Differential Effect of ITE on the Aryl Hydrocarbon Receptor Signaling in Breast Cancer Tissue: A Histopathological Study / Efecto Diferencial de ITE en la Señalización del Receptor de Hidrocarburo de Arilo en Tejido de Cáncer de Mama: Un Estudio Histopatológico

SUMMARY: Aryl hydrocarbon receptor (AhR) is a ligand-activated transcription factor that is highly expressed in various types of cancers including breast cancer. However, the role of AhR with its endogenous ligand 2-(1'H-indole-3'-carbonyl)-thiazole-4-carboxylic acid methyl ester (ITE) on the progression of breast cancer remains poorly understood. We aimed to investigate cell proliferation and migration states in breast cancer after activating AhR with the endogenous ligand ITE. Breast cancer tissue was evaluated by cell lines, immunohistochemistry, reverse transcription-polymerase chain reaction, cell proliferation, flow cytometry, migration assays and western blot techniques. We found that AhR was widely expressed in breast cancer tissues and metastasis lymph node tissues, but not in normal tissues. The expression AhR was independent between the age, grades and TNM classifications for breast cancer tissues. ITE treatment significantly induced the activation of AhR in a time-dependent manner in both MCF-7 and T47D breast cancer cell lines. Meanwhile, ITE did not affect the cell migration but significantly suppressed the cell proliferation in estrogen receptor positive (ER+) MCF-7 andT47D cells, which probably attribute to the induction of cell cycle arrest in G1 phase and shortened S phase. Further mechanism study showed that ERK1/2 and AKT signaling were required for the activation of AhR in MCF-7 cells. These data suggest that AhR is a potential new target for treating patients with breast cancer. ITE may be more potentially used for therapeutic intervention for breast cancer with the kind of ER(+).

El receptor de hidrocarburo de arilo (AhR) es un factor de transcripción activado por ligando que se expresa en gran medida en varios tipos de cáncer, incluido el cáncer de mama. Sin embargo, el papel de AhR con su ligando endógeno 2- (1'H-indol-3'-carbonil)-tiazol-4-ácido carboxílico metil éster (ITE) en la progresión del cáncer de mama sigue siendo poco conocido. Nuestro objetivo fue investigar la proliferación celular y los estados de migración en el cáncer de mama después de activar AhR con el ligando endógeno ITE. El tejido de cáncer de mama se evaluó mediante líneas celulares, inmunohistoquímica, reacción en cadena de la polimerasa con transcriptasa inversa, proliferación celular, citometría de flujo, ensayos de migración y técnicas de transferencia Western. Descubrimos que AhR se expresó ampliamente en tejidos de cáncer de mama y en linfonodos con metástasis, pero no en tejidos normales. La expresión AhR fue independiente entre la edad, grados y clasificaciones TNM para tejidos de cáncer de mama. El tratamiento con ITE indujo significativamente la activación de AhR de manera dependiente del tiempo en las líneas celulares de cancer de mama MCF-7 y T47D. Mientras tanto, ITE no afectó la migración celular, pero suprimió significativamente la proliferación celular en células MCF-7 y T47D con receptor de estrógeno positivo (ER+), lo que probablemente se atribuye a la inducción de la detención del ciclo celular en la fase G1 y la fase S acortada. Un estudio adicional del mecanismo mostró que las señales de ERK1/2 y AKT eran necesarias para la activación de AhR en las células MCF-7. Estos datos sugieren que AhR es un nuevo objetivo potencial para el tratamiento de pacientes con cáncer de mama. ITE puede ser utilizado más potencialmente en la intervención terapéutica para el cáncer de mama con el tipo de ER (+).

Relationship between chronotype and mental health problems among middle school students in Taiyuan / 中国学校卫生

Objective@#To examine mental health problems among adolescents in Taiyuan City and its relationship to chronotype, so as to give a scientific basis for supporting mental health of middle school students.@*Methods@#From October to November 2021, a total of 2 621 pupils were enrolled from three junior high schools and two senior high schools in Taiyuan by using a multi stage stratified cluster random sampling method to investigate demographic characteristics, mental health status, and chronotype. Chi squared test, Spearman correlation analysis and Logistic regression were used to analyze the relationship between sleep patterns and mental health problems in middle school students.@*Results@#The proportion of morning, intermediate and evening types of middle school students sleep were 17.9%, 65.6%, and 16.4%, respectively. The overall detection rate of mental health problems was 13.8 %, which was statistically significant among middle school students in different grades, self perceived family economic status, the number of friends and sleep patterns ( χ 2=42.69, 29.15, 46.02, 93.99, P <0.05). After adjusting for grade, self perceived family economic status and the number of friends, Logistic regression analysis revealed that mental health problems were positively associated with evening type ( OR =2.84) and negatively associated with morning type ( OR =0.61)( P ＜0.05).@*Conclusion@#Chronotype is associated with mental health problems among middle school students, with a higher risk for evening type and a lower risk for morning type. Mental health of middle school students can be enhanced by changing their chronotype.

Association between suicidal ideation and exposure to socialecological risk factors among middle school students in Taiyuan City / 中国学校卫生

Objective@#To understand the current situation of suicidal ideation among middle school students in Taiyuan City and its correlation with exposure to social ecological risk factors, so as to provide a reference basis for exploring the causes of suicidal ideation among middle and high school students and formulating effective preventive measures.@*Methods@#A questionnaire survey was conducted among 2 639 middle school students in urban and rural areas of Taiyuan City by multistage stratified random cluster sampling, including general demography characteristics, social ecological risk factors and suicidal ideation. SPSS 26.0 software was used for Chi squared test and binary Logistic regression analysis.@*Results@#The overall detection rate of suicidal ideation was 24.7 %. There were statistically significant differences in the detection rate of suicidal ideation among middle school students in different gender, grade, family residence, maternal education level, perceived family economic conditions, number of close friends, self-perceived academic burden ( χ 2=38.17, 13.44, 10.77, 8.15, 19.76, 18.95, 59.75, P <0.05). After adjusting the general demography characteristics, the binary Logistic regression showed that moderate and high risk in the individual, family and cultural dimension, and high risk in the school dimension of the social ecology were all positively correlated with suicidal ideation among middle school students ( OR=1.38, 2.28, 1.97, 3.28, 1.48, 2.15, 1.71, P <0.05).@*Conclusion@#The suicidal ideation among middle school students is related to individuals, families, and schools in the social ecological microsystem, as well as the cultural environment in the macro system. It is necessary to conduct intervention in suicidal ideation at the individual, family, and school levels, meanwhile, strengthening social and cultural construction to reduce the impact of adverse factors on the mental health among adolescents.

Transcriptome analysis of Aedes aegypti larvae before and after treatment with fipronil / 中国热带医学

@#Abstract: Objective　In order to explore the application prospects of the phenyl pyrazole insecticide fipronil for mosquito control and identify potential target genes involved in the resistance of Aedes aegypti to fipronil, and lay the foundation for an in-depth study of the resistance mechanism of Aedes aegypti to fipronil. Methods　Using Aedes aegypti sensitive strains as experimental materials, Aedes aegypti larvae were treated with fipronil, and the differences in gene expression of Aedes aegypti larvae before and after drug administration were compared at the transcriptome level using transcriptome sequencing combined with bioinformatics analysis, and the differential genes were analyzed. Results　A total of 757 differentially expressed genes were identified between the fipronil-treated group and control group, including 217 and 540 up- and down-regulated genes, respectively. Among these, the expression of glutamate-gated chloride channel (GluCls) genes varied significantly before and after treatment. Gene ontology analysis revealed that differentially expressed genes were enriched in catalytic activity, binding, metabolic processes, and membrane-related functions, while KEGG pathway analysis indicated enrichment in biosynthesis, metabolism, and life regulation processes, while the glutathione metabolic pathway was enriched in 15 differentially expressed genes. Conclusions The transcriptome results revealed that GST gene expression was significantly upregulated in fipronil-treated Aedes aegypti larvae, indicating that GST gene is involved in the development of fipronil resistance in Aedes aegypti larvae. In addition, GluCls gene expression was also significantly different before and after treatment, suggesting that GluCls migh be a potential target receptor for fipronil resistance in Aedes aegypti. As GluCls is an ideal target receptor found only in invertebrates, this discovery provides a reference and basis for further exploration of the toxicological mechanism of fipronil on Aedes aegypti.

Expression of COUP-TFⅡ in gastric cancer tissues and its regulation of transcriptional activity of VEGFR3-NRP2 axis in gastric cancer SGC7901 cells / 中国肿瘤生物治疗杂志

@#[摘 要] 目的：探讨COUP-TFⅡ在胃癌中对淋巴转移相关因子VEGFR3-NRP2轴的调控分子机制。方法：收集2015年3月至2015年8月在滨州医学院附属医院手术切除的60例胃癌组织和相应的癌旁组织及正常胃黏膜活检组织，用免疫组化和qPCR法检测COUP-TFⅡ、VEGFR3和NRP2的表达；培养胃癌细胞SGC7901和BGC823，构建过表达和siRNA-COUP-TFⅡ质粒后转染SGC7901细胞，用WB和qPCR检测转染后SGC7901细胞中COUP-TFⅡ、VEGFR3、NRP2的表达，用免疫共沉淀（CHIP）和双荧光素酶报告基因实验验证COUP-TFⅡ与VEGFR3-NRP2轴的靶向关系。结果:免疫组化检测显示，VEGFR3、NRP2、COUP-TFⅡ在胃癌组织中呈高表达（P<0.01）；qPCR结果显示，与癌旁组织和正常组织相比，胃癌组织VEGFR3、NRP2和COUP-TFⅡ的mRNA呈高表达（P<0.05或P<0.01）；WB和qPCR法结果显示，与对照组相比，过表达COUP-TFⅡ组SGC7901细胞中COUP-TFⅡ mRNA和蛋白水平表达均显著升高（均P<0.01）；敲减组SGC7901细胞中COUP-TFⅡ mRNA和蛋白水平均显著下降（P<0.05或P<0.01），且VEGFR3和NRP2 mRNA水平也均显著下降（均P<0.01）；CHIP结果显示，SGC7901和BGC823细胞中COUP-TFⅡ抗体的免疫共沉淀物中含有VEGFR3和NRP2启动子DNA序列；双荧光素酶报告基因实验结果显示，COUP TFⅡ表达水平与VEGFR3和NRP2表达水平呈正相关。结论：COUP-TFⅡ在胃癌组织中高表达且对VEGFR3-NRP2轴存在正性调控作用，且在胃癌中高表达，COUP-TFⅡ可能为胃癌治疗的新靶点。

Research on Anti-inflammatory Targets and Mechanisms of alkaloids in Picrasma quassioides Benn Through Network Pharmacology

Abstract This study aimed to investigate the molecular mechanism of Picrasma quassioides Benn against inflammation by means of network pharmacology. The paper will provide a reference for multi-target and multi-channel treatment of inflammation with traditional Chinese medicine. Through screening and analysis, 11 active ingredients and 109 anti-inflammation prediction targets were obtained and constructed a compound-target network. The targets such as VEGFA, TLR4 and STAT3 may play a crucial role. Network enrichment analysis showed that the 109 potential targets constitute a number of pathways or inflammatory reactions closely related to inflammation, including NF-κB signaling pathway and MAPK signaling pathway. The docking results indicated that the binding energy of Picrasidine Y and the inflammatory factors VEGFA is the highest. This study predicted the role of multiple active compounds in the alkaloids of Picrasma in the inflammatory response, and provided a theoretical basis for the anti-inflammatory mechanism of Picrasma

Nomogram for predicting post-traumatic hydrocephalus after decompressive craniectomy for traumatic brain injury

SUMMARY OBJECTIVE: This study aimed to develop and validate a practical nomogram to predict the occurrence of post-traumatic hydrocephalus in patients who have undergone decompressive craniectomy for traumatic brain injury. METHODS: A total of 516 cases were enrolled and divided into the training (n=364) and validation (n=152) cohorts. Optimal predictors were selected through least absolute shrinkage and selection operator regression analysis of the training cohort then used to develop a nomogram. Receiver operating characteristic, calibration plot, and decision curve analysis, respectively, were used to evaluate the discrimination, fitting performance, and clinical utility of the resulting nomogram in the validation cohort. RESULTS: Preoperative subarachnoid hemorrhage Fisher grade, type of decompressive craniectomy, transcalvarial herniation volume, subdural hygroma, and functional outcome were all identified as predictors and included in the predicting model. The nomogram exhibited good discrimination in the validation cohort and had an area under the receiver operating characteristic curve of 0.80 (95%CI 0.72-0.88). The calibration plot demonstrated goodness-of-fit between the nomogram's prediction and actual observation in the validation cohort. Finally, decision curve analysis indicated significant clinical adaptability. CONCLUSION: The present study developed and validated a model to predict post-traumatic hydrocephalus. The nomogram that had good discrimination, calibration, and clinical practicality can be useful for screening patients at a high risk of post-traumatic hydrocephalus. The nomogram can also be used in clinical practice to develop better therapeutic strategies.

The pollution of metal elements in PM2.5 at the metro stations / 预防医学

Objective @#To investigate the pollution of metal elements in PM2.5 at the metro station by monitoring, so as to provide evidence for health protection strategies.@*Methods@#The PM2.5 concentrations on the platforms, in the tunnels, and above the ground of two selected metro stations in some city were collected and measured by electronic balance. The concentrations of Fe, Al, Cu, Mn, Ni, Pb, Zn, Cr, Ba and Cd in PM2.5 were determined by inductively coupled plasma mass spectrometry (ICP-MS). The pollution index (PI) and enrichment factor (EF) of these elements were analyzed.@*Results@#The concentration of PM2.5 was (101.46±32.88) μg/m3 on the platforms, (104.42±32.95) μg/m3 in the tunnels and (74.25±13.29) μg/m3 above the ground. The highest Fe concentrations were (33.19±5.93) μg/m3 on the platforms and (39.95±11.56) μg/m3 in the tunnels, accounting for (33.73±9.40)% and (42.72±17.17)% of PM2.5. The average PI values of Fe, Mn and Ba in PM2.5 on the platforms were 29.67, 9.24 and 7.13, in the tunnels were 36.30, 11.23 and 8.30, respectively, with very high level of pollution; the average EF values of Fe, Mn and Ba in PM2.5 on the platforms were 20.15, 4.55 and 4.33, in the tunnels were 19.44, 4.16 and 4.07, with serious, medium and medium level of enrichment, respectively.@*Conclusion@#The main metal pollutants in PM2.5 at the metro station are Fe, Mn and Ba, which are enriched in the metro environment.

Cefazolin sodium pentahydrate combined with vacuum sealing drainage in the treatment of open fracture complicated with soft tissue injury

SUMMARY OBJECTIVE To investigate the clinical efficacy of cefazolin sodium pentahydrate combined with vacuum sealing drainage (VSD) in the treatment of open fracture complicated with soft tissue injury. METHODS Sixty-three patients with open fracture complicated with soft tissue injury were divided into observation (n = 33) and control (n = 30) groups. After surgical reduction, fixation, and repair of the fractures, the control group was treated with VSD for 10 days, and the observation group was treated with cefazolin sodium pentahydrate based on VSD for 10 days. The infection control time was recorded. After treatment, the pain of patients was evaluated. Before and after treatment, the serum levels of C-reactive protein (CRP), interleukin (IL)-6, IL-8, tumor necrosis factor α (TNF-α), cortisol, epinephrine, norepinephrine, and glucose were detected. After 6 months of treatment, the total effective rate of the treatment was evaluated. RESULTS The infection control time and Visual Analogue Scale score after treatment in the observation group were significantly lower than in the control group, respectively (P < 0.05). After the treatment, the serum levels of CRP, IL-6, IL-8, TNF-α, cortisol, epinephrine, norepinephrine, and glucose in each group were significantly lower than before the treatment (P < 0.05), and each index in observation was significantly lower than in the control group (P < 0.05). CONCLUSIONS In the treatment of open fractures complicated with soft tissue injury, cefazolin sodium pentahydrate combined with VSD can effectively reduce inflammation and stress, thus improving the treatment efficacy.

RESUMO OBJETIVO Investigar a eficácia clínica do cefazolin penta-hidrato de sódio combinado com drenagem por vedação a vácuo (VSD) no tratamento da fratura exposta complicada com lesão nos tecidos moles. MÉTODOS Sessenta e três doentes com fratura exposta complicada com lesões nos tecidos moles foram divididos em grupos de observação (n=33) e controle (n=30). Após redução cirúrgica, fixação e reparação da fratura, o grupo de controle foi tratado com VSD durante dez dias e o grupo de observação foi tratado com cefazolina penta-hidrato de sódio com base no VSD durante dez dias. O tempo de controle de infecção foi gravado. Após o tratamento, a dor dos doentes foi avaliada. Antes e após o tratamento, foram detectados os níveis séricos de proteína C-reativa (CRP), interleucina (IL)-6, IL -8, fator de necrose tumoral alfa (TNF-α), cortisol, epinefrina, norepinefrina e glicose. Após seis meses de tratamento, a taxa efetiva total de tratamento foi avaliada. RESULTADOS O tempo de controle da infecção e a pontuação da Escala Visual Analógica após o tratamento no grupo de observação foram significativamente inferiores ao do grupo de controle, respectivamente (P<0,05). Após o tratamento, os níveis séricos de CRP, IL-6, IL-8, TNF-α, cortisol, epinefrina, norepinefrina e glicose em cada grupo foram significativamente menores do que antes do tratamento, respectivamente (P<0,05), e cada índice de observação foi significativamente inferior ao do grupo de controle (P<0,05). CONCLUSÃO No tratamento da fratura exposta complicada com lesões nos tecidos moles, o cefazolin penta-hidrato de sódio combinado com VSD pode efetivamente reduzir a inflamação e o estresse, melhorando assim a eficácia do tratamento.

Outcomes following coronary artery bypass graft surgery in patients with mild preoperative renal insufficiency

Abstract Introduction: Preoperative renal insufficiency is an independent predictor of mortality after coronary artery bypass graft (CABG) surgery. However, there are few reports aimed to evaluate the impact of mild preoperative renal insufficiency on long-term follow-up outcomes after isolated CABG surgery. This study investigates the effect of mild preoperative renal insufficiency on long-term follow-up outcomes of patients after CABG. Methods: Five hundred eighty-four patients' data that underwent CABG between 1 January 2009 and 1 December 2016 were retrospectively analyzed. They were divided into two groups: normal group [Estimated glomerular filtration rate (eGFR) ≥ 90 ml/min/1.73 m2, n=304] and mild group (eGFR ranges from 60 to 89 ml/min/1.73 m2, n=280). Clinical material and long follow-up outcomes were compared inthe two groups. Results: Two groups had similar baseline and intraoperative data except eGFR. Six (0.01%) patients died in hospital, 15 in normal group and 28 in mild group during the long-term follow-up, which had statistical significance (P<0.05). Univariate factor analysis displayed that the two groups had similar in-hospital outcomes. Kaplan-Meier curves showed a better long-term survival in patients with normal preoperative renal function compared to mild preoperative renal insufficiency (x 2=4.255, P=0.039). Cox proportional model presented the hazard ratio of long-term mortality in patients with mild preoperative renal insufficiency compared to normal preoperative renal function was 1.79 (95% CI 1.17-2.88, P=0.027). Conclusions: Patients with mild preoperative renal insufficiency had a higher mortality rate than normal patients in long-term survival, whereas no evidence of worse in-hospital mortality rate was found. Patients with mild preoperative renal insufficiency showed a higher mortality rate than other studies.

Pancreatic Neuroendocrine Neoplasms: Correlation between MR Features and Pathological Tumor Grades / 华中科技大学学报（医学）（英德文版）

This study investigated the accuracy of MRI features in differentiating the pathological grades of pancreatic neuroendocrine neoplasms (PNENs).A total of 31 PNENs patients were retrospectively evaluated,including 19 cases in grade 1,5 in grade 2,and 7 in grade 3.Plain and contrastenhanced MRI was performed on all patients.MRI features including tumor size,margin,signal intensity,enhancement patterns,degenerative changes,duct dilatation and metastasis were analyzed.Chi square tests,Fisher's exact tests,one-way ANOVA and ROC analysis were conducted to assess the associations between MRI features and different tumor grades.It was found that patients with older age,tumors with higher TNM stage and without hormonal syndrome had higher grade of PNETs (all P＜0.05).Tumor size,shape,margin and growth pattern,tumor pattern,pancreatic and bile duct dilatation and presence of lymphatic and distant metastasis as well as MR enhancement pattern and tumor-topancreas contrast during arterial phase were the key features differentiating tumors of all grades (all P＜0.05).ROC analysis revealed that the tumor size with threshold of 2.8 cm,irregular shape,pancreatic duct dilatation and lymphadenopathy showed satisfactory sensitivity and specificity in distinguishing grade 3 from grade 1 and grade 2 tumors.Features ofperipancreatic tissue or vascular invasion,and distant metastasis showed high specificity but relatively low sensitivity.In conclusion,larger size,poorlydefined margin,heterogeneous enhanced pattern during arterial phase,duct dilatation and the presence of metastases are common features of higher grade PNENs.Plain and contrast-enhanced MRI provides the ability to differentiate tumors with different pathological grades.

Early vitreomacular separation with delayed macular hole closure after ocriplasmin treatment.

Based on the indications, one‑third to one‑half of patients can achieve full‑thickness macular hole (FTMH) closure with or without the separation of vitreomacular adhesion (VMA) within 28 days of ocriplasmin treatment. The authors report the case of a 63‑year‑old man with early VMA separation and delayed FTMH closure after ocriplasmin treatment. Four weeks posttreatment, the posterior vitreous detachment occurred at the optic disk, and the macular hole (MH) started decreasing thereafter. MH closure was finally achieved at 10 weeks posttreatment, leaving minimal subretinal fluid. The patient’s vision improved from 0.8 LogMAR (pretreatment) to 0.3 LogMAR (12 weeks posttreatment). This case suggests that FTMH closure can be achieved within 28 days of ocriplasmin treatment.

A meta-analysis of metronidazole and vancomycin for the treatment of Clostridium difficile infection, stratified by disease severity

The aim of this meta-analysis was to compare the efficacy of metronidazole and vancomycin for the treatment of Clostridium difficileinfection, especially to investigate which agent was superior for treating either mild or severe C. difficileinfection. A meta-analysis of randomized controlled trials and cohort studies identified in Pubmed, Embase, and the Cochrane Library was conducted. Four randomized controlled trials and two cohort studies involving 1218 patients were included in this meta-analysis. Metronidazole was inferior to vancomycin for treating C. difficileinfection in terms of both initial clinical cure rates (risk ratio, RR = 0.91, 95% confidence interval, CI = 0.84-0.98, p= 0.02) and sustained cure rates (RR = 0.88, 95% CI = 0.82-0.96, p= 0.003). For mild C. difficileinfection, the efficacy of metronidazole and vancomycin resulted in similar clinical cure rates (RR = 0.94, 95% CI = 0.84-1.04, p= 0.21) and sustained cure rates (RR = 0.93, 95% CI = 0.83-1.05, p= 0.26). For severe C. difficileinfection the efficacy of vancomycin was superior to metronidazole in terms of clinical cure rates (RR = 0.81, 95% CI = 0.69-0.95, p= 0.009), whereas sustained cure rates were similar (RR = 0.86, 95% CI = 0.72-1.02, p= 0.08). Regarding microbiological cure metronidazole therapy was as effective as vancomycin therapy (RR = 0.88, 95% CI = 0.64-1.21, p= 0.43). Recurrence rates with metronidazole and vancomycin for both mild C. difficileinfection (RR = 0.95, 95% CI = 0.56-1.60, p= 0.85) and severe C. difficileinfection (RR = 1.27, 95% CI = 0.85-1.91, p= 0.25) were not different. Likewise, no difference in all-cause mortality was found as well (RR = 0.87, 95% CI = 0.56-1.35, p= 0.53). In conclusion, vancomycin provides improved initial clinical and sustained cure rates in patients with C. difficileinfection compared with metronidazole, especially in patients with severe C. difficileinfection. In view of these data, vancomycin may be considered first line therapy for severe C. difficileinfection.

Endovascular embolization of large and giant intracranial aneurysms of long-term angiographic fol-low-up / 中国神经精神疾病杂志

Objective To investigate the outcome of endovascular treatment of large or giant intracranial aneu?rysm by long-term angiographic follow-up. Methods Clinical data of 72 patients with large or giant intracranial aneu?rysms receiving endovascular treatment were analyzed retrospectively. Thirty aneurysms were treated with coil emboliza?tion alone, 14 with stent-assisted coiling, 15 with covered stent-deployment and 13 with parent artery occlusion. Results complete occlusion was achieved in 10 cases of pure coil embolization, 7 cases of stent assisted coil embolization,11 cas?es of completely covered stent-deployment and,13 cases of parent artery occlusion. The postoperative immediate com?plete embolism rate was 56.9%. Nearly completely occlusion was achieved in 17 cases of pure coil embolization, in 6 cas?es of stent auxiliary coil embolization, 4 cases of covered stent-deloyment and zero case of parent artery occlusion. The total postoperative immediate nearly completely embolism rate was 37.5%. Incomplete occlusion was achieved in 3 cases of pure coil thrombosis, 1 case of stent assisted coil, zero case of ,covered stent-deloyment and zero case of parent artery occlusion. The total immediate postoperative incomplete embolization rate was 5.6%. Patients were followed up for 6 to 72 months, with an average follow-up of 24.2 months . All patients had no bleeding. The total periprocedural complica?tion rate was 9.7%and there were no death cases. The recurrence of aneurysm in pure spring coil embolization treatment was higher compared with other treatments. The overall recurrence rate was 23.6%. The recurrent 14 aneurysms were suc?cessfully treated endovascularly. Conclusions Endovascular embolization treatment of intracranial large or giant aneu?rysm is safe and effective but its long-term recurrence rate is high. Thus a close follow-up is needed. Endovascular inter?ventional therapy based on the location of aneurysm and shape characteristics can improve treatment effectiveness and re?duce recurrence rate.

PI3K/Akt/mTOR pathway participates in neuroprotection by dexmedetomidine inhibits neuronic autophagy following traumatic brain injury in rats.

Dexmedetomidine (Dex) has been demonstrated to provide neuroprotective effect against brain injury in the central nervous system. However, the underlying mechanism of this neuroprotection remains unclear. In this study, we explored whether Dex has the protective potential in rat models of traumatic brain injury(TBI). More importantly, our study further investigated the role of neuronic autophagy induced by PI3K/Akt/mTOR pathway in this neuroprotective action. Adult male Sprague-Dawley rats were subjected to a diffuse cortical impact injury caused by a modified weight-drop device and Dex (15ug/kg, i.v.) was administered immediately after TBI. Wet-dry weight method was used to evaluate brain edema. Motor function outcome was assessed by Neurologic Severity Score and the spatial learning ability was evaluated in a Morris water maze. The co-localization of microtubule-associated protein 1 light chain 3(LC3) and neuronal nuclei (NeuN), or LC3 and mammalian target of rapamycin (mTOR) were analyzed by immunofluorescence respectively. The expression of LC3, Phosphorylated protein kinase B (p-Akt) and p-mTOR were quantified using Western blot analysis. Our results showed treatment of rats exposed to TBI with Dex caused not only marked reduction in cerebral edema, motor and cognitive functions deficits, but also a decrease in LC3 levels and a increase in p-Akt and p-mTOR levels. Taken together, these findings indicated that treatment with Dex after TBI could inhibited neuronic autophagy in the hippocampus mediated by the activation of the PI3K/Akt/mTOR pathway, finally promoting neurological recovery.

The role of continuous vacuum sealing drainage in the prevention of lymph leakage after inguinal lymph nodes dissection / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical application of the vacuum-sealing drainage (VSD) in the prevention of lymph leakage after inguinal lymphadenectomy.</p><p><b>METHODS</b>From September 2003 to September 2013, 60 cases who underwent inguinal lymph nodes dissection received VSD (n = 30), or traditional pressure dressing and drainage( control group, n = 30) after operation. The flap blood supply, healing process and incidence rate of lymph leakage were observed.</p><p><b>RESULTS</b>Twenty-eight cases in VSD group were effective. Eleven cases were cured, ten cases were effective, and nine cases were invalid in control group. The cure rate, effective rate and healing period were significantly different between the two groups (P < 0.01).</p><p><b>CONCLUSIONS</b>The incidence of lymph leakage after inguinal lymphadenectomy can markedly decrease with VSD application. VSD could be an ideal preventive method for post-operative lymph leakage.</p>

Primary Tracheobronchial Amyloidosis in China: Analysis of 64 Cases and A Review of Literature / 华中科技大学学报（医学）（英德文版）

Primary tracheobronchial amyloidosis (TBA) is a rare pulmonary disease. A systematic review was performed on 64 cases of primary TBA in China and progress in the diagnosis and treatment of this disease is discussed. The Chinese biological and medical databases from 1970 to 2010were searched and 75 cases of complete clinical and pathological data were identified. The clinical characteristics of the disease were summarized and longitudinal comparisons were made of diagnostic and treatment methods over time. The results showed that the morbidity associated with primary TBA has increased over recent years. The clinical manifestations were non-specific. Progressive dyspnea, cough and sputum were the most common symptoms. The percentage of patients undergoing computed tomography (CT) scan has increased over the years. The bronchoscopy and transbrochial lung biopsy (TBLB) were usually sufficient to establish the diagnosis. Treatment was reported for a total of 44 cases. Bronchoscopic Nd:YAG laser irradiation, argon plasma coagulation (APC)and drugs administration such as steroids and colchicines were reported to be effective in some patients. It is concluded that the demographic characteristics and clinical manifestations of primary TBA patients in China are largely consistent with findings reported in other countries. Dramatically more cases were reported in recent years, mainly due to the extensive application of bronchoscopy since 1990s. Chest CT scan provides important clues for the diagnosis of the disease. The definite diagnosis was confirmed by bronchoscopic findings and Congo red staining of biopsy specimen.Bronchoscopic Nd:YAG laser irradiation, argon plasma coagulation (APC) and drugs administration,such as steroids and colchicines were reported to be effective in some patients.

Apoptosis of Alveolar Wall Cells in Chronic Obstructive Pulmonary Disease Patients with Pulmonary Emphysema Is Involved in Emphysematous Changes / 华中科技大学学报（医学）（英德文版）

s of alveolar wall cells, espe-cially apoptosis of type-Ⅱ cells, may take part in the pathogenesis of emphysema. Up-regulation of Bax expression may be responsible for the apoptosis of alveolar wall cells in the COPD patients with pulmonary emphysema.