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Glioma is a malignant tumor with extremely high rates of recurrence. Clinically ，with the prolongation of the use of chemotherapy drugs ，the drug resistance of glioma cells to chemotherapy drugs is also increasing ，which eventually leads to poor prognosis and shortens overall survival time of patients. It is well known that the development of drug resistance involves multiple mechanisms，including drug transport metabolism ，apoptosis，DNA damage repair ，autophagy，variation of cancer stem cells and epithelial mesenchymal transition. Abnormal expression of circular RNA （circRNA），a novel RNA molecule with unique stability and tissue specificity ，has been shown by more and more evidence to play a crucial regulatory role in the development of drug resistance in glioma. This paper systematically reviews the mechanism of multiple drug resistance in glioma ，and focuses on the role and molecular mechanism of circRNA regulating temozolomide-resistance in glioma. At the same time ，the potential function of circRNA as a new therapeutic target is prospected ，in order to provide an objective theoretical basis for the development of new therapeutic methods.
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Objective:To compare the clinical efficacy and safety of percutaneous transluminal septal branch anhydrous alcohol ablation (PTSAAA) and percutaneous transluminal septal branch microsphere embolization (PTSBME) in the treatment of patients with symptomatic hypertrophic obstructive cardiomyopathy.Methods:The clinical data of 55 patients with symptomatic hypertrophic obstructive cardiomyopathy treated by PTSAAA and PTSBME were retrospectively analyzed, among whom 27 were treated with PTSAAA and 28 with PTSBME. The changes of postoperative indicators of the two groups of patients were compared, including the improvement degree of symptoms [shortness of breath after activity (cardiac function NYHA classification), chest tightness, chest pain (angina CCS classification) and amaurosis, the decrease of left ventricular outflow tract pressure gradient (LVOTPG)], the ventricular septum thickness shown by color Doppler echocardiography, the incidences of complications at postoperative month 6 and 12, and the incidences of cardiovascular events at follow-up month 12. LSD- t, χ 2 or Fisher exact probability methods were used to compare the differences of indicators between the two groups. Results:Compared to the relative indicators before operation, there were significant differences in shortness of breath after activity, chest pain and amaurosis, LVOTPG, ventricular septum thickness, the incidences of complications at postoperative month 6 and 12 and the incidences of cardiovascular events at follow-up month 12 in both the PTSAAA group and PTSBME group ( P<0.05). The PTSBME group was not inferior to the PTSAAA group in the improvement degree of amaurosis, cardiac function NYHA classification and angina CCS classification and left ventricular ejection fraction (LVEF) at postoperative month 6 and 12 ( P>0.05) as well as in the LVOTPG decrease and the ventricular septum thickness at postoperative month 6 [(16.8±7.5) mmHg vs (15.8±7.3) mmHg, (19.8±4.9) mm vs (17.4±4.1) mm, P>0.05], but was superior to the PTSAAA group in the LVOTPG decrease and the ventricular septum thickness at postoperative month 12 [(15.2±6.7) mmHg vs (9.8±5.4) mmHg, (18.4±5.1) mm vs (12.2±3.2) mm, P<0.05]. There were statistical significances in the incidences of cardiovascular events and third degree atrio-ventricular block and nosocomial mortality between the two groups (6 vs 1; 5 vs 0, P<0.05), and the PTSBME group was superior to the PTSAAA group in safety. Conclusion:PTSBME may be a safe and effective method for the management of patients with symptomatic hypertrophic obstructive cardiomyopathy.
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Objective To summarize the clinical effect of urethroplasty using acellular dermal matrix patch for the treatment of anterior urethral stricture caused by lichen sclerosus.Methods The clinical data was analyzed retrospectively from 15 patients with anterior urethral stricture caused by lichen sclerosus treated with aeellular dermal matrix patch.Results The patients were followed up for 8-40 months.The urethral silicone stent was removed 4 weeks after operation in 15 cases and all the patients voided well 2 months after operation.The urinary peak flow rates ranged from 17.6 to 41.7 ml/s(mean,28.6ml/s).Urethral stricture occurred in 2 patients 3 months after operation undergoing discontinuous dilatation within 3 to 6 months,the patients voided very well.Conclusion It is feasible,safe and relatively simple to use acellular dermal matrix patch for anterior urethral stricture caused by lichen sclerosus.
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Objective:To investigate the relation between the angiotensinⅡ(AngⅡ)levels in thoracic aorta and plasma and atherosclerosis(AS).Methods:Totally40healthy male Wistar rats were randomly divided into4groups(n=10).Four different feeding methods,including normal diet,high lipid,high lipid+vitamin D overload,and high lipid+vitamin D over-load+endothelium injury,were used for inducing AS in rats.The thickness of intima was taken as the index of AS severity, radio-immunity analysis was used to assay AngⅡin each group in thoracic aorta and plasma.Results:Only rats in high lipid diet group did not develop AS plaque;high lipid+vitamin D only resulted in AS fibrous plaque with VSMC proliferation;high lipid+vitamin D+endothelium injury formed ripe AS plaque.The thickness of intima and AngⅡof thoracic aorta in-creased gradually compared with control group(P