ischemia reperfusion(I/R)injury.Methods Seventy male C57BL/6J mice were randomly divided sham-operated group (n=10),middle cerebral artery occlusion (MCAO) group (n=10) and prevention group (n=50) according to the random number table method;mice in the prevention group were then divided into XE991 (a M-type potassium channel blocker) group,RTG-treatment 0 h group,RTG-treatment 1 h group,RTG-treatment 3 h group,and RTG-treatment 6 h group (n=10).The MCAO models were established by suture method,and reperfusion was performed 90 min after cerebral ischemia.In RTG-treatment groups,a single dose of 10.5 mg/kg RTG was injected at the designated varying time points (0,1,3 and 6 h after the reperfusion);in XE991 group,a single dose of 3.0 mg/kg XE991 was injected after the reperfusion;mice in the sham-operated group and MCAO group received the same volume of saline.Twenty-four h after model making,infarct size was measured by TTC staining.HE staining was used to observe the morphological changes of neurons in hippocampal CA1 regions.The apoptotic neurons level and membrane protein CD40L expression in the ischemic penumbra were detected by TUNEL staining and Western blotting.Results In the sham-operated group,brain tissues had no obvious change,no infarction was observed,there was no CD40L expression,and TUNEL staining positive neurons were hardly found.(1) Cerebral artery territory infarction was visible in the MCAO group and intervention group;however,the infarction volume of the RTG-treatment groups was significantly lower than that in the MCAO group (P＜0.05);the infarction volume of the RTG-treatment 6 h group was increased as compared with that of the RTG-treatment 0 h group,RTG-treatment 1 h group,and RTG-treatment 3 h group,without significant difference (P＞0.05).(2) HE staining showed that hippocampal neurons were obviously swollen and necrotic in the MCAO group and XE991 group,while the pathological damages such as brain edema and neuron necrosis were ameliorated significantly in the RTG-treatment groups.(3) As compared with those in the MCAO group,the number of TUNEL staining positive neurons in the RTG-treatment 0 h group,RTG-treatrnent 1 h group,and RTG-treatment 3 h group and CD40L number in the RTG-treatment 0 h group and RTG-treatment 3 h group were decreased significantly (P＜0.05);as compared with that in the MCAO group,the number of TUNEL staining positive neurons increased significantly in the XE991 group (P＜0.05).Conclusion RTG has protective effect on cerebral I/R,and its mechanism might relate to reducing cell excitability and inflammation,thereby inhibiting cell apoptosis;these protection would be less effective when RTG is used outside a defined critical period of time.
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<p><b>OBJECTIVE</b>To explore the efficacy and prognostic factors of induction therapy combined with autogenetic peripheral blood stem cells transplantation (APBSCT)in patients with multiple myeloma (MM).</p><p><b>METHODS</b>From January 1998 to May 2015, 201 patients with MM were enrolled. All patients received APBSCT after induction therapy. With the follow up to 20 June 2015, the overall survival (OS), progression free survival (PFS)and prognostic factor were analyzed.</p><p><b>RESULTS</b>① With a media follow up of 36.67 months, the median PFS and OS were 22.87 (17.48- 28.26)and 69.63 (63.57- 75.69)months, 5-year PFS and OS were 17% and 49%, respectively. ②After APBSCT, when the subgroup (n= 112) achieved complete response (CR)compared with the subgroup (n=89) not achieved CR, the median PFS were 32.93 (21.03-44.83) and 18.13 (14.46-21.80) months (P<0.001), respectively; And the media OS were 96.77 (71.79- 121.75)and 54.70 (49.53- 59.87) months (P=0.004), respectively. The risks for disease progression and death declined in CR subgroup. ③ Two subgroups included or not included bortezomib/thalidomide at induction therapy (123 patientsvs 21 patients), the media PFS were 31.67 (24.36- 38.98)and 15.20 (10.11- 20.29) months (P=0.013), respectively; And the media OS were 76.30 (55.44- 97.15)and 52.03 (33.76- 70.30) months (P=0.014), respectively. ④According to the ISS stage, the media OS of stageⅠ, Ⅱ, Ⅲ were 99.47 (59.58-139.36), 66.77 (52.17-81.37), 53.97 (28.71-79.23) (P< 0.001), respectively. The risk for death of stage Ⅱ, Ⅲ were 2.16 and 3.04 times higher than stage Ⅰ, with no difference in terms of PFS. ⑤ The media PFS in IgD (n=22) and IgG (n=101) type MM were 11.17 (10.27- 13.13)and 35.43 (22.69- 48.17)months (P=0.007) , respectively; The media OS were 30.83 (0.24-61.42)and 70.70 (53.52-87.88) months (P=0.039), respectively. The risk for disease progression of IgD type was 2.47 times higher than IgG type. ⑥ Patients received 1 line induction therapy (n=132) compared with more than 1 line (n=69), the media PFS were 25.43 (16.09- 34.77)and 20.27 (15.04- 25.50) months (P=0.042). ⑦Cox analysis showed that CR after APBSCT and ISS stage were independent prognostic factors for OS. IgD type MM and CR after APBSCT were independent prognosis factor for PFS.</p><p><b>CONCLUSION</b>CR after APBSCT and ISS stage were independent prognostic factors for OS in MM. CR after APBSCT was independent prognostic factor for PFS in MM. However, disease progression more likely occurred in IgD type MM, which was independent negative prognostic factor for PFS in MM.</p>