Impact of neuromuscular block on myocardial injury after non-cardiac surgery (MINS) incidence in the early postoperative stage of older patients undergoing laparoscopic colorectal cancer resection: a randomized controlled study.

BACKGROUND: Myocardial injury after non-cardiac surgery (MINS) is a common and serious complication in older patients. This study investigates the impact of neuromuscular block on the MINS incidence and other cardiovascular complications in the early postoperative stage of older patients undergoing laparoscopic colorectal cancer resection. METHODS: 70 older patients who underwent laparoscopic colorectal cancer resection were separated into the deep neuromuscular block group and moderate neuromuscular block group for 35 cases in each group (n = 1:1). The deep neuromuscular block group maintained train of four (TOF) = 0, post-tetanic count (PTC) 1-2, and the moderate neuromuscular block group maintained TOF = 1-2 during the operation. Sugammadex sodium was used at 2 mg/kg or 4 mg/kg for muscle relaxation antagonism at the end of surgery. The MINS incidence was the primary outcome and compared with Fisher's exact test. About the secondary outcomes, the postoperative pain was analyzed with Man-Whitney U test, the postoperative nausea and vomiting (PONV) and the incidence of cardiovascular complications were analyzed with Chi-square test, intraoperative mean artery pressure (MAP) and cardiac output (CO) ratio to baseline, length of stay and dosage of anesthetics were compared by two independent samples t-test. RESULTS: MINS was not observed in both groups. The highest incidence of postoperative cardiovascular complications was lower limbs deep vein thrombosis (14.3% in deep neuromuscular block group and 8.6% in moderate neuromuscular group). The numeric rating scale (NRS) score in the deep neuromuscular block group was lower than the moderate neuromuscular block group 72 h after surgery (0(1,2) vs 0(1,2), P = 0.018). The operation time in the deep neuromuscular block group was longer (356.7(107.6) vs 294.8 (80.0), min, P = 0.008), the dosage of propofol and remifentanil was less (3.4 (0.7) vs 3.8 (1.0), mg·kg-1·h-1, P = 0.043; 0.2 (0.06) vs 0.3 (0.07), µg·kg-1·min-1, P < 0.001), and the length of hospital stay was shorter than the moderate neuromuscular block group (18.4 (4.9) vs 22.0 (8.3), day, P = 0.028). The differences of other outcomes were not statistically significant. CONCLUSIONS: Maintaining different degrees of the neuromuscular block under TOF guidance did not change the MINS incidence within 7 days after surgery in older patients who underwent laparoscopic colorectal cancer resection. TRIAL REGISTRATION: The present study was registered in the Chinese Clinical Trial Registry (10/02/2021, ChiCTR2100043323).

Regulatory pattern of abnormal promoter CpG island methylation in the glioblastoma multiforme classification.

Glioblastoma (GBM) is characterized by extensive genetic and phenotypic heterogeneity. However, it remains unexplored primarily how CpG island methylation abnormalities in promoter mediate glioblastoma typing. First, we presented a multi-omics scale map between glioblastoma sample clusters constructed based on promoter CpG island (PCGI) methylation-driven genes, using datasets including methylation profiles, expression profiles, and single-cell sequencing data from multiple highly annotated public clinical cohorts. Second, we identified differences in the tumor microenvironment between the two glioblastoma sample clusters and resolved key signaling pathways between cell clusters at the single-cell level based on comprehensive comparative analyses to investigate the reasons for survival differences between two of these clusters. Finally, we developed a diagnostic map and a prediction model for glioblastoma, and compared theoretical differences of drug sensitivity between two glioblastoma sample clusters. In summary, this study established a classification system for dissecting promoter CpG island methylation heterogeneity in glioblastoma and provides a new perspective for the diagnosis and treatment of glioblastoma.

[Assessment of nasal specific symptoms and psychological dysfunction in patients with chronic rhinosinusitis before and after surgery].

Objective:To investigate the effects of nasal specific symptoms on chronic rhinosinusitis（CRS） with anxiety, depression and other psychological dysfunction and endoscopic surgery for the improvement of psychological dysfunction in patients with CRS. Method:The Hamilton Anxiety Scale（HAMA）, Hamilton Depression Scale（HAMD） and the 22-Item Sino-Nasal Outcome Test（SNOT-22） were completed in 44 patients with CRS within one week before and 6 months after surgery. They were used to assess mental function and nasal specific symptoms. Result:According to the SNOT-22 score, patients with anxiety and depression mental dysfunction had more severe symptoms of dizziness, head and face pain and sleep disorders（P<0.01 or P<0.05）. After endoscopic sinus surgery, the scores of HAMD, HAMA and SNOT-22 in CRS patients were improved compared with preoperative（P<0.01）. Conclusion:Patients with CRS have more common anxiety and depression. The specific symptoms of dizziness and head and face pain are significantly related to the psychological dysfunction of patients with CRS. Endoscopic sinus surgery can significantly alleviate the specific symptoms and mental dysfunction.

Identification of key genes and molecular mechanisms associated with low egg production of broiler breeder hens in ad libitum.

BACKGROUND: Overfeeding reduces laying performance in broiler breeder hens, which is associated with obesity, hepatic steatosis and systemic inflammation. To unravel the underlying mechanisms governing the effect of feeding regimes on energy metabolism and egg production, a transcriptomics approach was carried out for screening differentially expressed genes (DEGs) in ovary, liver and adipose tissues of broiler chickens under ad libitum and restricted feeding. RESULTS: It showed that 289, 388 and 204 DEGs were identified in the adipose, liver and ovary, respectively. These DEGs were significantly enriched in phagosome pathway, lipid transport, activity and nutrient reservoir activity in ovary; steroid hormone biosynthesis and metabolism of xenobiotics by cytochrome P450 pathways in adipose tissue; and the metabolic pathways, peroxisome proliferator-activated receptor (PPAR) and Jak-STAT signaling pathway in liver. Estrogen receptor 1, identified as one of important hubs by constructing PPI network, was up-regulated in ad libitum group, which would make more apolipoproteins be transferred to ovary. CONCLUSIONS: High expression of VTGs, APOB, CYBB and CTSS in ovary would induce excess lipid deposit, oxidative stress and potential damage to ovulation. Our results contribute to understanding effects of feeding regimes on metabolic regulation during egg production of broiler breeder hens and also provide new evidence of metabolic regulation from integrated multi-tissue processes.

Oncological and genetic factors impacting PDX model construction with NSG mice in pancreatic cancer.

A patient-derived xenograft (PDX) approach, which relies on direct transplantation of tumor specimens into an immunocompromised animal, is a commonly used method for investigating tumor therapy predictions in vivo. This study evaluated influencing factors, including clinical, oncological, and genetic variables, for a pancreatic PDX model in mice. Tumor specimens were obtained from 121 patients with pancreatic ductal adenocarcinoma who underwent surgical resection at the Changhai Pancreatic Surgery Medical Center (Shanghai, China) between April 2016 and February 2017. Pancreatic cancer (PC) samples <3 mm3 were subcutaneously implanted into the NOD/Shi-scid/IL-2Rγnull (NSG) mice. Once the xenograft reached 300-500 mm3 or reached 180 d after cell inoculation, the tumor was excised. Part of the tumor was subsequently transplanted to next-generation mice, and another part was analyzed by using immunohistochemistry. Among the 121 patients with PC, tumor xenograft was successfully generated in 86 patients (71.1%). Primary tumor >3.5 cm in size was independently associated with xenograft formation rate. In addition, several enriched mutated genes within the VEGF pathway and higher microvessel density were found in the positive group (with xenograft) compared with the negative group (without xenograft). We concluded that tumor size and mutated VEGF pathway in PC are important factors affecting PDX model construction with NSG mice.-Guo, S., Gao, S., Liu, R., Shen, J., Shi, X., Bai, S., Wang, H., Zheng, K., Shao, Z., Liang, C., Peng, S., Jin, G. Oncological and genetic factors impacting PDX model construction with NSG mice in pancreatic cancer.

[Establishment of a comprehensive database for laryngeal cancer related genes and the miRNAs].

OBJECTIVE: By collecting and analyzing the laryngeal cancer related genes and the miRNAs, to build a comprehensive laryngeal cancer-related gene database, which differs from the current biological information database with complex and clumsy structure and focuses on the theme of gene and miRNA, and it could make the research and teaching more convenient and efficient. METHODS: Based on the B/S architecture, using Apache as a Web server, MySQL as coding language of database design and PHP as coding language of web design, a comprehensive database for laryngeal cancer-related genes was established, providing with the gene tables, protein tables, miRNA tables and clinical information tables of the patients with laryngeal cancer. RESULTS: The established database containsed 207 laryngeal cancer related genes, 243 proteins, 26 miRNAs, and their particular information such as mutations, methylations, diversified expressions, and the empirical references of laryngeal cancer relevant molecules. The database could be accessed and operated via the Internet, by which browsing and retrieval of the information were performed. The database were maintained and updated regularly. CONCLUSION: The database for laryngeal cancer related genes is resource-integrated and user-friendly, providing a genetic information query tool for the study of laryngeal cancer.

[Clinical analysis of otogenic extracranial and intracranial complications].

OBJECTIVE: To study the clinical feature and treatment of extracranial and intracranial complications caused by otitis media. METHOD: Three hundred and twenty patients of acute and chronic otitis media were admitted to our department between 2005 and 2014. Among them, 34 patients were diagnosed with extracranial and intracranial complications. The clinical features and treatment outcome were retrospectively studied. Of the 34 patients associated with complications, 25 had a single complication,8 had two complications and 1 had three complications. Complications included labyrinthitis in 14 cases, facial paralysis in 11, postauricular subperiosteal abscess in 6, Bezold abscess in 1, thrombophlebitis of sigmoid sinus in 2, otitis meningitis in land otogenic brain abscess in 8. RESULT: Thirty-three patients were cured or improved and 1 patient died. CONCLUSION: Due to the widespread use of antibiotics, the clinical manifestations of extracranial and intracranial complications of otitis media become more hidden and atypical. The surgery is the primary treatment method.

[A web-based integrated clinical database for laryngeal cancer].

OBJECTIVE: To establish an integrated database for laryngeal cancer, and to provide an information platform for laryngeal cancer in clinical and fundamental researches. This database also meet the needs of clinical and scientific use. METHOD: Under the guidance of clinical expert, we have constructed a web-based integrated clinical database for laryngeal carcinoma on the basis of clinical data standards, Apache+PHP+MySQL technology, laryngeal cancer specialist characteristics and tumor genetic information. RESULT: A Web-based integrated clinical database for laryngeal carcinoma had been developed. This database had a user-friendly interface and the data could be entered and queried conveniently. In addition, this system utilized the clinical data standards and exchanged information with existing electronic medical records system to avoid the Information Silo. Furthermore, the forms of database was integrated with laryngeal cancer specialist characteristics and tumor genetic information. CONCLUSION: The Web-based integrated clinical database for laryngeal carcinoma has comprehensive specialist information, strong expandability, high feasibility of technique and conforms to the clinical characteristics of laryngeal cancer specialties. Using the clinical data standards and structured handling clinical data, the database can be able to meet the needs of scientific research better and facilitate information exchange, and the information collected and input about the tumor sufferers are very informative. In addition, the user can utilize the Internet to realize the convenient, swift visit and manipulation on the database.

[Influence of nasal septal deviation on incidence of bilateral sinusitis].

OBJECTIVE: To investigate the influence of nasal septal deviation on the incidence of bilateral sinusitis. METHOD: Two thousand and seventy-four cases of nasal septal deviation with chronic sinusitis available from January 2006 to March 2012 were reviewed retrospectively. RESULT: Of these 2074 cases, 1 687 (81.3%) patients had sinusitis in narrow side and 1582 (76.3%) in wide side, the difference was statistically significant (P < 0.01) and the relative risk value in narrow side (1.4) was higher than wide side (0.7) associated with the incidence of sinusitis. There was significant difference (P < 0.05) between the two group counting datas analyzed by rank sum test, and the mean rank order in narrow side was 1656.396, significantly greater than wide side (1 612.184). The incidence of sinusitis in men was 50.6% (1049/2074), in women was 49.4% (1025/2074), and there was no significant difference between them. Deviating leftward was 1148 cases (55.4%), deviating rightward was 926 cases (44.6%), and the difference was statistically significant (P < 0.05). Anatomic variations in narrow side and wide side were uncinate process hypertrophy (7.0%, 27.0%), middle turbinate hypertrophy (7.8%,38.0%), ethmoidal bulla hypertrophy (26.2%, 39.0%), paradoxical middle turbinate (5.4%, 15.5%), hypertrophic inferior turbinate (52.9%, 67.0%) and mucosa pachynsis (0.5%, 2.8%), respectively. CONCLUSION: Sinusitis incidence in narrow side is higher than wide side. There is no significant difference between the incidence of sinusitis in men and women. The majority of nasal septum deviate leftward. Higher incidence of sinusitis in wide side is the result of compensatory mechanism. Only septoplasty may not restore the normal venting function in nasal cavity. Hypertrophic inferior turbinate are closely correlated with sinusitis.

[Clinicopathological analysis of sinonasal ectopic meningioma].

OBJECTIVE: To evaluate the diagnostic and therapeutic methods of sinonasal ectopic meningioma. METHOD: The clinical data of 8 patients treated in our department from Jan 1990 to Oct 2011 were retrospectively analysed. Among these patients, 5 cases were treated by lateral rhinotomy approach; 2 cases were treated by endoscopic plus modified Caldwell-Luc technique; 1 case was treated by endoscopic plus modified Caldwell-Luc technique. All patients were followed up postoperatively. RESULT: All patients had no complications after operation. All patients were followed up from six months to 22 years. Among them, two cases had recurred 18 months and one year postoperatively. The two cases did not recur after the second operation. CONCLUSION: Although sinonasal ectopic meningioma is difficult to diagnose because of their infrequent occurrence in this ectopic site and of their non-specific clinical appearance. The final diagnosis rests on the histological examination. Immunohistochemical studies are helpful to establish the accurate diagnosis. Prognosis is excellent after complete surgical resection.

Epidemiological features of allergic rhinitis in four major cities in Western China.

Allergic rhinitis (AR), with an increasing uptrend of the prevalence in many developed and developing countries, is a global health problem that affects people of all ages and ethnic groups. However, data on the prevalence of self-reported AR in western China are rare. This study investigated the epidemiological features of self-reported AR in western China. In the cross-sectional, population-based study, a validated questionnaire survey on self-reported AR was carried out in 4 major cities in western China by multistage, stratified and cluster sampling, from January to December 2008. The total prevalence rate was 34.3%, with 32.3% (Chongqing), 34.3% (Chengdu), 37.9% (Urumqi), 30.3% (Nanning), respectively. The prevalence presented to increase with age before 30 years old while decrease with age after 30 years old, and the highest prevalence was in 19-30 years group in Chongqing, Chengdu and Nanning which significantly showed "persistent and moderate-severe" type (P<0.0001); In Urumqi, there wasn't a significant increasing or decreasing trend of prevalence rate with age but with an "intermittent and mild"predominance (P<0.0001). There were no distinct sexual differences in prevalence rates in the 4 cities. The morbidity was positively related to monthly average temperature and sunshine (r=0.76645, P=0.0036; r=0.67303, P=0.0165), but negatively associated with relative humidity (r=-0.64391, P=0.0238) in Urumqi. Interestingly, the monthly morbidity was negatively associate with average temperature, sunshine and precipitation in Nanning (r=-0.81997, P=0.0011; r=-0.60787, P=0.0360; r=-0.59443, P=0.0415). Self-reported AR is becoming common in western China with a rapid development in recent years, affecting about three persons out of ten. The climatic factors may have an indirect impact on the prevalence rate through the effects on the local allergens.

Epidemiological Features of Allergic Rhinitis in Four Major Cities in Western China / 华中科技大学学报（医学）（英德文版）

Allergic rhinitis (AR),with an increasing uptrend of the prevalence in many developed and developing countries,is a global health problem that affects people of all ages and ethnic groups.However,data on the prevalence of self-reported AR in western China are rare.This study investigated the epidemiological features of self-reported AR in western China.In the cross-sectional,population-based study,a validated questionnaire survey on self-reported AR was carried out in 4 major cities in western China by multistage,stratified and cluster sampling,from January to December 2008.The total prevalence rate was 34.3％,with 32.3％ (Chongqing),34.3％ (Chengdu),37.9％ (Urumqi),30.3％ (Nanning),respectively.The prevalence presented to increase with age before 30 years old while decrease with age after 30 years old,and the highest prevalence was in 19-30 years group in Chongqing,Chengdu and Nanning which significantly showed “persistent and moderate-severe” type (P＜0.0001); In Urumqi,there wasn't a significant increasing or decreasing trend of prevalence rate with age but with an “intermittent and mild”predominance (P＜0.0001).There were no distinct sexual differences in prevalence rates in the 4 cities.The morbidity was positively related to monthly average temperature and sunshine (r=0.76645,P=0.0036; r=0.67303,P=0.0165),but negatively associated with relative humidity (r=-0.64391,P=0.0238) in Urumqi.Interestingly,the monthly morbidity was negatively associate with average temperature,sunshine and precipitation in Nanning (r=-0.81997,P=0.0011; r=-0.60787,P=0.0360; r=-0.59443,P=0.0415).Self-reported AR is becoming common in western China with a rapid development in recent years,affecting about three persons out of ten.The climatic factors may have an indirect impact on the prevalence rate through the effects on the local allergens.

[Discussion of cochlear implant indications in postlingually deaf adults].

OBJECTIVE: To explore the indications of cochlear implantation in postlingually deaf adults. METHOD: Five postlingually deaf adults participated in our investigation, surgery age 19-58 (median age 26 years). All patients received 24R (Cochlear,Australia). Four weeks after operation, all the patients have started the program. Through one year follow-up, we used the categories of auditory performance (CAP) and speech intelligibility rating criteria (SIR) to assess their hearing ability and speech intelligibility. RESULT: Through testing for five patients who used cochlear implant continuously more than one year by Pure-tone audiometry, CAP and SIR, we assessed and found that the five patients hearing threshold raise to 25-45 dB in 0.5 kHz, 1.0 kHz, 2.0 kHz, 4.0 kHz, CAP average of 3.4, SIR average of 2.4. Two patients' ability of speech recognition and emotional communication were not improved almost, while these ability in other three were improved in varying degrees. CONCLUSION: For postlingual deaf adults caused by different reasons, how to make patients benefit from cochlear implantation and increase their capacity for independent living and self-confidence due to select surgical indications correctly.

[Clinical study of carbon dioxide laser tonsillectomy].

OBJECTIVE: To investigate the therapeutic effect of carbon dioxide laser tonsillectomy. METHOD: In this prospective, randomized study, One hundred and two patients were divided into laser group or control group. Patients of laser group were cured with carbon dioxide laser tonsillectomy, and the control group was cured with routine method. All operations are executed by one person. Observation index included operation time, hemorrhage in operation, ache after operation, inflammatory reaction of raw surface, repair time of raw surface, rehaemorrhagia and scar. RESULT: Laser group had advantages of less operation time, less hemorrhage, less ache and less inflammatory reaction of raw surface. Laser group have hemorrhage in operation (7.2 +/- 2.1) ml, while control group have hemorrhage in operation (92.0 +/- 35.0) ml. Laser group have pseudomembrane early but desquamate late. CONCLUSION: Carbon dioxide laser tonsillectomy is effective to relieve pain, inflammatory reaction and with less time, it's a safe, efficient and mini-trauma operation.

Moxifloxacin in the treatment of acute bacterial rhinosinusitis: results of a multicenter, non-interventional study.

CONCLUSION: Moxifloxacin was generally well tolerated and highly effective in the treatment of acute bacterial rhinosinusitis (ABS). The incidence of adverse events (AEs) and adverse drug reactions (ADRs) was low. The effectiveness, safety, and tolerability information collected in this study confirm the clinical safety profile of moxifloxacin and its benefit as a treatment option for ABS. OBJECTIVE: To assess the effectiveness, safety, and tolerability of moxifloxacin under daily life treatment conditions in patients with ABS. METHODS: The study was carried out in China between September 2005 and May 2007. Patients with ABS were treated with moxifloxacin tablets 400 mg once daily for a duration that was left to the physician's discretion. Data were collected on demography, diagnosis of infection, pretreatment, concomitant diseases and medications, moxifloxacin therapy, course of symptoms during investigations, and final assessment of therapy. RESULTS: In all, 578 patients with ABS treated with moxifloxacin were valid for effectiveness analysis. An improvement was observed in 98.8% (n = 571/578) of the patients. Cure was documented in 89.4% (n = 517/578) of the patients. The physicians' overall tolerability rating was 'very good' or 'good' in 92.9% (n = 537/578) of patients. The incidence rates of AEs and ADRs were 1.5% (n = 10/681) and 0.6% (n = 4/681), respectively. No serious AE was reported.

[Relationships of human laryngeal squamous cell carcinomas with the expression of VEGF-C and VEGFR-3].

In order to detect the relationships of human laryngeal squamous cell carcinoma (LSCC) with the expression of Vascular Endothelial Growth Factor C (VEGF-C) and Vascular Endothelial Growth Factor Receptor-3 (VEGFR-3), we examined the level of VEGF-C and VEGFR-3 gene expression in the samples from 30 cases of normal laryngeal mucosa tissue (NLM), primary laryngeal carcinoma (PLC) and cervical lymph node (CLN) by using reverse transcription polymerase chain reaction (RT-PCR). The protein levels of VEGF-C and VEGFR-3 expression were also determined by Western blotting in 10 cases of NLM, PLC, CLN,respectively. We found that in the samples from the same patient, the VEGF-C and VEGFR-3 expression level is different among normal laryngeal mucosa tissue, primary laryngeal carcinoma and cervical lymph node. In primary laryngeal carcinoma, the level of VEGF-C and VEGFR-3 expression was significantly higher in lymph node positive group than in lymph node negative group, and this difference was the associated with the histological grade of differentiation (P < 0.05). The expression levels of VEGF-C and VEGFR-3 were not associated with age, sex, site and T stage (P > 0.5). These results suggest that there is a close relationship of LSCC with VEGF-C/VEGFR-3; and VEGF-C/VEGFR-3 may have the potential for use as an indicator with prognostic significance in dealing with LSCC.

[Clinical study on submental island flaps in repairing pharyngeal fistula].

OBJECTIVE: To explore the application of submental island flaps in repairing pharyngeal fistula after total laryngectomy. METHODS: From July 2002 to February 2006, 9 cases of concomitant pharyngeal fistula (including 7 cases of laryngeal carcinoma and 2 cases of hypopharyngeal neoplasms) were repaired with submental island flaps after total laryngectomy. All patients were male and their ages were 52-71 years (mean 61.8 years). Pharyngeal fistula occurred 5-62 days (mean 14.7 days) after total laryngectomy. The diameter of medial pharyngeal fistula ranged from 1.9 cm to 4.1 cm. All patients failed to respond to conservative therapy for 25-46 days. The size of submental island flap was 2.5 cm x 2.4 cm to 4.6 cm x 4.0 cm. After the pharyngeal fistula were repaired with submental flap, the donor site were sutured directly. RESULTS: All of the nine submental flaps were survived and no local necrosis or wound infection occurred. Incision at donor site healed by first intention and no obvious scar formed. Fistula occurred 10 days after operation and was cured after symptomatic treatment in one patient who received radiotherapy before operation; other patients achieved the satisfactory results of one-stage repair. The gastric tube was pulled out 14 to 22 days after operation, all of the patients have no sense of swallow obstruction. Nine patients were followed up for 10-38 months (mean 27 months). The appearance of neck was satisfactory. CONCLUSION: Because of its short distance, abundant blood supply, convenient operation and minimal donor-site morbidity, the submental island flap is a good alternative method in repairing pharyngeal fistula.