Long-term results of stent graft in the treatment of TASC C, D femoropopliteal artery occlusive disease / 中华普通外科杂志

Objective:To evaluate the long-term outcome of Viabahn stent graft in the treatment of complex femoropopliteal occlusive lesions.Methods:From Sep 2013 to Mar 2020, clinical data of TASC C and D femoropopliteal lesions treated with Viabahn were retrospectively analyzed. Patency rates, the freedom rate from clinically-driven target lesion revascularization (F-TLR), limb salvage and survival after five years were calculated.Results:A total of 65 patients (67 lower limbs) were included. 20 limbs were TASC C lesions, 47 limbs were TASC D lesions. The mean lesion length was (29.1±9.4) cm, including 48 chronic total occlusion (CTO) lesions (71.6%) with mean lesion length of (26.1±10.4) cm. Technique success rate was 98.6%. Mean length of stent graft was (31.3±10.1) cm.Major amputation was performed in 4.2% cases within 5 years. All-cause mortality in 5 years was 23.1%. Primary patency rates at 1,3,and 5 years were 76.8%,59.4%,50.9%, Assisted primary patency rates were 88.4%, 83.4%, 83.4% and secondary patency rates were 88.4%, 85.8%, and 85.8% . F-TLR at 1, 3 and 5 year was 88.2%,76.9%,73.1% .Conclusion:Viabahn for complex and long femoropopliteal artery occlusions is an acceptable treatment with fair long-term outcome.

Analysis of the prevalence and social security situation of pneumoconiosis in non-coal mine industry in Jiangsu Province / 中华劳动卫生职业病杂志

Objective: To understand the social security situation of current cases of pneumoconiosis in non-coal mine industries in Jiangsu Province, and to provide reference for the treatment and security work of pneumoconiosis patients. Methods: From January to October 2020, a follow-up survey was conducted on 4038 cases of pneumoconiosis in non-coal mine industries of the province from October 1949 to December 2019. The age, type of pneumoconiosis, industry type, and social security status of the patients were collected. Namely, work-related injury insurance, employer compensation, basic medical insurance for urban and rural residents, major illness insurance, etc. SPSS 19.0 was used for statistical description and analysis. Results: The cases of pneumoconiosis in non-coal mine industries in Jiangsu Province ranged in age from 36 to 105 (70.78±8.43) years old, and had been exposed to dust for 1 to 55 (19.27±9.29) years. Silicosis was the main form (3875 cases, 95.96%), and non-metallic mining and dressing industry was the main form (2618 cases, 64.83%). A total of 3991 cases (98.84%) of pneumoconiosis patients enjoyed social security, most of them were urban and rural residents with basic medical insurance (3624 cases, 89.75%), but there were still 47 patients without any social security. 15 cases (0.37%) enjoyed the subsistence allowance, with the monthly allowance amount ranging from 104 to 3960 yuan, with the average amount of 954.87 yuan/month. Conclusion: In Jiangsu Province, the proportion of pneumoconiosis patients in non-coal mine industries enjoying social security is relatively high, but there are still patients who do not enjoy any social security, and the difference in the amount of subsistence allowance is slightly larger. It is necessary to further improve the medical security of pneumoconiosis patients and improve their quality of life.

Efficacy of drug-coated balloons in treatment of TASC Ⅱ C/D femoro-popliteal artery de novo stenosis and in-stent restenosis / 中华全科医师杂志

Objective:To evaluate the mid-term clinical efficacy of drug-coated balloons (DCB)in the treatment of femoro-popliteal artery TASC Ⅱ C/D de novo stenosis and in-stent restenosis.Methods:A total of 126 patients with TASC Ⅱ C/D femoro-popliteal artery stenosis treated with DCB in Renji Hospital and Pudong New Area People's Hospital from December 2016 to August 2020 were retrospectively enrolled, including 74 cases of de novo stenosis (de novo group) and 52 cases of in-stent restenosis (ISR group). The clinical data and lesion characteristics were analyzed; the primary patency rate, primary-assisted patency rate, secondary patency rate, and the freedom from target lesion revascularization (f-TLR)rate were evaluated; the perioperative complications, mortality and amputation rate were compared between two groups. Kaplan-Meier method was used to evaluate the patency rate of target vessel lesions, and Cox regression analysis was used to evaluate the relative risk factors.Results:There were 6 patients died in each group during the followup period. The lesion length of the de novo and ISR groups were (21.25±12.64) cm and (34.71±12.02) cm, respectively( t=33.74, P<0.001). The popliteal artery involvement was 33.8% (25/74) in the de novo group and 15.4% (8/52) in the ISR group (χ 2=5.35, P=0.021). The operational success rate was 100.0% in both groups, and the perioperative complication rate was 6.8% (5/74) in the de novo group and 1.9% (1/52) in ISR group. The median follow-up time was 22 month and 17 months; the mean follow-up time were(19.78 ± 11.02) months and (20.02 ± 11.32) months in the de novo group and ISR group, respectively. The primary patency rates at 6, 12 and 24 months after intervention were 89.1%, 73.4%, 50.8% in the Denovo group, and 87.8%, 68.8%, 42.0% in the ISR group, respectively; the primary assisted patency rate was 90.7%, 78.4%, 62.8% in the de novo group, and 89.3%,77.1%, 62.8% in the ISR group, respectively; the secondary patency rate was 95.1%,95.1%, 88.7% in de novo group, and 94.9%, 88.9%, 84.3% in ISR group, respectively; the f-TLR rate was 97.3%, 88.6%, 79.2% in de novo group, and 90.0%, 77.7%, 74.7% in ISR group, respectively (all P>0.05). Cox regression analysis showed that P2 and P3 segment involvement of the popliteal artery were independent factors affecting the patency rate of target lesion. Conclusions:The mid-term clinical efficacy of DCB in the treatment of TASC Ⅱ C/D femoro-popliteal artery de novo stenosis and in-stent restenosis is satisfactory.

Medium-term result of drug-coated balloon with paclitaxel in endovascular treatment of femoropopliteal artery in- stent restenosis / 中华普通外科杂志

Objective:To evaluate the efficacy and safety of drug-coated balloon (DCB) with paclitaxel in the treatment of femoropopliteal artery in-stent restenosis.Methods:From Dec 2016 to Jul 2020, clinical and follow-up data of femoropopliteal artery in-stent restenosis (ISR) treated with paclitaxel DCB were retrospectively analyzed.Results:Firty-two patients (56 lower limbs) with femoropopliteal artery ISR underwent DCB therapy. According to Rutherford classification, 1 case was R2 (1.7%), 9 cases were R3 (23.2%), 23 cases were R4 (41.1%), 15 cases were R5 (26.8%) and 4 cases were R6 (7.1%). According to Tosaka classification of ISR, 46 (81.2%)limbs were Tosaka Ⅱ, 10(17.9%)limbs were Tosaka Ⅲ Mean lesion length of ISR was (240±122)mm. Bail-out stent implantation was performed in 25% cases. The median follow-up time was 18 months. The all-cause mortality rate was 11.8%, the major amputation rate was 5.9%, the primary patency rate was 53.4%, the primary assisted patency rate was 67.1%, the secondary patency rate was 93.2%, and the F-TLR was 77.2%.Conclusion:DCB is a safe and effective endovascular therapy for femoropopliteal artery ISR.

Investigation on diagnosis of pneumoconiosis in non-coal mining industry in Jiangsu Province / 中华劳动卫生职业病杂志

Objective: To understand the incidence of pneumoconiosis in the non-coal mining industry in Jiangsu Province, and provide reference for the prevention and control of pneumoconiosis in the non-coal mining industry. Methods: The data of 7019 newly diagnosed pneumoconiosis patients in non-coal mining industry in Jiangsu Province from January 1956 to December 2019 were collected through the Jiangsu Province Pneumoconiosis Follow-up Network Report System, including the gender of the pneumoconiosis patients, the name of the employer and the location, the industry classification of the employer, the duration of dust exposure in dust exposure, the name of occupational pneumoconiosis disease, the date of diagnosis of pneumoconiosis, etc. The collected case data of patients with pneumoconiosis were entered into the statistical software, and the characteristics of the patients' diagnosis time, region and industry were analyzed. Results: The number of confirmed pneumoconiosis patients in the non-coal mining industry in Jiangsu Province was mostly in 2007 (395 cases) , concentrated in Wuxi City (40.96%, 2875/7019) and Suzhou City (27.72%, 1946/7019) . The industries to which the patients belonged were mainly non-metallic mining and dressing (60.95%, 4278/7019) , and the most common type of pneumoconiosis was silicosis (96.40%, 6766/7019) . The patients were mainly stageⅠpneumoconiosis (61.33%, 4305/7019) . There were statistically significant differences in the mean age of diagnosis and the average duration of dust exposure among patients with different pneumoconiosis stages (P<0.01) . The differences in the average diagnosis age and the average duration of dust exposure of patients with different types of pneumoconiosis were statistically significant (P<0.05) , the mean age of diagnosis and the average duration of dust exposure of electric welders were the smallest, which were (44.92±7.74) years old and (17.38±10.15) years, respectively. Conclusion: The regional and industry distribution characteristics of new pneumoconiosis patients in the non-coal mining industry in Jiangsu Province are obvious, and attention should be paid to the treatment of pneumoconiosis patients with young diagnosed age and short duration of dust exposure, as well as the personal protection and health protection of front-line workers such as electric welders who are exposed to productive dust in a short period of time.

Effect of homologous overexpression of nucleoside diphosphate kinase on the yield and molecular weight of hyaluronic acid / 中国药科大学学报

@#To investigate the effect of nucleoside diphosphate kinase (NDK) on the synthesis of hyaluronic acid, nucleoside diphosphate kinase gene (ndk) was overexpressed along with the hyaluronic acid-producing genes in recombinant B.subtilis. Two engineered strains named Hp8tg and Pn8tg were constructed.Uniform hyaluronic acid (HA) could be obtained from both engineered strains.HA produced by both recombinant strains was confirmed by monosaccharide composition analysis, Fourier transform infrared spectometry and nuclear magnetic resonance spectroscopy.Inducing conditions of HA fermentation were optimized by response surface methodology.Overexpression of ndk could increase the production and molecular weight of HA by 1.3-fold and 1.1-fold, respectively. This study revealed for the first time that overexpression of ndk could relieve the inhibition effect of uridine diphosphate (UDP) on Class II HA synthase and increase the production and molecular weight of HA, which proves to be an efficient strategy for the production of HA, and the preparation of other polysaccharides.

Short-term efficacy of paclitaxel -coated balloon in the treatment of femoropopliteal artery disease / 中华普通外科杂志

Objective:To evaluate the efficacy and safety of drug-coated balloon (DCB) with paclitaxel in the treatment of femoropopliteal arteriosclerosis obliterans (ASO).Methods:From Dec 2016 to Dec 2018, clinical data of femoropopliteal artery disease patients treated with paclitaxel DCB in Renji Hospital, School of Medicine, Shanghai Jiaotong University were retrospectively analyzed.Results:A total of 83 patients (95 lower limbs) underwent DCB therapy. Including 50 chronic total occlusion (CTO) lesions (52.6%) with mean lesion length of (18.35±10.61) cm. Twenty-four lesions (25.3%) were moderately or severely calcified. Bail-out stent implantation was performed in 29.5% cases. The mean follow-up time was 17.5 months. Twelve months after intervention, the all-cause mortality rate was 6.0%, the major amputation rate was 4.3%, the primary patency rate was 60.6%, the primary assisted patency rate was 72.4%, the secondary patency rate was 83.4%, and the freedom rate from clinically-driven target lesion revascularization(F-TLR) was 77.0%. Moderate to severe calcification was an independent risk factor for the primary patency of DCB therapy.Conclusion:DCB is a safe and effective endovascular therapy for femoropopliteal artery disease.

Loss of GRB2 associated binding protein 1 in arteriosclerosis obliterans promotes host autophagy / 中华医学杂志(英文版)

BACKGROUND@#Arteriosclerosis obliterans (ASO) is a major cause of adult limb loss worldwide. Autophagy of vascular endothelial cell (VEC) contributes to the ASO progression. However, the molecular mechanism that controls VEC autophagy remains unclear. In this study, we aimed to explore the role of the GRB2 associated binding protein 1 (GAB1) in regulating VEC autophagy.@*METHODS@#In vivo and in vitro studies were applied to determine the loss of adapt protein GAB1 in association with ASO progression. Histological GAB1 expression was measured in sclerotic vascular intima and normal vascular intima. Gain- and loss-of-function of GAB1 were applied in VEC to determine the effect and potential downstream signaling of GAB1.@*RESULTS@#The autophagy repressor p62 was significantly downregulated in ASO intima as compared to that in healthy donor (0.80 vs. 0.20, t = 6.43, P < 0.05). The expression level of GAB1 mRNA (1.00 vs. 0.24, t = 7.41, P < 0.05) and protein (0.72 vs. 0.21, t = 5.97, P < 0.05) was significantly decreased in ASO group as compared with the control group. Loss of GAB1 led to a remarkable decrease in LC3II (1.19 vs. 0.68, t = 5.99, P < 0.05), whereas overexpression of GAB1 significantly led to a decrease in LC3II level (0.41 vs. 0.93, t = 7.12, P < 0.05). Phosphorylation levels of JNK and p38 were significantly associated with gain- and loss-of-function of GAB1 protein.@*CONCLUSION@#Loss of GAB1 promotes VEC autophagy which is associated with ASO. GAB1 and its downstream signaling might be potential therapeutic targets for ASO treatment.

Modified approach improves the clinical efficacy of AngioJet in treatment of whole-lower-limb acute deep vein thrombosis / 中华普通外科杂志

Objective:To investigate whether the clinical efficacy of mechanical pharmacothrombectomy (PMT) in treatment of whole-lower-limb acute deep vein thrombosis (DVT) could be improved by the modified approach removing popliteal vein thrombosis.Methods:From Mar 2016 to Mar 2018, 31 patients with whole-lower-limb acute DVT were enrolled and treated with PMT by AngioJet. The clinical data was retrospectively analyzed, and the clinical efficacy was evaluated.Results:26 cases were treated by contralateral common femoral vein approach and the other 5 cases by ipsilateral calf deep vein. Urokinase was given in bolus in 29 patients before thrombectomy. After PMT, 7 cases combined with catheter-directed thrombolysis. 26 cases underwent iliac vein PTA, and 14 cases underwent iliac vein stenting. The average hospitalization days was (7.6±1.8) d. The thrombus clearance rate was grade Ⅱ (50%~99%) in 16 cases (51.6%) and grade Ⅲ (100%) in 15 cases (48.4%). 30 patients were followed up and the mean follow-up time was 19.7 months. The 12-month primary patency rate was 83.3%. All the 5 patients with occlusion had different degrees of post-thrombotic syndrome (PTS), and the incidence of PTS was 16.7% (5/30).Conclusions:The modified approach to treat the whole-lower-limb acute deep vein thrombosis with PMT is safe and effective. The popliteal vein thrombosis can be cleared in one stage. The blood inflow can be improved, and the incidence of PTS is relatively low.

Globally Ecological Suitability Analysis of Phellodendron chinense and Phellodendron amurense / 中国实验方剂学杂志

Objective: Phellodendri Cortex, one of the "three wood medicine materials", is a Chinese traditional medicinal material and also a national second-class protected plant in China. Its is considered as excellent trees for the Natural Forest Conservation Program and the Grain-to-Green Program because of its high economic value and ecological value. The Phellodendron Cortex is divided into Phellodendron chinense and P. amurense according to species and origins. The global potential suitable areas predicted by Global Geographic Information System for Medicinal Plant (GMPGIS) can provide data for us to decide which specie can be selected in different areas. Method: Sample ecological information was collected from global genuine areas, main producing areas and wild distribution areas, and a total of 364 sampling sites of P. chinense and 247 sampling sites of P. amurense were used by GMPGIS to analyze the suitable growth areas in the world. Result: A clear geographical line existed between P. chinense and P. amurense. P. chinense was mainly distributed in tropical monsoon climate and had the most suitable areas in Asia, Europe, North America, South America and Oceania, including 65 countries and regions such as China, the United States, France, Brazil, Japan, Italy and New Zealand. P. amurense was mainly distributed in temperate monsoon climate and had the most suitable areas in Asia, Europe, and North America, including 30 countries and regions such as the United States, China, Russia and Canada.. Conclusion: The results of GMPGIS can provide scientific data for selecting correct species and cultivation areas for Phellodendris Cortex in future.

Application of improved TOPSIS based on entropy weight to evaluating township health education program / 预防医学

Objective To explore a more objective scheme for comprehensive evaluation of township health education program. Methods Based on the indicators and grading results of 17 township hospitals (named from A to Q) in Xiangshan County, we calculated the weight of each indicator by entropy weight method and sorted the township hospitals by the improved TOPSIS. Then we compared the ranking with the annual assessment results in 2017 to verify the rationality of this scheme. Results The entropy weights of"printed materials of health education","play of audio-visual materials","health education bulletin board","public health consultation" ,"health knowledge lecture" ,"individualized health education" and"awareness rate of health knowledge"were 0.122 0, 0.125 3, 0.134 6, 0.157 2, 0.157 0, 0.179 8 and 0.124 1, respectively. Through the improved TOPSIS, 17 hospitals were sorted as follows: P, L, O, C, G, A, H, N, B, E, M, Q, K, J, F, D, I. Compared with the annual assessment rankings which were P, L, A, C, B, O, G, H, K, N, D, E, M, J, I, F, Q, thirteen of them were different. Conclusion "Printed materials of health education","awareness rate of health knowledge" and"play of audio-visual materials" have little room for improvement, while"individualized health education" should be focused on in the future. The improved TOPSIS based on entropy weight could objectively evaluate the quality of health education service.

Endovascular therapy with covered stent for aortoiliac occlusive disease:clinical effect in 20 patients / 介入放射学杂志

Objective To evaluate the clinical effect of endovascular therapy with covered stent in treating aortoiliac occlusive disease. Methods The clinical data of 20 patients with aortoiliac occlusive disease, who received endovascular therapy with covered stent during the period from January 2014 to December 2016, were collected. According to Rutherford standard of clinical symptom classification, gradeⅢ, grade Ⅳ and grade V were seen in 9, 7 and 4 patients respectively. Based on the Trans-Atlantic Society Coalition (TASC) treatment guidelines Ⅱ classification, B type, C type and D type were observed in 4, 7 and 9 patients respectively. The postoperative primary patency and secondary patency of the stent as well as the clinical efficacy were analyzed. Results Endovascular treatment was successfully accomplished in all 20 patients. After the treatment, the clinical symptoms were significantly relieved. Two patients developed complications (10％). One patient developed thrombus at the distal end of stent, which was improved after thrombolytic therapy. Another patient developed hematoma at puncture site, which was absorbed after conservative therapy. No perioperative death occurred. The patients were followed up for 5-37 months, with a mean of (17±10) months. The primary patency rate was 95％ and the secondary patency rate was 100％. Conclusion For the treatment of aortoiliac occlusive disease, endovascular therapy with covered stent has excellent clinical efficacy.

The application of bidirectional subintimal technique in endovascular treatment of subclavian arterial occlusion / 介入放射学杂志

Objective To evaluate the feasibility and safety of using bidirectional subintimal technique,i.e.subintimal arterial flossing with antegrade-retrograde intervention (SAFARI),in endovascular treatment of subclavian arterial occlusion when the guide wire cannot re-enter into the distal true cavity.Methods The clinical data of 11 patients with symptomatic subclavian artery occlusion,who were admitted to authors' hospital during the period from August 2013 to June 2016 to receive treatment,were retrospectively analyzed.The patients included 8 males and 3 females,with a mean age of 67 years old (61-74 years).Endovascular recanalization of subclavian artery with SAFARI technique and stent implantation were carried out in all patients after conventional reopening surgery of obstructed artery failed.Results Subclavian artery recanalization by using SAFARI technique together with implantation of stent (average length of 46.4 mm) was successfully accomplished in 10 patients,but in one patient the technical management failed,the technical success rate was 90.9％.No serious postoperative complications occurred.The patients were followed up for 6-36 months by telephone,and no in-stent restenosis was verified during the follow-up period.Conclusion In treating severely calcified and long-segmental subclavian artery occlusion,endovascular treatment using SAFARI technique is safe and effective,SAFARI technique can further improve the success rate of endovascular treatment.

Analysis of clinical characteristics on a hybrid deletion mutation of GNAS-AS1 gene Exon 5E leading to pseudohypoparathyroidism with hypokalemia and hypomagnesemia / 中华内分泌代谢杂志

To improve clinicians'understanding of the diagnosis and treatment of pseudohypoparathyroidism with hypokalemia and hypomagnesemia. The clinical manifestations, laboratory examinations, imaging data, gene results, diagnosis and treatment of a pseudohypoparathyroidism type Ⅰb with hypokalemia and hypomagnesemia patient were retrospectively analyzed. The literatures related to pseudohypoparathyroidism in recent years were also summarized. A young man, mainly manifested as repeated tetany. The physical examination showed short stature, round face, short neck, with positive Trousseau sign. The laboratory examination revealed parathyroid hormone resistance, hypocalcemia, hyperphosphatemia, hypokalemia and hypomagnesemia. The urinary calcium and phosphorus levels were low. Cerebral magnetic resonance imaging ( MRI ) showed bilateral basal ganglia calcification. Genetic screening revealed a hybrid deletion mutation of GNAS-AS1 gene Exon 5E. After the supplement of element calcium 720 mg/d, plain vitamin D 375 U/d, active vitamin D 0.5 μg/d and potassium chloride 3 g/d, the levels of blood potassium and phosphorus rise to normal, the levels of blood calcium and magnesium were close to normal. Pseudohypoparathyroidism typeⅠb may accompany with hypokalemia and hypomagnesemia.

Infrapopliteal arteries revascularization in patients with limb ischemic ulcer / 中华普通外科杂志

Objective To analyze the clinical effect of infrapopliteal arteries revascularization in patients with limb ischemic ulcer.Methods Clinical data of 152 patients (152 legs) suffering from CLI ischemic ulcer from June 2011 to June 2013 undergoing arterial revascularization using angiosome concept were retrospectively reviewed.Patients were grouped according to runoff,WB angiography,the number of outflow,angiosome model of revascularization and quality of pedal arch.Results Reintervention or ampatation (RAO) rate within 12 months was higher in runoff 0 group that in runoff ＞ 1 group (P ＜ 0.05)and runoff 1 (P ＜0.05).WB (+) group vs WB (-) group of RAO rate within 12 months,ulcer healing rate within 12 months showed no statistical difference.Limb salvage rate within 18 months was higher in WB (+) group than that in WB (-) group (P ＜0.05).Ulcer healing rate within 12 months and limb salvage · rate 18 months in group IRw was lower than group DR (P ＜ 0.05) and group IRc(P ＜ 0.05).RAO rate within 12 month rate was higher in IRw group than in DR group (P ＜ 0.05) and group IRe (P ＜ 0.05).Ulcer healing rate within 12 months and limb salvage rate within 18 months in group NPA was lower than group CPA (P ＜ 0.05) and group IPA (P ＜ 0.05).RAO rate within 12 month rate was higher in NPA group than in CPA group (P ＜ 0.05) and group IPA (P ＜ 0.05).Conclusion The rate of limb salvage was higher in WB (+).IRc revascularization has similar outcome with DR revascularization in ulcer healing rate and limb salvage rate.Clinical effect of CPA and IPA are better than NPA.

Infrapopliteal arteries revascularization in patients with limb ischemic ulcer / 中华普通外科杂志

Objective To analyze the clinical effect of infrapopliteal arteries revascularization in patients with limb ischemic ulcer.Methods Clinical data of 152 patients (152 legs) suffering from CLI ischemic ulcer from June 2011 to June 2013 undergoing arterial revascularization using angiosome concept were retrospectively reviewed.Patients were grouped according to runoff,WB angiography,the number of outflow,angiosome model of revascularization and quality of pedal arch.Results Reintervention or ampatation (RAO) rate within 12 months was higher in runoff 0 group that in runoff ＞ 1 group (P ＜ 0.05)and runoff 1 (P ＜0.05).WB (+) group vs WB (-) group of RAO rate within 12 months,ulcer healing rate within 12 months showed no statistical difference.Limb salvage rate within 18 months was higher in WB (+) group than that in WB (-) group (P ＜0.05).Ulcer healing rate within 12 months and limb salvage · rate 18 months in group IRw was lower than group DR (P ＜ 0.05) and group IRc(P ＜ 0.05).RAO rate within 12 month rate was higher in IRw group than in DR group (P ＜ 0.05) and group IRe (P ＜ 0.05).Ulcer healing rate within 12 months and limb salvage rate within 18 months in group NPA was lower than group CPA (P ＜ 0.05) and group IPA (P ＜ 0.05).RAO rate within 12 month rate was higher in NPA group than in CPA group (P ＜ 0.05) and group IPA (P ＜ 0.05).Conclusion The rate of limb salvage was higher in WB (+).IRc revascularization has similar outcome with DR revascularization in ulcer healing rate and limb salvage rate.Clinical effect of CPA and IPA are better than NPA.

Association of etheno-DNA adduct and DNA methylation level among workers exposed to diesel engine exhaust / 中华预防医学杂志

Objective@#To investigate the association between etheno-DNA adduct and the promoter of DNA methylation levels of cyclin dependent kinase inhibitor 2A (P16), Ras association domain family 1 (RASSF1A) and O-6-methylguanine-DNA methyltransferase (MGMT) in workers with occupational exposure to diesel engine exhaust (DEE).@*Methods@#We recruited 124 diesel engine testing workers as DEE exposure group and 112 water pump operator in the same area as control group in Henan province in 2012 using cluster sampling. The demographic data were obtained by questionnaire survey; urine after work and venous blood samples were collected from each subject. The urinary etheno-DNA adducts were detected using UPLC-MS/MS, including 1,N6-etheno-2'-deoxyadenosine (εdA) and 3,N4-etheno-2'-deoxycytidine(εdC). The DNA methylation levels of P16, RASSF1A, and MGMT were evaluated using bisulfite-pyrosequencing assay. The percentage of methylation was expressed as the 5-methylcytosine (5mC) over the sum of cytosines (%5mC). Spearman correlation and multiple linear regression were applied to analyze the association between etheno-DNA adducts and DNA methylation of P16, RASSF1A, and MGMT.@*Results@#The median (P25-P75) of urinary εdA level was 230.00 (98.04-470.91) pmol/g creatinine in DEE exposure group, and 102.10 (49.95-194.48) creatinine in control group. The level of εdA was higher in DEE exposure group than control group (P<0.001). DNA methylation levels of P16, RASSF1A and MGMT were 2.04±0.41, 2.19 (1.94-2.51), 2.22 (1.94-2.46)%5mC in exposure group, and 2.19±0.40, 2.41 (2.11-2.67), 2.44 (2.15-2.91)%5mC in control group. DNA methylation levels were lower in exposure group (P values were 0.005, 0.002 and 0.001, respectively). Spearman correlation analysis showed that DNA methylation levels of P16, RASSF1A, and MGMT were negative associated with urinary εdA level (r values were -0.155, -0.137, and -0.198, respectively, P<0.05). No significant correlation was observed between the εdC level and any measured DNA methylation levels (P>0.05) . Multiple linear regression confirmed the negative correlation between εdA and DNA methylation levels of P16, RASSF1A, and MGMT in non-smoking group (β (95%CI) was -0.068 (-0.132--0.003), -0.082 (-0.159--0.004) and -0.048 (-0.090--0.007), P values were 0.039, 0.039 and 0.024, respectively). Moreover, εdC was negative associated with DNA methylation level of MGMT in non-smoking group (β (95%CI) was -0.094 (-0.179--0.008), P=0.032).@*Conclusion@#DEE exposure could induce the increased of εdA and decreased of DNA methylation levels of P16, RASSF1A and MGMT.

Reasons and preventive measures of intraoperative errors and complications of transforaminal endoscopic surgery / 局解手术学杂志

Objective To analyze the causes of surgical errors and complications of lumbar degenerative diseases treated by transforaminal endoscopic spine system(TESSYS),and explore the treatment and prevention measures.Methods From July 2012 to January 2016,the data of 660 patients with lumbar degenerative diseases who treated with TESSYS were analyzed retrospectively,of which 528 patients were lumbar disc herniation with 192 cases of single segment(L4/L5) and 336 cases of multi-segment.Lumbar spinal stenosis in 132 cases,were lateral recess and nerve root canal stenosis.Surgical errors and complications were recorded,and analyzed the reasons and the treatment and preventive measures.Results Intraoperative errors:1 case of sterile film with the dilating catheter went into the surgical area;1 case with wire fracture,and stump retention in vivo;for discography staining,the proportion of mixed solution was not enough,the leakage of excess concentration of methylene blue caused caudal nerve injury in 3 cases;expansion of the intervertebral foramen,the drilling part of the articular process was too deep and too close to the medial wall of the articular process,which caused cutting injury of nerve fiber sheath in 2 cases;after the rupture of the dura mater,the rinse solution was perfused,caused bloating,elevated intracranial pressure,elevated blood pressure and other symptoms of spinal cord hypertension in 3 cases;low dose of local anesthetic into the blood caused toxic reaction in 2 cases;total spinal cord anesthesia with paravertebral nerve root block in 1 case.Postoperative complications:3 cases of nerve root edema;2 cases of free nucleus pulposus tissue;2 cases of local hematoma led to nerve root compression;1 case of intervertebral space infection and 3 cases of local skin neuritis in the puncture area.Conclusion In the process of intervertebral foramen surgery,there are some deficiency on instruments or operating skill.Therefore,rigorous treatment of each link in the perioperative period,is the guarantee of successful surgery.

Effects of bcl-3 gene silencing on apoptosis of human colon cancer cell line RKO / 中国病理生理杂志

AIM:To investigate the effects of bcl-3 gene on the migration and apoptosis of human colon cancer cell line RKO, and the changes of cyclin D1 and apoptosis-related proteins.METHODS:After silencing of bcl-3 gene expression in human colon cancer cell line RKO by lentiviral vector with RNA interference, the changes of RKO cell migration ability were investigated by wound healing assay.The changes of RKO cell apoptotic rate after bcl-3 gene silencing were detected by flow cytometry with Annexin V/PI staining.The protein expression of cyclin D1 and apoptosis-related proteins in the RKO cells after bcl-3 gene silencing was determined by Western blot.RESULTS:The wound healing rates of the RKO cells were 84.00% and 40.00% before and after bcl-3 gene silencing, respectively, with statistically significant difference (P<0.05).Annexin V/PI staining showed that the cell apoptotic rates were 12.89% and 59.67% before and after bcl-3 gene silencing, respectively, when RKO cells were treated with 5 μmol/L cisplatin for 24 h, with statistically significant difference (P<0.05).The expression of cyclin D1 decreased, while the expression of Bax increased after bcl-3 gene silencing (P<0.05).CONCLUSION:After bcl-3 gene silencing, the migration ability of RKO cells decreases, and the apoptotic rate increases, accompanying with the changes of cyclin D1 and Bax.bcl-3 gene can affect the apoptosis of RKO cells by changing the expression of cyclin D1 and Bax.

Effect of ω-3PUFAs on cognitive deficit in rats with schizophrenia / 中华行为医学与脑科学杂志

Objective To investigate the antagonistic effect of ω-3PUFAs on cognitive impairment in MK-801-induced schizophrenia (SZ) rats and its mechanism.Methods Rat model of schizophrenia was induced by MK-801.Morris water maze was used to detect the change of cognitive function in rats.The number of neonatal neurons in hippocampus was detected by Brdu staining.CREB,p-CREB,BDNF,TrkB and p-TrkB levels were detected by Weston Blot.Results MK-801 induced schizophrenia-like cognitive impairment (the escape latency in the water maze test was (6.51±3.10)s for Ctr group,(15.27±6.20)s for Mod group;acrossing times was (4.63±1.06) times for Ctr group,(2.00±1.15) times for Mod group),reduced the number of neonatal neurons in hippocampus (the relative level of neonatal neuron number per unit area,Mod/Ctr was 0.656±0.066) and impaired the CREB/BDNF/TrkB pathway (the relative level of gray value,Mod/Ctr:CREB was 0.393±0.065,p-CREB was 0.591±0.015,BDNF was 0.716±0.115,TrkB was 0.787±0.029,p-TrkB was 0.586±0.013).ω-3PUFAs improved the CREB/BDNF/TrkB pathway activity by increasing CREB and TrKB level and their phosphorylation (the relative level of gray value,Pre/Ctr:CREB was 1.139±0.111,p-CREB was 0.845±0.243,BDNF was 0.864±0.133,TrkB was 0.916±0.022,p-TrkB was 0.952±0.047),and then recovered the number of neonatal neurons in hippocampus (the relative level of neonatal neuron number per unit area,Pre/ Ctr was 1.183±0.101),thereby reduced the cognitive dysfunction in schizophrenia rats(the escape latency in the water maze was (7.44±4.55)s for Pre;acrossing times was (3.86±1.68) times for Pre).Conclusion ω-3PUFAs can relieve the MK-801-induced schizophrenia-like cognitive impairment.