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ObjectiveTo investigate the value of baseline red cell distribution width （RDW） and alkaline phosphatase （ALP） level after ursodeoxycholic acid （UDCA） treatment for one month in predicting the response to UDCA treatment in patients with primary biliary cholangitis （PBC）. MethodsA retrospective analysis was performed for the data of 127 patients with PBC who were diagnosed in Department of Hepatology， The Third People’s Hospital of Jiangsu University， from January 2015 to July 2022， with data collected at baseline， after one month of treatment， and after one year of follow-up. Based on the Paris-I criteria， the patients were divided into good response group and poor response group， and the two groups were analyzed in terms of clinical and laboratory features and their association with response to UDCA. The Logistic regression method was used to investigate the independent risk factors for response to UDCA treatment. The area under the ROC curve （AUC） was used to determine the optimal cut-off values of related indicators； the patients were divided into two groups based on such values， and the two groups were compared in terms of baseline indicators and response. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups； the chi-square test was used for comparison of categorical data between two groups. ResultsCompared with the good response group， the poor response group had significantly higher levels of total bilirubin， aspartate aminotransferase/alanine aminotransferase， ALP， RDW， and RDW-CV at baseline and a significantly higher level of ALP after one month of UDCA treatment （Z=-4.792， -3.697， -2.399， -4.102， -3.220， and -4.236， all P<0.05）. Compared with the good response group， the poor response group had significantly lower levels of albumin， hemoglobin， lymphocytes， hematocrit， and body mass index at baseline （Z=-3.592， -3.603， -2.602， -3.829， -2.432， all P<0.05）， as well as significantly lower levels of prealbumin， albumin/globulin ratio， apolipoprotein A， and free triiodothyronine at baseline （t=4.530， 3.402， 3.485， and 3.639， all P<0.001）. Compared with the poor response group， the good response group had a significantly lower proportion of patients with liver cirrhosis， gallstones/cholecystitis， or anemia （χ2=20.815， 3.892， and 12.283， all P<0.05）. Baseline RDW （odds ratio ［OR］=1.157， 95% confidence interval ［CI］： 1.028 — 1.301， P=0.015） and ALP level after one month of treatment （OR=1.012， 95%CI： 1.005 — 1.020， P=0.002） were independent risk factors for response to UDCA， with an AUC of 0.713 and 0.720， respectively. The patients with baseline RDW≥upper limit of normal （ULN） and ALP≥2.2×ULN after one month of UDCA treatment had a lower UDCA response rate （42.6% vs 8.2%， χ2=20.813， P<0.001）. ConclusionPatients with baseline RDW≥ULN and ALP≥2.2×ULN after one month of UDCA treatment tend to have a low biochemical response rate to UDCA.
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AIM: To explore the synthesis of thermo-sensitive poly N-isopropylacry-lamide(PNIPAAm)and the petri dish grafted with PNIPAAm hydrogels by the electron accelerator, as well as the growth conditions and the biological characteristics of rabbit corneal stromal cells on thermo-sensitive PNIPAAm hydrogels, and the cell sheets obtained from the PNIPAAm hydrogels.METHODS: NIPAAm monomer was dissolved in 2-propanol at concentrations of 55% with 0.5% N,N'-Methylenebisacry-lamide(MBA). Solution(70 μL)was added and spread uniformly over 35 mm petri dish. These dishes were immediately subjected to irradiation. After follow-up treatment, rabbit corneal stromal cells were cultured on thermo-sensitive petri dish in vitro.RESULTS: According to the monomer formula and radiation synthesis scheme in this experiment, PNIPAAm can be synthesized on the surface of the petri dish. Rabbit corneal stromal cells grew well in the thermo- sensitive surface and can be separated into sheets.CONCLUSION: The single and multilayer carrier-free cell sheets can be obtained from the use of thermo-sensitive petri dish.
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Objective To study the serum levels of adisintegrin and metalloproteases 17(ADAM17)and C-X-C chemokine ligand 16(CXCL16)in patients with chronic atrophic gastritis(CAG)and their clinical value.Methods A total of 174 patients admitted to Xidian Group Hospital Affiliated to Shaanxi University of Traditional Chinese Medicine from January 2018 to January 2020 due to abdominal discomfort and other symptoms were selected.Based on pathological biopsy results,they were divided into CAG group(n=94)and non CAG group(n=80).The CAG group was divided into mild group(n=27),moderate group(n=30),and severe group(n=37)based on the severity.Meanwhile,50 healthy examinees were used as the control group.Enzyme-linked immunosorbent assay was used to detect serum ADAM17 and CXCL16 levels.Multivariate logistic regression analysis was used to investigate the influencing factors of CAG occurrence,and the diagnostic values of serum ADAM17 and CXCL16 for CAG were analyzed using receiver operating characteristic curves.Results The serum levels of ADAM17(79.25±9.34ng/L)and CXCL16(4.66±0.58μg/L)in CAG group were higher than those in non-CAG group(73.94±8.26ng/L,4.03±0.55μg/L)and control group(53.04±7.20ng/L,1.02±0.35μg/L),and the differences were statistically significant(t=5.794,24.854;11.053,55.497,all P＜0.05).The serum levels of ADAM17(87.17±9.30ng/L)and CXCL16(5.14±0.51μg/L)in severe CAG patients were higher than those in mild CAG group(79.12±9.52ng/L,4.65±0.57μg/L)and moderate groups(68.54±7.89ng/L,4.02±0.63μg/L),and the differences were statistically significant(t=11.574,5.152;11.065,4.987,all P＜0.05).Serum ADAM17(OR=1.851,95%CI:1.350～2.522)and CXCL16(OR=1.682,95%CI:1.233～2.296)were independent risk factors for CAG.The area under the curve of serum ADAM17 and CXCL16 combined diagnosis of CAG was 0.912(95%CI:0.858～0.949),which was larger than the single indicator of 0.843(95%CI:0.801～0.907)and 0.785(95%CI:0.722～0.834),and the differences were statistically significant(Z= 9.357,12.894,all P＜0.05).Conclusion The serum levels of ADAM17 and CXCL16 were increased in CAG patients,indicating they may be related to the severity of CAG.The combined detection of ADAM17 and CXCL16 has a high predictive value for CAG.
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Objective:To investigate the effects of different levels of ophthalmic surgical stimulation on blood glucose in patients with type 2 diabetes mellitus(T2DM).Methods:From Mar to Oct 2021,236 patients with T2DM who underwent ophthalmic surgery in our hospital were enrolled,including 71 cases of secondary surgery,89 cases of tertiary surgery,and 76 cases of quaternary surgery.According to the operation time,the 236 patients were divided into groups A(＜60 min),B(60-120 min)and C(＞120 min).The preoperative and postoperative blood glucose levels were compared in patients with different levels of surgery,and in groups A,B and C.Results:The postoperative blood glucose level was lower than that before surgery in secondary and tertiary surgery,and it was higher than that before surgery in quaternary surgery(P＜0.05).The fluctuation value of blood glucose in secondary and tertiary surgery was higher than that in quaternary surgery(P＜0.05).In groups A,B and C,the postoperative blood glucose level was lower than that before surgery in secondary and tertiary surgery(P＜0.05).In group A,there was no significant difference in the blood glucose before and after surgery in quaternary surgery(P＞0.05),and in groups B and C,the postoperative blood glucose was higher than that before surgery in quaternary surgery(P＜0.05).In group A,there was no difference in the fluctuation value of blood glucose at different levels of surgery(P＞0.05).In group B,the fluctuation value of blood glucose in patients with secondary and tertiary surgery was higher than that in quaternary surgery(P＜0.05).In group C,the fluctuation value of blood glucose in patients with tertiary and quaternary surgery was higher than that in patients with secondary surgery(P＜0.05).Conclusions:For ophthalmic surgery patients with T2DM,the postoperative blood glucose values of patients undergoing secondary and tertiary surgery generally show a downward trend,while the postoperative blood glucose value of patients undergoing quaternary surgery generally shows an upward trend.It is suggested that clinical workers should actively manage the perioperative blood glucose of patients with high-level surgery.
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Farnesoid X receptor (FXR) is widely accepted as a promising target for various liver diseases; however, panels of ligands in drug development show limited clinical benefits, without a clear mechanism. Here, we reveal that acetylation initiates and orchestrates FXR nucleocytoplasmic shuttling and then enhances degradation by the cytosolic E3 ligase CHIP under conditions of liver injury, which represents the major culprit that limits the clinical benefits of FXR agonists against liver diseases. Upon inflammatory and apoptotic stimulation, enhanced FXR acetylation at K217, closed to the nuclear location signal, blocks its recognition by importin KPNA3, thereby preventing its nuclear import. Concomitantly, reduced phosphorylation at T442 within the nuclear export signals promotes its recognition by exportin CRM1, and thereby facilitating FXR export to the cytosol. Acetylation governs nucleocytoplasmic shuttling of FXR, resulting in enhanced cytosolic retention of FXR that is amenable to degradation by CHIP. SIRT1 activators reduce FXR acetylation and prevent its cytosolic degradation. More importantly, SIRT1 activators synergize with FXR agonists in combating acute and chronic liver injuries. In conclusion, these findings innovate a promising strategy to develop therapeutics against liver diseases by combining SIRT1 activators and FXR agonists.
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Hepatic venous pressure gradient (HVPG) is the "gold standard" for the diagnosis of portal hypertension, which could be applied in the evaluation of liver cirrhosis. Combined use of HVPG with model for end-stage liver disease (MELD) scoring system may more accurately match the donors and recipients undergoing liver transplantation for liver cirrhosis, select the appropriate timing of surgery, and provide guidance for bridging treatment for patients on the waiting list for liver transplantation. Besides, HVPG may also predict clinical prognosis of liver transplant recipients, and provide evidence for early detection and intervention of potential complications. Therefore, the value of HVPG in preoperative evaluation and prognosis prediction of liver transplant recipients was reviewed, aiming to provide guidance for clinical diagnosis and treatment of liver transplant recipients before and after surgery.
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Objective:To investigate the clinical efficacy and prognostic factors of Neodymium doped: Yttrium Aluminum Garnet (Nd:YAG ) laser combined with Erbium:Yttrium Aluminum Garnet (Er:YAG) laser assisted subgingival scaling root planing (SRP) in the treatment of periodontitis.Methods:A prospective research method was adopted. A total of 66 patients with periodontitis treated in Hebei Chest Hospital from August 2018 to August 2020 were selected and divided into experimental group and control group according to the random number table method, with 33 cases in each group. The control group was treated with SRP, and the experimental group received Er:YAG laser curettage combined with root surface leveling on the basis of SRP, and irradiated the periodontal pocket with Nd:YAG laser. The changes of periodontal clinical indicators and cytokine levels in gingival crevicular fluid were examined before treatment, 4 weeks and 12 weeks after treatment. The patients were divided into PD<3 mm group and PD ≥ 3 mm group according to the probing depth (PD) of periodontal pocket after 12 weeks of treatment, the clinical data of the two groups were compared and analyzed, and the Logistic regression analysis was performed to analyze the risk factors affecting the prognosis of patients with periodontitis after laser treatment.Results:After 4 and 12 weeks of treatment, the PD, clinical attachment loss (CAL), sulcus bleeding index (SBI) and plaque index (PLI) of the two groups were significantly lower than those before treatment ( P<0.05), and the PD, CAL, SBI and PLI in experimental group were significantly lower than those in control group, after 4 weeks of treatment: (3.36 ± 0.21) mm vs. (3.91 ± 0.39) mm, (4.14 ± 0.67) mm vs. (4.75 ± 0.73) mm, (1.83 ± 0.20) scores vs. (2.58 ± 0.17) scores, (1.29 ± 0.24) scores vs. (1.61 ± 0.52) scores; after 12 weeks of treatment: (3.04 ± 0.28) mm vs. (3.66 ± 0.54) mm, (3.91 ± 0.47) mm vs. (4.68 ± 0.66) mm, (0.88 ± 0.06) scores vs. (1.35 ± 0.14) scores, (1.05 ± 0.31) scores vs. (1.57 ± 0.56) scores, the differences were statistically significant ( P<0.05). After 12 weeks of treatment, the levels of interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-α (TNF-α), matrix metalloproteinase-8 (MMP-8) and interleukin-1β (IL-1β) in gingival crevicular fluid in experimental group were significantly decreased compared with those in control group: (2.95 ± 0.19) μg/L vs. (4.32 ± 0.84) μg/L, (2.63 ± 0.82) μg/L vs. (3.58 ± 0.51) μg/L, (12.42 ± 1.19) μg/L vs. (13.26 ± 0.68) μg/L, (4.15 ± 1.12) ng/L vs. (5.36 ± 0.42) ng/L, (2.65 ± 0.08) ng/L vs. (4.12 ± 0.19) ng/L, the differences were statistically significant ( P<0.05), while the level of transforming growth factor-β (TGF-β) was significantly increased compared with that in control group: (51.35 ± 8.95) ng/L vs. (44.90 ± 5.84) ng/L, and the differences between the groups were statistically significant ( P<0.05). Logistic regression analysis showed that the clinical indexes PD, SBI, PLI, IL-6, IL-8, TNF- α, MMP-8, IL-1β and crown root ratio of gingival crevicular fluid were all the risk factors for prognosis of periodontitis treated with dual wavelength laser ( P<0.05). Conclusions:Nd:YAG laser combined with Er:YAG laser assisted SRP can obtain good curative effect in the treatment of periodontitis. Periodontal clinical indexes PD, SBI, PLI, gingival crevicular fluid IL-6, IL-8 and TNF-α, MMP-8, IL-1β level and crown root ratio were independent risk factors for the prognosis of periodontitis treated with dual wavelength laser.
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ObjectiveTo establish an ischemia-reperfusion model in cynomolgus macaques and to analyse the effects of edaravone intervention. MethodsA total of fifteen adult male cynomolgus macaques were randomly divided into three groups: sham operation (Sham group, n=3), ischemia-reperfusion model (Model group, n=6) and edaravone treatment (Edaravone group, n=6). Ischemic-reperfusion model of cynomolgus macaques was established by clamping the M1 branch of the left cerebral artery for 1 h. After 2 h of reperfusion, the animals in Edaravone group were injected with 0.5 mg/kg edaravone intravenously for intervention treatment, while the animals in Sham and Model groups were injected with an equal volume of normal saline intravenously, twice a day, from the 2nd to 7th day. The behavioral video recordings, clinical observations and neurological deficit scores of cynomolgus macaques were obtained, and brain edema volume and cerebral ischemia volume were statistically analyzed. ResultsCompared with the Sham group, the animals in Model group showed typical symptoms of ischemic stroke, with a significant increase in the neurological deficit score， the volumes of edema and infarct of brain tissue (all P＜0.01). Compared with Model group, the neurological deficit score, the volumes of edema and infarct of brain tissue were significantly reduced in Edaravone group (all P＜0.05). ConclusionAn animal model of ischemia-reperfusion in cynomolgus macaques was successfully established, and edaravone was confirmed to alleviate the damage caused by ischemia-reperfusion.
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The clustered regularly interspaced short palindromic repeats (CRISPR)-Cas9 system has been widely used for genome engineering and transcriptional regulation in many different organisms. Current CRISPR-activation (CRISPRa) platforms often require multiple components because of inefficient transcriptional activation. Here, we fused different phase-separation proteins to dCas9-VPR (dCas9-VP64-P65-RTA) and observed robust increases in transcriptional activation efficiency. Notably, human NUP98 (nucleoporin 98) and FUS (fused in sarcoma) IDR domains were best at enhancing dCas9-VPR activity, with dCas9-VPR-FUS IDR (VPRF) outperforming the other CRISPRa systems tested in this study in both activation efficiency and system simplicity. dCas9-VPRF overcomes the target strand bias and widens gRNA designing windows without affecting the off-target effect of dCas9-VPR. These findings demonstrate the feasibility of using phase-separation proteins to assist in the regulation of gene expression and support the broad appeal of the dCas9-VPRF system in basic and clinical applications.
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Humans , Transcriptional Activation , RNA, Guide, CRISPR-Cas Systems , Gene Expression Regulation , CRISPR-Cas Systems/geneticsABSTRACT
Objective:To detect the enhancer of zeste 2 polycomb repressive complex 2 subunit ( EZH2) in glioma patients and analyze its value in disease and prognosis evaluation. Methods:Patients with glioma (glioma group, 90 cases) and patients with benign brain diseases (control group, 45 cases) in Beichen District Hospital of Traditional Chinese Medicine from January 2017 to December 2018 were selected as the research subjects. Methyl-specific PCR was employed to detect the methylation status of the EZH2 gene of the patients in the glioma group (tumor tissue, adjacent normal tissue), the control group (brain tissue), and in glioma cell lines (SHG-44, U251, U87, and CRT). The relationship between EZH2 gene unmethylation and clinicopathological factors was analyzed. The survival difference between the unmethylated and methylated EZH2 gene in tumor tissue of glioma patients was analyzed by Kaplan-Meier survival analysis. Results:The unmethylated rate of the EZH2 gene in the tumor tissue of the glioma group (68.9%) is significantly higher than that of the control group (5.6%) and in the normal tissue adjacent to the tumor (4.4%), and the differences are statistically significant (all P < 0.05). The EZH2 gene of glioma cell lines such as SHG-44, U251, U87, and CRT is unmethylated. There are significant differences in the unmethylated rate of the EZH2 gene in the tumor tissue of the glioma group in terms of intracranial hypertension, maximum tumor diameter, tumor number, and WHO grade (all P < 0.05). The unmethylated rate of the EZH2 gene in patients with intracranial hypertension, tumor maximum diameter ≥ 5 cm, multiple and grade Ⅲ + Ⅳ gliomas is significantly higher than that without intracranial hypertension, tumor maximum diameter < 5 cm, single and grade Ⅰ + Ⅱ gliomas, and the difference is statistically significant (all P < 0.05). The median survival time of EZH2 unmethylated patients is (13.45 ± 3.15) months, and the median survival time of EZH2 methylated patients is (19.45 ± 3.56) months. The median survival time of EZH2 methylated patients is significantly higher than that of unmethylated patients (Logrank = 30.084, P < 0.05). Conclusions:EZH2 is hypomethylated in glioma tumor tissue and can be used as a molecular marker for glioma disease and prognosis assessment
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Objective To investigate the infection status and drug resistance of urogenital tract mycoplasma in Lianyungang district,Jiangsu.Methods Based on retrospective collection of 22 889 cases of suspected mycoplasma genital infection in Lianyungang Mater-nity and Child Health Hospital from 2015 to 2022,the infection and drug resistance rate of genital mycoplasma were analyzed.Results A total of 8 943 genital mycoplasma positive specimens were detected.Among them,the infection rate of Ureaplasma urealyticum(Uu)was the highest,accounting for 33.64％(7 700/22 889),which was significantly higher than that of Mycoplasma hominis(Mh),3.91％(894/22 889),and that of mixed(Uu+Mh)type,1.52％(349/22 889).The difference was statistically significant(P＜0.05).The infection rates of genital mycoplasma and Uu showed increasing trend from 2015 to 2022.The overall infection rates of genital mycoplasma in females were 42.42％,which was significantly higher than that in males of 22.47％.The highest infection rate of 40.84％(6 108/14 955)was found in the group of 20 to 40 years old as compared to those younger than 20 years old as well as those over 40 years old.The genital mycoplasma was highly sensitive to doxycycline,minocycline and josamycin,and the drug resistance rate was lower than 5.00％.From 2015 to 2022,there was an increasing trend of resistance rates to erythromycin,ofloxacin and ciprofloxa-cin in Uu-infected patients(P＜0.05)and erythromycin,roxithromycin,azithromycin and ofloxacin in Mh-infected patients(P＜0.05).Conclusion The incidence of urogenital tract mycoplasma infection in Lianyungang district shows a gradual increase for recent years.Doxycycline,minocycline and josamycin are suitable as the first choice for the treatment of genital mycoplasma infection.Most quinolo-ne drugs have shown high resistance rate,indicating that this type of drugs are possibly overused.The strengthened relevant monitoring of antibacterial drugs should be necessary.
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Objective To study epigenetic diversity of Astragalus mongolicus by methylation-sensitive amplification polymorphism(MSAP)technique,and to establish and optimize the response system of MSAP technique applicable to Astragalus Mongolicus.Methods Astragalus membranaceus(Fisch.)Bge.var.mongholicus(Bge.)Hsiao was used as material.The single factor and orthogonal design method were used to optimize the key influencing factors of the reaction system of Astragalus Mongolian methylation-sensitive amplification polymorphism(MSAP)technique,and the best reaction system of Astragalus Mongolian MSAP was established.Results 0.5 μL each of EcoR I and Msp I/Hpa II were added to the 20 μL double-enzyme digestion reaction system,and the digestion was completed in a water bath at 37℃for 6 h to complete the digestion;the optimal ligation system was 25 μL,including 10 μL digestion product,0.2 μL T4 DNA Ligase,1 μL EcoR I-adapter,1 μL Hpa II/Msp I-adapter,2.5 μL 10×T4 Buffer;25 μL optimal pre-amplification reaction system,including 2.5 μL 10×PCR buffer,0.5 μL dNTP,2.0 μL ligation product,0.3 μL Taq DNA polymerase,1.0 μL upstream and downstream primers;25 μL optimal selective amplification system,including 2 μL 20-fold diluted pre-amplification product,1.0 μL 10×PCR buffer,1.0 μL dNTP,0.2 μL Taq DNA polymerase,0.8 μL primers.Conclusion The optimized MSAP system was detected by polyacrylamide gel electrophoresis,which showed that the polymorphism was good,the system was stable,the bands were clear and repeatable,which laid the foundation for the subsequent MSAP analysis of Astragalus mongolica.
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Objective:To investigate the application value of three-dimensional (3D) recons-truction combined with endoscopic ultrasonography (EUS) in preoperative accurate evaluation of biliary tract neoplasms.Methods:The retrospective and descriptive study was conducted. The clinico-pathological data of 19 patients with biliary tract neoplasms who underwent 3D reconstruction combined with EUS in the Shangdong Provincial Third Hospital from January 2019 to October 2022 were collected. There were 13 males and 6 females, aged 64(range, 35-75)years. All patients underwent preoperative abdominal enhanced computer tomography (CT) thin-slice scan with 3D reconstruction combined with EUS. Some patients further received other endoscopic techniques such as intraductal ultrasonography, endoscopic retrograde cholangiopancreatography or SpyGlass cholangioscopy to obtain tumor tissues for histopathology evaluation. The surgical implementation protocol was developed based on the results of 3D reconstruction and EUS. Observation indicators: (1) results of 3D reconstruction; (2) results of EUS; (3) comparison between preoperative surgical protocol and actual intraoperative conditions. Measurement data with skewed distribution were represented as M(range), and count data were described as absolute numbers and/or percentages. Results:(1) Results of 3D reconstruction. Results of 3D reconstruction in 19 patients with biliary tract neoplasms showed morphology of the liver, bile ducts, pancreas, blood vessels, and duodenum, including 4 cases of hilar cholangiocarcinoma, 14 cases of middle and lower cholangiocarcinoma, and 1 case of intrahepatic cholangiocarcinoma. The accuracy of 3D reconstruction in 19 patients was 18/19. (2) Results of EUS. All 19 patients underwent preoperative EUS, including 7 cases obtained tumor tissue for histopathology evaluation, with the results indicating abnormal hyperplasia or malignant tumor. The rate of histopathology evaluation was 7/19, with the sensitivity as 7/7. Of 19 patients, results of EUS in 2 cases indicated positive of lymph node metastasis, but results of postoperative histopathology evaluation indicated negative of lymph node metastasis in lymph node specimens. Results of EUS in the rest of 17 cases indicated negative of lymph node metastasis, but results of intraoperative laparoscopic exploration on 1 case indicated extensive intra-abdominal metastasis. (3) Comparison between preoperative surgical protocol and actual intraoperative conditions. Of 19 patients, 18 cases underwent radical resection and 1 case underwent bile duct drainage, with the compliance rate between preoperative surgical protocol and actual intraoperative conditions as 18/19. The volume of intraoperative blood loss in the 18 cases receiving radical resection was 336(range, 50-1500)mL. Two cases had postoperative complications.Conclusion:Results of 3D reconstruction combined with EUS can accurately map the the size, location, extent of bile duct invasion, and adjacent relationships of surrounding tissues of malignant biliary tract neoplasms, for preoperative accurate evaluation and surgical planning.
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@#Objective To analyze and compare the perioperative efficacy difference between full-port Da Vinci robotic surgery and thoracoscopic surgery in patients with mediastinal tumor resection. Methods The data of 232 patients with mediastinal tumors treated by the same operator in the Department of Thoracic Surgery of the Second Affiliated Hospital of Harbin Medical University were included. There were 103 (44.4%) males and 129 (55.6%) females, with an average age of 49.7 years. According to the surgical methods, they were divided into a robot-assisted thoracic surgery (RATS) group (n=113) and a video-assisted thoracoscopic surgery (VATS) group (n=119). After 1 : 1 propensity score matching, 57 patients in the RATS group and 57 patients in the VATS group were obtained. Results The RATS group was better than the VATS group in the visual analogue scale pain score on the first day after the surgery [3.0 (2.0, 4.0) points vs. 4.0 (3.0, 5.0) points], postoperative hospital stay time [4.0 (3.0, 5.5) d vs. 6.0 (5.0, 7.0) d] and postoperative catheterization time [2.0 (2.0, 3.0) d vs. 3.0 (3.0, 4.0) d] (all P<0.05). There was no statistical difference between the two groups in terms of intraoperative blood loss, postoperative complications, postoperative thoracic closed drainage catheter placement rate or postoperative total drainage volume (all P>0.05). The total hospitalization costs [51 271.0 (44 166.0, 57 152.0) yuan vs. 35 814.0 (33 418.0, 39 312.0) yuan], operation costs [37 659.0 (32 217.0, 41 511.0) yuan vs. 19 640.0 (17 008.0, 21 421.0) yuan], anesthesia costs [3 307.0 (2 530.0, 3 823.0) yuan vs. 2 059.0 (1 577.0, 2 887.0) yuan] and drug and examination costs [9 241.0 (7 987.0, 12 332.0) yuan vs. 14 143.0 (11 620.0, 16 750.0) yuan] in the RATS group was higher than those in the VATS group (all P<0.05). Conclusion Robotic surgery and thoracoscopic surgery can be done safely and effectively. Compared with thoracoscopic surgery, robotic surgery has less postoperative pain, shorter tube-carrying time, and less postoperative hospital stay, which can significantly speed up the postoperative recovery of patients. However, the cost of robotic surgery is higher than that of thoracoscopic surgery, which increases the economic burden of patients and is also one of the main reasons for preventing the popularization of robotic surgery.
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Objective:To quantitatively evaluate the energy loss (EL) and vortex characteristics in the left ventricle by vector flow mapping (VFM) technique in heart failure patients with mid-range ejection fraction (HFmrEF) and reduced ejection fraction (HFrEF).Methods:One hundred and five patients in Qilu Hospital of Shandong University from October 2016 to November 2017 with heart failure and left ventricular ejection fraction (LVEF)<50% were enrolled and divided into HFmrEF Group (LVEF40%~<50%, 56 cases) and HFrEF group (LVEF<40%, 49 cases). Another 32 healthy people at the same period were matched as control group. The EL, vortex area and circulation of isovolumic relaxation phase (IVR), rapid filling phase (RFP), atrial contraction phase (ACP), isovolumic contraction phase (IVC) and rapid ejection phase (REP) in the left ventricle was measured by VFM technique.Results:The EL in HFmrEF group and HFrEF group was lower than that in the control group. In ACP, the EL was gradually decreased among the control group, HFmrEF group and HFrEF group( P<0.05). In ACP, the vortex area and circulation was larger in heart failure patients than those in the control group, and gradually increased from control group, to HFrEF group( P<0.05). Positive correlation between EL and E/e ′ was evidenced in the RFP ( r=0.524, P< 0.001). While in ACP, there was a positive correlation between EL and A peak ( r=0.492, P<0.001), and a negative correlation between EL and vortex area ( r=-0.235, P=0.040). Conclusions:VFM can be applied to evaluate the EL in left ventricle. The EL in the left ventricle of patients with HFmrEF and HFrEF is significantly lower than that in control group. El is correlated with cardiac systolic and diastolic function and vortex area.
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Single-cell proteome analysis can perform in-depth research on cell heterogeneity and further promote the development of precision medicine and tumor research. In recent years, mass spectrometry-based proteomics has made substantial progress, but proteomics analysis at the single-cell level still faces sensitivity challenges. At present, liquid chromatography tandem mass spectrometry has become the main analysis method of proteomics. Because of its high sensitivity, high throughput, and high stability, it has been widely used in the field of single cells. In recent years, the representative single-cell proteomics methods can be divided into three types: single-tube technology, microfluidic platform, and integrated processing platform according to different sample processing methods. Different kinds of data collection and analysis methods have their own advantages and disadvantages. If single-cell proteomics, still a laboratory study, can be applied in diagnostic practice as soon as possible, it will definitely promote the progress of precision medicine and oncology research.
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Objective:To investigate the immune response characteristics of helper T cells Th1, Th2, Th17 and their related cytokines in acute, chronic and recovery phases after Brucella infection. Methods:Using prospective study, a total of 130 patients with brucellosis in the First Affiliated Hospital of Medical College of Shihezi University from January 2017 to December 2018 were selected as the research subjects, including acute phase group (49 cases), chronic phase group (44 cases), recovery phase group (37 cases), and 30 cases of healthy physical examination during the same period were included in the control group. The peripheral blood samples of all subjects were collected, and flow cytometry was used to detect Th1, Th2 and Th17 cells in the peripheral blood; the cytometry bead array (CBA) was used to detect the serum cytokines interferon-γ (IFN-γ), interleukin (IL)-4 and IL-17A expression levels.Results:In the control, acute phase, chronic phase and recovery phase groups, the differences of the expression ratios of Th1 [(1.03 ± 0.85)%, (5.46 ± 3.54)%, (4.48 ± 2.26)%, (2.29 ± 2.25)%], Th2 [(4.72 ± 2.36)%, (7.00 ± 3.14)%, (13.99 ± 9.14)%, (5.89 ± 4.69)%], and Th17 cells [(2.09 ± 0.48)%, (3.04 ± 2.17)%, (3.61 ± 2.67)%, (2.74 ± 2.58)%] were statistically significant ( F = 20.95, 21.15, 2.90, P < 0.05). Compared with the control group, the expressions ratio of Th1, Th2, Th17 cells in acute and chronic phase groups and Th1 cells in recovery phase group were significantly higher ( P < 0.05); compared with the recovery phase group, the expressions ratio of Th1, Th2 and Th17 cells in acute and chronic phase groups were significantly higher, but the expression ratio of Th2 cells in acute phase group was lower than that in chronic phase group ( P < 0.05). The expression levels of IFN-γ, IL-4, and IL-17A in serum of control group, acute phase, chronic phase and recovery phase groups were significantly different ( F = 7.79, 15.85, 7.55, P < 0.05); compared with the control group, the expression levels of IFN-γ, IL-4, IL-17A in acute and chronic phase groups and IFN-γ, IL-4 in recovery phase group were significantly higher ( P < 0.05); compared with the recovery phase group, the expression levels of IFN-γ, IL-4, IL-17A in acute phase group and IFN-γ, IL-17A in chronic phase group were significantly higher ( P < 0.05). The expression ratio of Th1 cells in recovery phase patients who finished treatment for less than 12 months was significantly higher than that of recovery phase patients who finished treatment for ≥12 months ( t = 2.26, P < 0.05). Conclusions:After patients are infected with Brucella, Th1 cell immunity is dominant in acute phase, Th2 cell immunity is dominant in chronic phase, and there is no significant difference in the response of Th17 cell immunity between acute and chronic phases. The immune function of patients in the recovery phase may still be abnormal when the treatment time is less than 12 months. Some clinically cured patients in the recovery phase still have a relatively high proportion of Th1 cells, suggesting that the patient's immune function has not fully recovered.
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The fovea avascular area (FAZ) is an area of the retina surrounded by a continuous capillary plexus that does not have any capillary structure of its own. FAZ is an important region for the formation of fine vision function. The changes of its morphology and surrounding capillary density reflect the degree of macular ischemia, and are closely related to retinal vascular diseases such as diabetic retinopathy, retinal vein occlusion, Coats disease, idiopathic macular telangiectasia, and retinopathy of prematurity. Early observation of FAZ region changes in patients with retinal vascular disease by optical coherence tomography angiography (OCTA) can evaluate the severity and prognosis of the disease. However, the measurement error of FAZ-related data is still a problem that cannot be ignored. At present, OCTA devices of various manufacturers have different methods and algorithms for measuring and analyzing FAZ, which makes it impossible to compare the measured data between different devices. It is believed that with the continuous progress of OCTA related technology, more accurate data of FAZ regional changes can be obtained, which will bring more help to clinical work.
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We retrieved the PDTC patient medical record in our center who have received multi-disciplinary comprehensive treatment in March 2019. By reviewing his treatment process, we hope to improve the recognition of this disease and provide reference for individualized programs.
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Objective To evaluate the biomechanical effects of lateral meniscus posterior root (LMPR) tears fixed at different suture positions, so as to investigate the optimal suture method for repairing LMPR tears. Methods Eight fresh cadaveric knees were used. Each knee was tested under 6 conditions: intact knee, ruptur of LMPR, suture of LMPR to the center point of root insertion, suture of LMPR posterior, interior and later 5 mm to the center point of root insertion, respectively. The peak contact pressure, the average contact pressure and contact area were evaluated using a Tek-scan sensor positioned between the meniscus and tibial plateau, under 1 kN compressive loading, at 0 degree knee extension. Results In the lateral compartment, the average contact pressure and peak pressure significantly increased under rupture of LMPR compared with the intact state (P0.05). Conclusions The average contact pressure, the peak contact pressure and the contact area between the lateral meniscus and the tibial plateau changed obviously due to the LMPR tears. When the suture position was 5 mm lateral to the center point of root insertion, similar biomechanical function with the intact knee could be obtained.