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@#Objective To summarize the efficacy of robot-assisted thoracic surgery (RATS) and video-assisted thoracoscopic surgery (VATS) in the treatment of left upper lobectomy for non-small cell lung cancer. Methods The clinical data of patients with non-small cell lung cancer who underwent left upper lobectomy with RATS or VATS in our center from January 2019 to October 2021 were retrospectively analyzed. The patients were divided into two groups according to surgical methods: a RATS group and a VATS group. The baseline clinical data and results were compared between the two groups. Results A total of 145 patients were included. There were 78 males and 67 females with a mean age of 59.9 years. There were 63 patients in the RATS group and 82 patients in the VATS group. There was no death within 30 days after operation in both groups. In the RATS group, the drainage volume on the second postoperative day (233.49±83.94 mL vs. 284.88±120.21 mL, P=0.003), total operative time (126.94±29.50 min vs. 181.59±61.51 min, P=0.000), intraoperative resection time of the left upper lobe (76.48±27.52 min vs. 107.23±47.84 min, P=0.000), intraoperative blood loss (P=0.000), and conversion rate to thoracotomy (P=0.018) were significantly better than those in the VATS group. The group (5.41±0.94 groups vs. 4.83±1.31 groups, P=0.002) and number (18.27±7.39 vs. 12.76±6.54, P=0.000) of dissected lymph nodes in the RATS group were significantly more than those in the VATS group. The differences in the drainage volume on the first day after operation, postoperative intubation time, postoperative hospital stay or postoperative complications between the two groups were not statistically significant (P>0.05). Conclusion The application of RATS in the left upper lobectomy for non-small cell lung cancer is safe and feasible, and has obvious advantages over VATS.
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@#Objective To compare the postoperative chylothorax outcomes of robot-assisted thoracic surgery (RATS) and video-assisted thoracoscopic surgery (VATS), analyze the risk factors for postoperative chylothorax after minimally invasive radical lung cancer resection and explore possible prevention and control measures. Methods Between June 2012 and September 2020, 1 083 patients underwent minimally invasive pulmonary lobectomy and systematic lymph node dissection in our hospital, including 578 males and 505 females with an average age of 60.6±9.4 years. Patients were divided into two groups according to the operation methods: a RATS group (499 patients) and a VATS group (584 patients). After propensity score matching, 434 patients were included in each group (868 patients in total). Chylothorax and other perioperative indicators were compared between the two groups. Univariate and multivariate logistic regression analyses were performed to identify risk factors for postoperative chylothorax. Results Overall, 24 patients were diagnosed with chylothorax after surgery. Compared with the VATS group, the rate of chylothorax was higher (3.9% vs. 1.6%, P=0.038), the groups and numbers of dissected lymph nodes were more (both P<0.001), and the intraoperative blood loss was significantly less (P<0.001) in the RATS group. There was no statistical difference in the postoperative hospital stay (P=0.256) or chest tube drainage time (P=0.504) between the two groups. Univariate analysis showed that gender (P=0.021), operation approach (P=0.045), smoking (P=0.001) and the groups of dissected lymph nodes (P<0.001) were significantly associated with the development of chylothorax. Multivariate analysis showed that smoking [OR=4.344, 95%CI (1.149, 16.417), P=0.030] and the groups of dissected lymph nodes [OR=1.680, 95%CI (1.221, 2.311), P=0.001] were the independent risk factors for postoperative chylothorax. Conclusion Compared with the VATS, the rate of chylothorax after RATS is higher with more dissected lymph nodes and less blood loss. The incidence of chylothorax after minimally invasive radical lung cancer resection is higher in the patients with increased dissected lymph node groups and smoking history.
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Objective:To investigate the diagnostic value and imaging characteristics of ultrasound and multi-slice spiral CT in rheumatoid arthritis (RA) wrist joint lesions.Methods:The clinical data of 54 cases of RA wrist arthropathy in Jianhu Hospital Affiliated to Nantong University from December 2018 to April 2020 were analyzed. All the patients were examined by ultrasound and multi-slice spiral CT. The imaging characteristics of ultrasound and multi-slice spiral CT were analyzed, and the detection rates of synovitis, joint effusion, tenosynovitis, bone erosion and wrist joint lesions were calculated.Results:A total of 1 188 joints were examined in 54 patients with RA, including 108 wrist joints, 540 metacarpophalangeal joints and 540 proximal interphalangeal joints. There was no significant difference in the detection rate of wrist joint synovitis, joint effusion and tenosynovitis between ultrasound and CT ( P>0.05). The wrist joint lesions detection rates of ultrasound and CT were 97.2%(105/108) and 46.3% (50/108), the difference was statistically significant ( χ2 = 36.52, P<0.05). Ultrasound image features: synovitis ultrasound image showed hypoechoic joint cavity, not by joint displacement or compression image, color Doppler flow imaging (CDFI) examination could see blood flow signal;joint effusion in ultrasound image of joint effusion was strip, strip-shaped, non-uniform distribution, image was affected by joint displacement or compression, CDFI examination had no blood flow signal; bone erosion ultrasound image showed bone cortical continuous interruption or "crater" "insect erosion" like defects. CT imaging features: wrist joint space narrow, osteoporosis, some patients with scaphoid, distal radius visible bone erosion. Conclusions:The detection rate of wrist synovitis, joint effusion and tenosynovitis by ultrasound and multi-row spiral CT are similar. The multi-row spiral CT examination have a slight advantage in evaluating the joint space and bone changes. The sensitivity of wrist bone erosion and wrist joint lesions are higher than those of multi-row spiral CT, which can guide the early clinical diagnosis and treatment of RA.
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Objective:To compare the short-term outcomes of segmentectomy for stage ⅠA non-small cell lung cancer by two surgical methods.Methods:A retrospective analysis was performed on 101 patients with stage ⅠA non-small cell lung cancer and undergoing segmentectomy admitted to the Department of Thoracic Surgery of The General Hospital of the Northern Theater Command from July 2016 to July 2020, including 50 patients who underwent Da Vinci robotic segmentectomy and 51 patients who underwent video-assisted thoracoscopic segmentectomy during the same period. By collecting the clinical data of the patients, the operation time, intraoperative blood loss, lymph node dissection stations, lymph node dissection number, drainage volume on the first day after the operation, total drainage volume on the third day after the operation, postoperative chest catheter insertion time, postoperative hospitalization days, and postoperative complication rate were compared and analyzed.Results:Patients in both groups successfully completed pulmonary segmental resection, and there were no cases of conversion to thoracotomy and perioperative death.Compared and analyzed the postoperative clinical results of the two groups, the intraoperative blood loss [(34.40±12.96) ml vs.(85.10±26.41)ml, P=0.000], the number of lymph node dissection stations(4.72±1.20 vs. 3.60±1.40, P=0.000) and the number of lymph node dissection(15.14±5.91 vs. 10.76±5.26, P=0.000) showed statistically significant differences, and RATS group was superior to VATS group.There were no statistically significant differences in operation time[(153.90±21.88) min vs.(155.39±25.04) min, P=0.751], drainage volume on the first day after surgery[(217.80±76.94) ml vs.(210.98±86.98) ml, P=0.678], total drainage volume three days after surgery[(612.60±169.93) ml vs.(595.10±203.90) ml, P=0.641], duration of chest drainage tube after operation[(5.36±2.33) days vs.(5.18±2.54) days, P=0.706], postoperative hospitalization days[(7.50±2.35) days vs.(7.47±2.93) days, P=0.956]and postoperative complication incidence. Conclusion:Da Vinci robot segmentectomy is a safe and effective surgical method, with less bleeding and more lymph node dissection stations and number than video-assisted thoracoscopic segmentectomy for stage ⅠA non-small cell lung cancer.
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Objective To evaluate the clinical repair effects of the reconstruction of different vermilion tubercle after primary cleft lip repair.Methods According to the tight lip deformity and dif ferent degrees of defect of the vermilion tubercle and exposing the gums and the crown of the anterior incisors,178 patients after primary repair of the cleft lip from Department of Oral and Maxillofacial Surgery of Xiangya Hospital,Central South University were classified into the tight lip deformity and four grades of whistling deformities.According to different deformities and defects,the different operative techniques were used as follows:classic Abbé flap and modified Abbé flap were used for tight lip deformity;the bilateral advanced myomucosal flaps of lip were used for the grade Ⅰ;modified Abbé flap was used for repairing the grade Ⅱ and the grade Ⅲ whistling deformities;for grade Ⅳ whistling deformity,we mainly used classic Abbé flap.The follow-up after operation was performed,all patient's Cupid's bow,Cupid's bow peak,the vermilion tubercle and the height and width of the upper lip were observed.The scarring of the upper lip was also observed.Results The follow-up after operation was performed from six months to ninteen years,all the 187 patient's anatomical structures of the upper lip were nearly normal after recovery.The all patients showed an obvious Cupid's bow,Cupid's bow peak,the vermilion tubercle and the height and width of the upper lip.The relation of the upper lip and lower lip was harmonious.The scarring of the upper lip was not obvious 2 years after operation.Conclusions The different repair methods are chosen to repair different deformity and defect that has an important clinical value.
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@#The development of osteoarthritis (OA) is associated with the synovium around the joints, and the synovitis is closely related to the pain and swelling of OA. The synovitis is not only involved in the early OA, but also played an important role in the progression of OA throughout.
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Benign symmetric lipomatosis is a rare disease and may appear as a huge tumor in the neck. Four benign symmetric lipomatosis associated with gigantic painless mass or neck motion limitation were reported. Operative technique of one-time radical resection or stage resection was used to remove these tumors. One patient had a postoperative complication of incision effusion and infection, and three patients had no significant complication. At more than one-year follow-up, the motion and appearance of a patient's neck returned to normal, and no recurrence was observed. The etiology, clinical manifestations, diagnosis, and treatment of the disease were discussed.
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Humanos , Lipomatosis Simétrica Múltiple , Cuello , RecurrenciaRESUMEN
The development of osteoarthritis (OA) is associated with the synovium around the joints, and the synovitis is closely related to the pain and swelling of OA. The synovitis is not only involved in the early OA, but also played an important role in the progression of OA throughout.
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Objective To analyse the 24 h ambulatory blood pressure monitoring(ABPM)character-istics and effect of health education in children with orthostatic hypertension (OHT)retrospectively.Methods A total of 19 children[1 1 males and 8 females with mean age of (1 1.26 ±2.16)years]who were outpa-tients or had been hospitalized in the Second Xiangya Hospital of Central South University due to unexplained syncope,presyncope,and finally diagnosed as OHT after head up tilt test(HUTT).HUTT and ABPM were reexamined at 12 ~190(47 ±48 )days after receiving health education (including psychological guidance, avoiding sudden changes in posture,increasing the amount of water,avoiding syncope inducement,etc). Results (1 )ABPM parameters:there were no significant differences of ABPM parameters before and after health education respectively(P ﹥0.05,respectively).(2)After the health education,HUTT 3 min diastolic pressure[(71.89 ±1.60)mmHg vs.(76.47 ±8.49)mmHg,1 mmHg =0.133 kPa,t =2.785,P ﹤0.05]and diastolic blood pressure change[(7.37 ±4.98)mmHg vs.(12.42 ±3.27)mmHg,t =3.560,P ﹤0.05]de-creased than those before health education.(3 )Blood pressure pattern changes:after the health education,“dipper blood pressure”increased and “non-dipper blood pressure”decreased[42.1 %(8 /19)vs.31.6%(6 /19)and 57.9%(1 1 /19)vs.68.4%(13 /19),χ2 =0.452,P ﹥0.05,respectively].(4)OHT cure rate:after health education,to review the HUTT,within 3 minutes in HUTT,blood pressure changes of 14 cases were normal range.The cure rate was 73.7%.Conclusion OHT children's blood type is given priority to with “non-dipper blood pressure”,and the ratio of“dipper blood pressure”increase and the HUTT 3 min di-astolic pressure and diastolic blood pressure change decrease after health education.It suggests that the health education of OHT children has a certain clinical effect.
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External applies and washing of traditional Chinese medicine has sound curative effect in treating muscular and bone pain.The author reported some his experiences on the treatment of muscular and bone pain with hot applies and tendon-relaxing and collaterals-activating lotion.
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<p><b>OBJECTIVE</b>To investigate the inhibitory effect of ampelopsin (AMP) combined with adriamycin (ADR) on growth of human leukemia multidrug resistant cell line K562/ADR.</p><p><b>METHOD</b>MTT assay was used to detect the effect of AMP on the cytotoxicity of ADR. Jin's formula was used to analyze the effect of combined drug therapy. The expression of P-glycoprotein (P-gp) on cell membrane of K562/ADR was detected using PE-labeled antibody. Flow cytometry was used to determine the influence of AMP on the intracellular accumulation of ADR.</p><p><b>RESULT</b>AMP at the concentration of 1.25 to 5 mg x L(-1) could significantly reverse the multidrug resistance (MDR) to ADR in K562/ADR cells. Co-administration of 1.25 mg x L(-1) AMP and low concentrations of ADR showed an antagonistic effect, while there was an additional to synergistic effect when the concentration of AMP was above 2.5 mg x L(-1). AMP could decrease the expression of P-gp in a concentration-dependent manner and increase the intracellular accumulation of ADR in K562/ADR cells.</p><p><b>CONCLUSION</b>AMP could increased the cytotoxicity and the intracellular accumulation of chemotherapeutic drugs in MDR associated tumor cells through inhibiting the efflux of drugs by P-gp. AMP may be a promising MDR modulator.</p>
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Animales , Humanos , Miembro 1 de la Subfamilia B de Casetes de Unión a ATP , Metabolismo , Antineoplásicos , Metabolismo , Farmacología , Línea Celular Tumoral , Proliferación Celular , Doxorrubicina , Metabolismo , Farmacología , Resistencia a Múltiples Medicamentos , Resistencia a Antineoplásicos , Flavonoides , Farmacología , Regulación Neoplásica de la Expresión Génica , Espacio Intracelular , MetabolismoRESUMEN
Objective To qualitatively analyze the expressions of key marker genes involved in osteogenic differentiation of bone marrow stromal cells (BMSCs) of mice at defined stages in vitro using real-time RT-PCR. Methods The BMSCs of mice were cultured in vitro and induced to osteoblasts for 7, 14, and 21 days. The total RNA was extracted from the cultured cells and the gene expression levels of collagenⅠ, bone alkaline phosphatase (APL), osteopontin (OPN) and bone sialoprotein (BSP) in the osteoblasts at the defined stages were determined by real-time RT-PCR. Results The ColⅠmRNA levels in 14 and 21 days were (0. 75?0. 04) and (0. 34?0. 03) times respectively of that in 7 days. ALP, OPN and BSP mRNA levels in 21 days were (19. 70?2. 36), (150. 12?9. 31) and (7. 73?0. 58) times of those in 7 days respectively. Conclusions ColⅠexpression levels tend to gradually decline while ALP, OPN and BSP levels gradually increase along with the culture time. Real-time RT-PCR is a reliable method for investigation of gene expressions in BMSCs cultured in vitro.
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Aim To investigate the effects of ampelopsin on induction of apoptosis in human hepatocellular carcinoma Bel-7402 cells.Methods Bel-7402 cells were treated with ampelopsin with different concentrations for 24,48 and 72 h.The cell proliferation was detected by MTT assay.The morphological change of cells was observed through microscope observation by fluorescence staining.DNA fragmentation was visualized by agarose gel electrophoresis.The apoptosis rate was analyzed by flow cytometry.The expressions of caspase-3,Bcl-2 and Bax protein were detected by Western blot.Results Ampelopsin inhibited the proliferation of Bel-7402 cell line in a dose-and time-dependent manner.The IC50 values were 89.6?16.1,36.2?6.5 and 15.3?3.0 mg?L-1 at 24,48 and 72 h,respectively.The fluorescence microscope showed clearly cell apoptosis with apoptotic body.Agarose gel electrophoresis result showed that Bel-7402 treated with ampelopsin produced a DNA ladder band.The sub-G1 peak was detected and resulted in dose-and time-dependent increasing of the population of sub-G1 DNA content by flow cytometry.The expression of Bcl-2 protein was down-regulated,while the expression of Bax protein was up-regulated.The pro-caspase-3 protein was down-expressed and activated.Conclusions Ampelopsin could inhibit Bel-7402 proliferation through inducing cell apoptosis.The mechanism might be that ampelopsin could directly or indirectly enhance the level of anti-apoptosis protein Bcl-2 and decrease the level of apoptosis protein Bax.The pathway of pro-caspase-3 activated was initiated and effector caspase-3 was sequentially activated.
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Aim To investigate the release feature of ginsenoside Rd solid lipid nanoparticles (Rd-SLN) in vitro,and to clarify the difference in absorption of Rd-SLN from varied rat intestinal segments and pharmacokinetic properties in vivo. Methods Dialysis method was used to determine ginsenoside Rd release rate from nanoparticles in vitro. Perfusion method was used to study the intestinal absorption of Rd-SLN in rat. HPLC assay was established to determine the concentration of ginsenoside Rd in plasma. After intragastric administration,the concentrations of drug in rat blood at different time points were recorded to investigate the absorption and pharmacokinetics of Rd-SLN. Results The release of ginsenoside Rd from Rd-SLN was slowed down and presented the property of sustained release. There was no significant difference between the absorption rate of Rd-SLN and control solution in duodenum and jejunum. However,it was obviously different in ileum and colon. Comparing with other intestinal segments,significantly higher percentage of Rd-SLN was absorbed in colon. In Rd-SLN group,the concentration of ginsenoside Rd in blood was maintained,and the Cmax,MRT,AUMC,and AUC were all increased. Conclusions Rd-SLN possesses sustained-release effect. The colon is the preferable absorption site for Rd-SLN in intestinal tract. Rd-SLN can enhance the oral bioavailability of ginsenoside Rd.