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【Objective】 To investigate the clinical application of self-developed magnetic anchoring device for assisting thoracoscopic pulmonary resection. 【Methods】 Eleven patients underwent thoracoscopic pulmonary assisted with resection magnetic anchoring technique at the Department of Thoracic Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, from March to May 2019. Their clinical data were retrospectively analyzed. The operation time, blood loss, blood transfusion volume, postoperative hospital stay, and postoperative complications were recorded. 【Results】 There were seven male and four female patients, with the average age of (51.6±13.9) years (range from 22 to 69 years). Three single-port and eight single-utility-port thoracoscopic surgeries were performed. Magnetic instruments provided good surgical field exposure in all operations. Among 11 surgeries, one was converted to thoracotomy and one to three-hole surgery due to enlargement and adhesion of hilar lymph nodes. The operation time was (107.8±63.1) minutes (range of 27-182 minutes). The blood loss was 50 (10-50)mL (range of 5-1 000 mL). No blood transfusion was needed during the operation. The postoperative hospital stay was (5.0±1.8) days (range of 3-9 days). No postoperative complications occurred in all the patients. 【Conclusion】 Magnetic anchor technique can effectively alleviate the "chopstick effect" in thoracoscopic surgery. Magnetic anchor technique is safe and feasible in assisting thoracoscopic pulmonary resection.
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The effect of body mass index (BMI) on the incidence rate and prognosis of esophageal cancer is one of the significant subjects of clinical research about esophageal cancer in recent years.Researchers have attempted to use BMI to predict the risk and prognosis of esophageal cancer.However,no consensus has yet been reached.In this article,the author reviewed related articles published at home and abroad during the last decade to explore the correlation between BMI and esophageal cancer.
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Objective To observe the impairment effect of retinol binding protein 4(RBP4) on neurocognitive function in diabetic nephropathy(DN) patients with silent cerebral infarction(SCI) and to explore its mechanism.Methods Sixty patients with newly diagnosed DN and 30 healthy volunteers were selected as the study subjects and the DN cases were divided into the complicating SCI group(SCI,n=30) and non-complicating SCI group(NSCI,n=30) according to the imaging results.The degrees of neurological function deficit and Montreal cognitive assessment(MoCA) were evaluated.Serum RBP4 level was determined by ELISA and expressions of Lp-PLA2 and C-X-C chemokine receptor type 4(CXCR4) were determined by Western blot.Results Compared with the NSCI group,the neurocognitive function in the SCI group was subsided,the expression levels of RBP4,Lp-PLA2 and CXCR4 were increased(P＜0.05).The RBP4 level was positively correlated with the neurocognitive function impairment in SCI patients,moreover,there existed a regression correlation between them.Conclusion Serum RBP4 may serve as the predictive factor of DN complicating SCI and is positively correlated with neurocognitive dysfunction.Lp-PLA2/CXCR4 pathway activation may be one of its pathogenesis.
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Objective To investigate the value of neurite orientation dispersion and density imaging (NODDI) in quantitative evaluation of the microstructural changes in basal ganglia and thalamus in Wilson's disease (WD) patients,and to assess the diagnostic efficacy of NODDI.Methods Totally 27 WD patients (WD group) and 26 age-and sex-matched controls (control group) were enrolled.All subjects underwent MR scanning with NODDI.Parameters of NODDI,including intracellular volume fraction (Vic),orientation dispersion index (ODI) and isotropic volume fraction (Viso) of bilateral caudate nucleus,globus pallidus,putamen and thalamus were compared between the 2 groups.Correlation analysis was performed between each parameter of NODDI and clinical Young scores.Random Forest model was used to assess the relative importance of each parameter and to evaluate the diagnostic efficacy.Results The Vic and ODI of bilateral caudate nucleus,globus pallidus and putamen in WD patients were significantly lower than those in normal controls (all P＜0.05),while Viso was significantly higher than that in normal controls (all P＜0.05).The Vic of bilateral thalamus was lower,while Viso was higher in WD patients than those in normal controls (all P＜0.05),and ODI had no significant difference between the 2 groups (P=0.055).In WD patients,Vic and ODI of bilateral caudate nucleus,globus pallidus and putamen were negatively correlated with clinical Young scores.Viso of globus pallidus and putamen were positively correlated with clinical scores.The prediction accuracy of NODDI was 96.23％,and the area under ROC curve was 0.96.Conclusion NODDI can effectively evaluate changes in microstructures and metabolism during copper deposition in WD patients,and it may be useful in detecting changes of brain deep nuclei and assessing the progression of WD.
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Objective: To introduce the application and practice of information technology in the management of charitable donated injection drugs in our hospital, and explore the information management mode of injection-type charitable drugs in the new era. Meth-ods: Taking herceptin injection as an example, the injection-type drug management system was introduced by comparing October 2016-April 2017 (before the implementation of the information system) and May 2017-October 2017 (after the implementation of the infor-mation system). The comparison items included infusion qualified rate, consumption time for the management and deployment of hu-man resources of each bottle of herceptin, and satisfaction of related doctors, nurses and patients during the drug management process. Results: The qualified rate of finished infusion before and after the implementation of the information system was 94. 29% and 99. 05% , respectively. The consumption time for the management and deployment of human resources of each bottle of herceptin was 2. 11 and 0. 36 working hours before and after the implementation of the system. The overall satisfaction of doctors, nurses and patients was 78% , 42% and 62% before the implementation, and 98% , 96% and 98% after the implementation. The differences in the above indices between pre-implementation and post-implementation were significant (P<0. 01). Conclusion: The use of information man-agement in the growing number of injection-type charitable drugs can ensure the safety, effectiveness and convenience, and the system is worthy of promotion and application.
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Based on thorough analysis of the present healthcare big data,and present problems found in precision medicine,the paper proposed the implementation approach of precision medicine driven by healthcare big data.Citing the practice of the hospital as an example,the authors centered on clinical data to build a precision medicine knowledge system,and leveraged in-depth data mining to develop integrated analysis technology for precision medicine.These efforts aim at application development of precision medicine series upon a panoramic medicine knowledge display,so as to enhance medical quality and diagnosis efficiency and translated use of healthcare big data in precision medicine.
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Objective To evaluate the efficacy and safety of donepezil in the treatment of cognitive dysfunction caused by radiation-induced encephalopathy.Methods A total of fifty-five patients with radiation-induced cognitive impairment were divided into treatment group with extra donepezil 5-10 mg/d combined with conventional therapy and control group with conventional treatment for 16 weeks.The cognitive function was assessed according to Montreal cognitive assessment (MoCA) and mini-mental state examination (MMSE) before and 16 weeks after treatment.Results After 16 weeks of treatment,the patients in treatment group displayed significantly greater improvement in cognitive function.In treatment group,the scores of patients after donepezil therapy in MoCA and MMSE were obviously higher than the control group (t =5.40,3.88,P ＜ 0.01).The scores in the visual space and executive function,naming,attention,abstract thinking,delayed memories also had improved,which suggested the statistically significant difference(t=-3.55,-3.08,-3.21,-2.58,-3.65,P＜0.05).The scores of control group unchanged accordingly.Conclusions Donepezil combined with conventional treatment was signally effective in the therapy of cognitive dysfunction caused by radiation-induced encephalopathy.
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This article sorts out and analyzes recent years’ literature about experimental studies on Huatuo jiaji (Ex-B2) point acupuncture treatment for spinal cord injury (SCI), discusses the mechanism of Huatuo jiaji point acupuncture treatment for spinal cord injury from three aspects:improving microenvironment for nerve repair, inhibiting apoptosis and promoting nerve repair and tries to explore the possible direction of its future development.
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BACKGROUND:Porous gradient hydroxyapatite/zirconia composite, which can adhere to a variety of cel s, such as osteoblasts, bone marrow mesenchymal stem cel s and chondrocytes, can induce and promote fracture healing or replace bone defects. OBJECTIVE:To review the development and application of porous gradient hydroxyapatite/zirconia composite in bone tissue engineering. METHODS:Articles related to porous gradient hydroxyapatite/zirconia composite in bone tissue engineering were retrieved in CNKI and PubMed databases (1971-01/2014-12). The key words were“porous bioceramic, bone tissue engineering, bone morphogenetic protein-2, induced pluripotent stem cel s”in Chinese and English, respectively. A total of 54 articles based on inclusion criteria and exclusion criteria were obtained for the review. RESULTS AND CONCLUSION:Porous gradient hydroxyapatite/zirconia composite can provide a scaffold to induce natural y forming bone growing to fil the three-dimensional pores, thus realizing the perfect integration of tissue-engineered bone material and host-bone tissue. As zirconia functions as an enhancer of hydroxyapatite, high-quality artificial bone materials, which have elastic modulus, fracture toughness and structure similar to human bone, can be prepared by adjusting the proportion and porosity of materials. Additional y, the new hydroxyapatite/zirconia foamed ceramics as tissue-engineered bone carrying bone morphogenetic protein-2/chitosan gel sustained release system and bone marrow mesenchymal stem cel s derived from induced pluripotent stem cel s wil be expected to increase bone formation and bone fusion rates significantly in the future.
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Objective To explore the correlation between the glucose variability and the severity of acute isolated traumatic brain injury(TBI). Method According to the inclusion/exclusion criteria,a total of 125 cases of acute isolated TBI admitted in Department of Neurosurgery of China Medical University from July 2012 to June 2015 were included. According to Glasgow coma scale(GSC),the patients were divided into five groups including control(GCS 15),mild(GCS 13?14),moderate(GCS 9?12),severe(GCS 6?8),and extra?severe(GCS 3?5)groups. Blood glucose control(including relief of the stress and the application of insulin)were carried out immediately. The average,standard deviation,and variation co?efficient of blood glucose of all groups were recorded at admission,48 hours and 3?7 days after hospitalization. The clinical records and glycemic in?dex were compared among different groups and during different periods,so as to analyze the relationship of the variability of glucose and the duration of hyperglycemia with the severity of TBI and the effects of glycemic intensive care management. Results The results of Kruskal Wallis test and Mann?Whitney Utest showed that the average,standard deviation,and variation coefficient of glucose in the extra?severe group and the severe group were statistically higher than those in the control group(P1). Conclusion The glucose variability in acute isolated TBI patients could be considered as the index of the severity of TBI.
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Objective To analysis the effects of Ang-(1-7) on the blood brain barrier permeability after subarachnoid hemor-rhage .Methods SAH-rats were produced by two times injection of blood into cisterna magna .Evans blue was used to detect the the permeability of SAH-rats brains and brain water content .RT-PCR and Western blot were performed to measure the expression of adhesion protein ICAM-1 and VCAM-1 in brains of SAH-rats .The artificial hemorrhagic cerebrospinal fluid (BCSF) was used to stimulate vascular endothelial cells (HBMEC) ,and the proliferation and apoptosis of HBMEC cell were analyzed .Results Ang-(1-7) reduced the content of Evans blue and brain water in brains of SAH-rats in dose and time dependent manner with the most sig-nificant change under the treatment of 10 - 5 mol/L Ang-(1-7) for 24 h (P< 0 .05) .Under the above condition ,the mRNA and pro-tein levels of ICAM-1 and VCAM-1 in brains of SAH-rats were significantly up-regulated (P< 0 .05) ,while the content of Evans blue in HBMEC cells stimulated by BCSF was obviously reduced .Besides ,Ang-(1-7) was observed to increase the expression of ICAM-1 and VCAM-1 in BCSF-stimulated HBMEC cells ,enhance the proliferation of HBMEC cells but reduce their apoptosis . Conclusion Ang-(1-7) plays a protective role in the blood-brain barrier damage induced by subarachnoid hemorrhage .
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An analysis of the opportunities and challenges brought forth to research hospitals in the face of emerging new technologies,described the development direction of such hospitals in terms of strategic planning of precision medicine, breakthrough of mechanism barriers for technology development,andInternet+ service mode innovation.These efforts aim at exploring to build a new type of medical technology service system.
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This study was aimed to evaluate the feasibility of wind-warm lung-heat disease (non-severe community-acquired pneumonia, CAP) from the clinical curative effect, hospitalization days, medical expenses and other aspects. This study selected 198 wind-warm lung-heat disease (non-severe CAP) inpatients from January, 2012 to December, 2012 with the conventional therapy in the Respiratory Department, Wuhan Integrated Traditional Chinese Medicine (TCM) & Western Medicine Hospital as the control group. And another 179 wind-warm lung-heat disease (non-severe CAP) inpatients were selected from January, 2013 to December, 2013 with the TCM clinical pathway treatment in the Respiratory Department of the same hospital as the treatment group. Retrospective analysis was used to compare the clinical curative effects, hospitalization days, and medical cost differences. The results showed that TCM clinical pathway for wind-warm lung-heat disease (non-severe CAP) can shorten the hospitalization days and reduce patients’ medical costs, and ensure the clinical curative effects. It was concluded that the standardized TCM clinical pathway had positive effect on wind-warm lung-heat disease (non-severe CAP). Therefore, the formulation and implementation of TCM clinical pathway was of great significance in the treatment of wind-warm lung-heat disease (non-severe CAP).
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OBJECTIVE:To observe the effecacy and safety of using cefotaxime using different doses in perioprative period on the prevention of postoperative infection of lung cancer resection. METHODS:61 patients with non-small cell lung cancer who re-ceived lung cancer resection were retrospectively analyzed divided into cefotaxime 2 g group(26 cases) and cefotaxime 4 g group (35 cases)according to dosage. Cefotaxime 2 g group was treated with Cefotaxime for injetion 2 g 30 min before operation,add-ing into 0.9% sodium chloride injection 100 ml,by intravenous infusion,if the operation time was more than 3 h,cefotaxime 2 g was intravenously infused during operation and cefotaxime 2 g was intravenously infused after operation,interval of 12 h was re-quired for preoperative and postoperative medication time and the total medication time was no more than 48 h. Cefotaxime 4 g group was treated with Cefotaxime for injection 4 g(the usage was the same as cefotaxime 2 g group). Leukocyte,hemoglobin,al-bumin,infection rate and incidence of adverse reactions in 2 groups before and after operation were observed. RESULTS:There was no significant difference in the infection rates between 2 groups(P>0.05). Leukocyte,hemoglobin and albumin in 2 groups were significantly lower than before,the differences were statistically significant(P0.05). There were no obvious adverse reactions during treatment. CONCLUSIONS:Small dose of ce-fotaxime has good prevention effect on the postoperative infection of non-small cell lung cancer,with good safety,which meets the principles of rational use of antibiotics.
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Objective To investigate the effect of mitogen activated protein kinase / extracellular signal-regulated kinase (MEK / ERK)1 / 2 signaling pathway on early brain injury (EBI)following experimental subarachnoid hemorrhage (SAH)in rats. Methods Sixty male SD rats were randomly divided into a control group and a 1,6,12,24,48,or 72 h group after SAH modeling. SAH + MEK inhibitor U0126 was used to intervene the 24,48,and 72 h groups (a total of 10 groups;n = 6 in each group). In addition to the control group,blood was injected into the cisterna magna of the rats to induce a SAH model in another 9groups. The blood samples were taken from infraorbital venous plexus. Enzyme-linked immune sorbent assay (ELISA)was used to detect the levels of interleukin-6 (IL-6),IL-1β,and tumor necrosis factor α(TNF-α)in each group. Evans blue content in brain tissue was used to evaluate the blood-brain barrier damage. Western blot was used to detect the levels of phosphorylated extracellular signal-regulated kinase (p-ERK1/ 2)and matrix metalloproteinase-9 (MMP-9)proteins in basilar artery tissue,and compared them. Results Compared with the control group at the same time points,there were significant differences in the levels of IL-6 and IL-1β at 6,12,24,48,and 72h after modeling in the SAH group (all P <0. 05). At 12,24, 48,and 72 h after modeling,the expression levels of p-ERK1/ 2 protein of the basilar artery tissue of the SAH group were 0. 73 ± 0. 09,0. 85 ± 0. 12,0. 94 ± 0. 09,and 0. 96 ± 0. 09,respectively,they were significantly higher than those of the control group (all P < 0. 05). At 48 and 72 h after modeling in the SAH group,the level of MMP-9 protein was significantly higher than that in the control group (1. 27 ± 0. 15 vs. 0. 68 ± 0. 08,2. 41 ± 0. 11 vs. 0. 71 ± 0. 14). At 72 h after modeling,the Evans blue content in brain tissue of the SAH group was significantly higher than that of the control group (15. 3 ± 2. 2 μg/ g vs. 2. 7 ± 0. 4 μg/ g). After giving the MEK inhibitor U0126 intervention,the levels of serum IL-6,IL-1β,and TNF-α at 24,48, and 72 h after modeling,and the expression levels of p-ERK1 / 2 and MMP-9 proteins at 48 and 72 h (p-ERK1 / 2:0. 76 ± 0. 07,0. 81 ± 0. 06;MMP-9:0. 92 ± 0. 14,1. 79 ± 0. 16),and the Evans blue content (8. 9 ± 1. 7 μg / g)in brain tissue at 72 h after modeling were significantly lower than those of the SAH group (P < 0. 05). Conclusion The MEK/ ERK1/ 2 signal pathway may be closely associated with the inflammatory reaction and blood-brain barrier damage after SAH,which suggests that the intervention of the MEK/ ERK1 / 2 signal pathway may be a potential target for the prevention of early brain injury after SAH.
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AIM:To investigate whether oxidative stress is able to induce autophagy in mesenchymal stem cells (MSCs), and to explore the effects of autophagy on MSC proliferation and apoptosis under oxidative stress circumstance as well as the underlying mechanism for promoting the therapeutic effects of transplanted MSCs on treating diabetes mellitus e -rectile dysfunction ( DMED) .METHODS: Hydrogen peroxide ( H2 O2 ) was applied to simulate the oxidative stress cir-cumstance.The effects of H2 O2 at concentration of 0, 50, 100, 200, 400μmol/L on the viability of MSCs were tested by the method of Trypan blue exclusion and MTT assay respectively .The methods of MTT assay , Western blot and transmis-sion electron microscope ( TEM) were used to explore the effects of H 2 O2 on MSC apoptosis and autophagy .RESULTS:The proliferation of MSCs was obviously inhibited by H 2 O2 in a dose-dependent manner ( P<0.01) and the 50%inhibiting concentration (IC50) was (384.58 ±16.89) μmol/L.H2O2 induced apoptosis and autophay of MSCs .The proliferation rate of MSCs was suppressed by H 2 O2 significantly ( P<0.05 ) , with a further decline by blockade of autophagy ( P<0.05) whereas increased by blockade of apoptosis (P<0.05).H2O2 induced MSCs apoptosis obviously (P<0.05), with an augment of apoptosis ( P<0.05) by blockade of autophagy .Furthermore, the H2 O2 increased expression of cleaved caspase-3 and cleavage of poly ADP-ribose polymerase 1 (PARP1), Which were decreased by apoptosis blockade whereas were enhanced by blockade of autopahgy .CONCLUSION:Oxidative stress plays a dual role in MSC survival , which in-duces MSC apoptosis and autophagy .Moreover , blockade of autophagy intensifies MSC apoptosis .Therefore , it is a promis-ing method to ameliorate the effects of stem-cell based therapy on DMED by enhancing protective autophagy to increase the survival rate of transplanted MSCs against oxidative stress circumstance caused by diabetes mellitus .
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The treatment for severe pancreatitis includes surgical and non-surgical methods,and the key points of treatment include surgical timing,surgical method selection and the management of postoperative complications.Hepatic artery thrombosis after surgery for severe pancreatitis is rarely seen,and few experiences in the diagnosis and treatment for this disease have been summarized.A patient with the course of severe pancreatitis of 10 years and suffered from 3 different kinds of diseases including thrombosis of right hepatic artery was cured by open surgery for 2 times and intervention therapy in the Affiliated Hospital of Hainan Medical College in October 2011.The treatment experience was summarized based on the clinical data of this patient.