MiRNA-122 contributes to the effect of exercise on non-alcoholic fatty liver / 中国组织工程研究

BACKGROUND:In recent years,with the improvement of living standards,non-alcoholic fatty liver disease has a gradually increasing trend.miRNA-122 is one of the most abundant microRNAs in the liver,which plays an important role in maintaining the environmental stability and differentiation of the liver.Exercise training is a non-drug treatment for non-alcoholic fatty liver disease,which may improve liver lipid metabolism by regulating the expression of miRNA-122. OBJECTIVE:To review the effects of miRNA-122 on the pathological factors related to non-alcoholic fatty liver disease as well as the effects of exercise on the expression of miRNA-122 and the occurrence and development of nonalcoholic fatty liver disease. METHODS:The first author searched the databases of CNKI,WanFang,VIP,PubMed,Geenmedical,EBSCO,Medline,Web of Science,and Elsevier using"non-alcoholic fatty liver disease,microRNA,microRNA-122,lipid metabolism,inflammatory response,insulin resistance,exercise,physical exercise,exercise training"as the English and Chinese search terms for all relevant literature published before June 5,2022.All included documents were screened,summarized,and analyzed.Finally,68 documents were included for review. RESULTS AND CONCLUSION:Compared with the healthy control group,the expression of circulating miRNA-122 is increased in patients with non-alcoholic fatty liver disease.The level of miRNA-122 may show different expression levels at different stages of non-alcoholic fatty liver disease.miRNA-122 can regulate the expression of downstream-related proteins,influence lipid metabolism,inflammatory response,insulin resistance and other pathogenic factors in non-alcoholic fatty liver disease by targeting base complementary pairing sites on mRNA or directly acting as physiological ligands of some RNA receptors.Different exercise modes can improve non-alcoholic fatty liver disease.Therefore,patients with non-alcoholic fatty liver disease need to complete at least 120 minutes of moderate-intensity exercise every week to have a positive effect.For patients who can tolerate various exercises,priority should be given to the combination of aerobic and resistance exercises 4-5 times a week.The exercise intensity should be 50%-70%of the maximum heart rate and the exercise should last for>3 months.For patients with poor tolerance,resistance exercise may be more feasible than aerobic exercise.In addition,patients with non-alcoholic fatty liver disease can also choose proper exercise modes according to their own disease conditions(such as liver enzymes and lipid levels).Exercise can be used as a feasible strategy to prevent non-alcoholic fatty liver disease,reduce liver steatosis,and alleviate liver inflammatory response and insulin resistance.Exercise training can regulate the expression of miRNA-122,but in patients with non-alcoholic fatty liver disease,the effect of exercise on miRNA-122 and its related signal pathways remains to be studied.

GE Linyi's Experience in the Treatment of Ulcerative Colitis by Stages with the Method of Clearing / 中医杂志

This paper summarized the clinical experience of Professor GE Linyi in treating ulcerative colitis （UC） by stages with the method of clearing. Professor GE believes that the core pathogenesis of UC is dampness and heat in the intestines， and by taking the method of clearing as the basis， he proposed four methods for treatment of UC including clearing and transforming， clearing and dispersing，clearing and moisterning， clearing and nourishing. The pathogenesis of UC in its active stage is dampness and heat in the intestines， congestion and stagnation of qi and blood， and accumulation of stasis toxins， for which the treatment method is to clear and transform， accompanied by clearing and dispersing method. In terms of the clearing and transforming method， Bai Tou Weng Decoction （白头翁汤） combined with Haungqin （Radix Scutellariae）， Machixian （Herba Portulacae） and Pugongying （Herba Taraxaci） is taken as the basic prescription to clear and transform dampness and heat， cool blood， resolve toxins and stop dysentery. For the clearing and dispersing method， medicinals to rectify qi such as Chaihu （Radix Bupleuri）， Cuxiangfu （Vingar Rhizoma Cyperi）， Muxiang （Radix Aucklandiae）， Zhiqiao （Fructus Aurantii）， and Binlang （Semen Arecae）， as well as those to regulate blood such as Danggui （Radix Angelicae Sinensis）， Cebaiye （Cacumen Platycladi） and Diyutan （Radix Sanguisorbae Carbonisatus） are recommended. The pathogenesis of the remission stage is healthy qi depletion and lingering pathogen of dampness and heat stasis toxin in the intestines， for which the method of clearing and nourishing， clearing and moistening can be used； the latter is mainly for people with yin fluids injury， and self-made Qingrun Yichang Decoction （清润益肠汤） is recommended， while the former is for those with spleen and stomach weakness， and self-made Qingyang Jianpi Decoction （清养健脾汤） can be used.

Global Research Trends and Hotspots Analysis of Proprotein Convertase Subtilisin/Kexin Type 9 Monoclonal Antibodies / 医药导报

Objective To analyze the global research status,hotspots,and frontiers of proprotein convertase subtilisin/Kexin type 9(PCSK9)monoclonal antibodies,and to provide a reference for related scientific research and the rational drug use in clinical practice in China.Methods The research literature related to PCSK9 monoclonal antibody included in the Web of Science database was searched for the period from January 2011 to February 2022,and the literature included in the study was visually analyzed by the CiteSpace software.Results A total of 723 articles were included,and the annual number of publica-tions showed an overall upward trend.The top three countries were the United States,France,and the United Kingdom.Sanofi was the organization with the largest number of articles,and the organization with the highest citation of articles was Brigham and Women's Hospital.The hotspots of research mainly included the use of PCSK9 monoclonal antibody in the treatment of patients with hypercholesterolemia,patients who do not tolerate statins,patients with high cardiovascular risk,and the efficacy and safety of PCSK9 monoclonal antibody in lipid-lowering therapy combined statins;The frontiers of research in recent two years is the appli-cation of PCSK9 monoclonal antibodies in patients with acute coronary syndrome and the clinical benefits after reducing the level of lipoprotein(a).Conclusion A large number of studies have confirmed the efficacy and safety of PCSK9 monoclonal anti-bodies in reducing blood lipids,but there is still a lack of research on its economics and application in special populations,which should be the focus of future research.

Application of health self-management intervention program for metabolic syndrome patients in the bereaved population following the Wenchuan earthquake.

Background: The destructive Wenchuan earthquake has led to approximately 800,000 people being bereaved. In the previous cross-sectional study, we explored the long-term incidence of Metabolic Syndrome (MS) and studied its influencing factors among the bereaved population 12 years after the Wenchuan earthquake. Chronic disease self-management has become a recognized public health service. Studies have shown that demographic and genetic factors, stress, geographical environment, society, culture, dietary habits, lifestyle, and other aspects influence MS. Due to the Wenchuan earthquake being a serious stress event, the implementation of targeted interventions should be discussed further. Objectives: To verify the effect of applying a self-management intervention program for patients with MS among the bereaved population following the Wenchuan earthquake. Design: A randomized controlled trial (RCT) design was adopted. Participants: A total of 132 bereaved patients with MS following the Wenchuan earthquake constituted the sample. Methods: The study was based on the Cognitive-Phenomenological-Transaction, Chronic Disease Self-Management Program, and Patient Empowerment Conceptual Model, which combined with the latest evidence-based guidelines, were used to systematically evaluate cross-sectional results of this study that were used to construct a stress management-based health self-management intervention program and MS health self-management manual for bereaved patients with MS following the Wenchuan earthquake. In addition, we revised and completed a health self-management intervention program and health self-management manual for patients with MS by using the expert consultation method. General data were collected prior to intervention (T0). We collected the patients' MS disease-related physiological indicators before intervention (T0), after intervention (T1), and 2 months after intervention (T2). EipData3.1 software was used to input data in duplex and duplicate, and SPSS22.0 software was used for statistical analysis. Results: The variance analysis showed that the total score of healthy self-management behavior and the score of diet management, exercise management, drug management, and emotional management have intergroup effects, time effects, and group-time interaction effects (p < 0.05). When the differences between groups were further compared, we found that the total score and the score of six dimensions (excluding disease self-monitoring management) were higher than those of the control groups at T1 and T2, and the differences were statistically significant (p < 0.05). Conclusion: The intervention program of healthy self-management for patients with MS who come from bereaved families following the Wenchuan earthquake can effectively improve patients' health self-management behaviors.

Inhibition of GPR30 sensitized gefitinib to NSCLC cells via regulation of epithelial-mesenchymal transition.

Introduction: G-protein coupled receptor 30 (GPR30) is associated with cell metastasis and drug resistance in many different cancer cells. The present study aimed to reveal the sensitivity of GPR30 to gefitinib in non-small cell lung cancer (NSCLC) cells.Methods: Cell viability and proliferation were detected using cell counting kit 8 and 5-ethynyl-2'-deoxyuridine assays, respectively. Western blotting and quantitative real-time reverse transcription PCR were used to detect GPR30 or epithelial-mesenchyme transition (EMT)-related mRNA and protein expression.Results: The results showed that GPR30 expression is associated with gefitinib sensitivity. G15, as a GPR30 antagonist, reduced GPR30 expression. We chose the maximum concentration of G15 with minimal cytotoxicity to detect cell viability after combined treatment with gefitinib in NSCLC cells, which indicated that G15 could increase sensitivity to gefitinib. However, the effect of G15 on gefitinib sensitivity disappeared after treatment with a small interfering RNA targeting GPR30. Further research showed that G15 or GPR30 siRNA treatment could upregulate E-cadherin and downregulate vimentin levels.Conclusion: Taken together, these data suggested that G15 could enhance NSCLC sensitivity to gefitinib by inhibition of GPR30 and EMT.

Investigation on quality of disinfection in the SARS-CoV-2 nucleic acid sampling sites in Shanghai， 2022 / 上海预防医学

ObjectiveTo investigate the quality of disinfection in the SARS-CoV-2 nucleic acid sampling sites in Shanghai. MethodsSwab samples of medical staff’ hands and environments of different SARS-CoV-2 nucleic acid sampling sites were collected from July to September 2022， with the total number of bacterial colonies cultured and counted. ResultsA total of 728 swab samples were collected from 69 sampling sites. The median total number of bacterial colonies on hand surface， object surface and air samples were 0 CFU·cm-2， 0 CFU·cm-2， and1 CFU·（petri dish∙5 min）-1， respectively， and P95 was 13 CFU·cm-2， 5.3 CFU·cm-2， and 17.8 CFU·（culture vessel∙5 min）-1， respectively. According to the GB 15982‒2012 Hygienic Standard for Disinfection in Hospitals class Ⅳ environment， 680 samples met the standard （93.4%）. Furthermore， 96.9%， 92.0%， and 92.2% of the samples in the sampling sites of tertiary/secondary hospitals， community health centers， and community convenience sampling sites met the standard， respectively. Quality of disinfection did not differ significantly across these sampling sites. ConclusionThe quality of disinfection in the SARS-CoV-2 nucleic acid sampling sites in Shanghai is generally good. Additionally， hand hygiene of medical staff and disinfection on object surface in some sampling sites need to be strengthened.

Ambient fine particulate matter and cardiopulmonary health risks in China / 中华医学杂志(英文版)

In China, the level of ambient fine particulate matter (PM 2.5 ) pollution far exceeds the air quality standards recommended by the World Health Organization. Moreover, the health effects of PM 2.5 exposure have become a major public health issue. More than half of PM 2.5 -related excess deaths are caused by cardiopulmonary disease, which has become a major health risk associated with PM 2.5 pollution. In this review, we discussed the latest epidemiological advances relating to the health effects of PM 2.5 on cardiopulmonary diseases in China, including studies relating to the effects of PM 2.5 on mortality, morbidity, and risk factors for cardiovascular and respiratory diseases. These data provided important evidence to highlight the cardiopulmonary risk associated with PM 2.5 across the world. In the future, further studies need to be carried out to investigate the specific relationship between the constituents and sources of PM 2.5 and cardiopulmonary disease. These studies provided scientific evidence for precise reduction measurement of pollution sources and public health risks. It is also necessary to identify effective biomarkers and elucidate the biological mechanisms and pathways involved; this may help us to take steps to reduce PM 2.5 pollution and reduce the incidence of cardiopulmonary disease.

Advances in epidemiology, etiology, and treatment of community-acquired pneumonia / 中华预防医学杂志

Community-acquired pneumonia (CAP) is the third leading cause of death worldwide and one of the most commonly infectious diseases. Its epidemiological characteristics vary with host and immune status, and corresponding pathogen spectrums migrate over time and space distribution. Meanwhile, with the outbreak of COVID-19, some unconventional treatment strategies are on the rise. This article reviewed the epidemiological characteristics, pathogen spectrum and treatment direction of CAP in China over the years, and aimed to provide guidance for the diagnosis and treatment of CAP in clinical practice.

Protective effects of ginsenosides Rg1 and Rb1 against cognitive impairment induced by simulated microgravity in rats / 中国药理学与毒理学杂志

OBJECTIVE Microgravity exerts several negative effects on the learning and memory of astro-nauts during space flight.Rg1 and Rb1,the key steroidal components of ginseng,have shown potent neuroprotec-tive effects with a high safety profile.The object of the current study is to investigate the influence of Rg1 and Rb1 on simulated microgravity-induced memory and learning dysfunction in the hindlimb suspension(HLS)rat model.METHODS The HLS rats were orally administered Rg1(30 and 60 μmol·kg-1)or Rb1(30 and 60 μmol·kg-1)for four weeks.The Morris water maze test(MWM)and reward operating conditioning reflex test(ROCR)were conducted to evaluate spatial and associative learning and memory.After the behavior tests,the serum and the prefrontal cortex(PFC)were dissected to measure the mechanism.RESULTS Rg1 and Rb1 treatment amelio-rated the cognitive deficits of HLS-exposure rats in MWM and ROCR,reduced reactive oxygen species generation and increased antioxidant enzyme activity.Rg1 and Rb1 also assisted in the recovery of mitochondrial complex Ⅰ(NADH dehydrogenase)activities and Mfn2,and decrea-sed Drp-1 expression.Furthermore,Rg1 and Rb1 reduced the ratio of Bax/Bcl-2 and the expression of cleaved-cas-pase 3,cytochrome c,increased the levels of SYN,PSD95 and activated BDNF-TrkB/PI3K-Akt pathway in the PFC.CONCLUSION Rg1 and Rb1 treatment attenuated cog-nitive deficits induced by HLS,mitigated mitochondrial dysfunction,attenuated oxidative stress,inhibited apopto-sis,and increased the synaptic plasticity,which was partly mediated by the modulation of the BDNF-TrkB/PI3K-Akt signaling.

Areca catechu L.ameliorates chronic unpredictable mil stress-induced depression behavior in rats by the promotion of the BDNF signaling pathway / 中国药理学与毒理学杂志

OBJECTIVE To investigated the anti-de-pressant effects of the fruit Areca catechu L.(ACL)and elucidated its potential underlying mechanism using a rat model of chronic unpredictable mild stress(CUMS).METHODS CUMS was induced in rats to establish a depression animal model for 28 d.According to the baseline sucrose preference,the male rats were divided into six different groups.They were treated with parox-etine hydrochloride,ACL,and water once a day until the behavioral tests were performed.The levels of corticoste-rone(CORT),malondialdehyde(MDA),catalase(CAT),and total superoxide dismutase(T-SOD)in serum were de-tected using a commercial kit,and the concentrations of 5-hydroxytryptamine(5-HT)and dopamine(DA)mono-amine neurotransmitters in the brain tissues were detect-ed by liquid chromatography-tandem mass spectrometry.Doublecortin(DCX)expression in the hippocampal den-tate gyrus(DG)was determined by immunofluorescence,and the relative abundance of brain-derived neurotrophic factor(BDNF),TrkB,PI3K,p-Akt/Akt,PSD-95,and p-GSK-3β/GSK-3β of brain tissues were assayed by West-ern blotting.RESULTS ACL markedly increased sucrose preference,decreased the immobility time,and short-ened the feeding latency of CUMS-induced rats.CUMS induction resulted in marked changes in the contents of the monoamine neurotransmitters(5-HT and DA)in the hippocampus and cortex of brain tissues and the levels of CORT,MDA,CAT,and T-SOD in serum,whereas ACL administration alleviated these considerable changes.ACL promoted DCX expression in DG and increased the protein levels of BDNF,TrkB,PI3K,p-Akt/Akt,PSD-95,and p-GSK-3β/GSK-3β in the brains of CUMS-induced rats.CONCLUSION Our results indicated that ACL may improve depression-like behaviors in CUMS-induced rats by decreasing the hyperfunction and oxidative stress of the hypothalamic-pituitary-adrenal axis,stimulating hippo-campal neurogenesis,and activating the BDNF signaling pathway.

Pathological evaluation of 30 cases of esophageal squamous cell carcinoma after two neoadjuvant therapies / 中华放射肿瘤学杂志

Objective:To explore the pathological differences of surgically resected specimens of advanced esophageal squamous cell carcinoma (ESCC) to different neoadjuvant therapies (neoadjuvant radiochemotherapy and toripalimab combined with neoadjuvant radiochemotherapy).Methods:Thirty patients diagnosed with advanced ESCC who underwent surgical operation after neoadjuvant therapy in Jiangsu Cancer Hospital from October 2020 to September 2021 were included. Among them, 15 patients received neoadjuvant radiochemotherapy (radiochemotherapy group) and 15 patients were treated with toripalimab combined with radiochemotherapy (immunotherapy combined with radiochemotherapy group). Surgically resected specimens were collected. The histopathological features of primary esophageal lesions and the responses of involved lymph nodes were analyzed and compared between two groups.Results:The major pathological response (MPR) rate in the radiochemotherapy group was 10/15, and 14/15 in the immunotherapy combined with radiochemotherapy group ( P=0.17). The pathological complete response (pCR) rate of the primary lesions in the radiochemotherapy group was 7/15, and 10/15 in the immunotherapy combined with radiochemotherapy group ( P=0.46). In the radiochemotherapy group, the incidence rate of tertiary lymphoid structure (TLS) was 7/15, and 12/15 in the immunotherapy combined with radiochemotherapy group ( P=0.02). The incidence rate of necrosis in the radiochemotherapy group was 6/15, and 1/15 in the immunotherapy combined with radiochemotherapy group ( P=0.03). In addition, the incidence rate of foam cell infiltration in the radiochemotherapy group was 6/15, and 13/15 in the immunotherapy combined with radiochemotherapy group ( P=0.01). Furthermore, the pCR rate of involved lymph nodes in the radiochemotherapy group was 7/33, and 11/12 in the immunotherapy combined with radiochemotherapy group ( P<0.001). Conclusion:Compared with the radiochemotherapy group, the incidence of TLS and foam cell infiltration is higher, the incidence of necrosis is lower and clinical efficacy of involved lymph nodes is higher in the immunotherapy combined with radiochemotherapy group, prompting that toripalimab combined with neoadjuvant radiochemotherapy exert higher synergistic immune effect.

Neurovascular coupling responses and cognitive function: The impact of aging and the interventional effect of exercise / 生理学报

Aging is a natural process accompanied with a progressive deterioration of cognitive functions. With an aging population, more and more elderly people are suffering from cognitive impairment. Previous studies have paid more attention to the impact of inflammation and oxidative stress on cognitive function during aging. Recently, it has been discovered that neurovascular coupling (NVC), a mechanism regulating cerebral blood flow, may play a significant role in aging-related cognitive impairment. NVC responses regulate the supply of energy substances and oxygen during brain activity, which in turn enhances cognitive function. However, as people grow older, NVC responses gradually weaken, which may be one of the mechanisms underlying aging-induced cognitive impairment. Given the important role of NVC responses in the brain, it is necessary to search for intervention methods that can improve NVC responses and promote cognitive function. Exercise is an effective means to delay aging and improve cognitive function. It also has a certain promoting effect on NVC responses. This article reviews the regulatory mechanisms of NVC responses, the relationship between NVC responses and cognitive function, and explores the effects of aging and exercise intervention on NVC responses, hoping to provide new research ideas for exercise intervention to improve NVC responses and promote cognitive function in the elderly.

Rare tumors: a blue ocean of investigation / 医学前沿

Advances in novel drugs, therapies, and genetic techniques have revolutionized the diagnosis and treatment of cancers, substantially improving cancer patients' prognosis. Although rare tumors account for a non-negligible number, the practice of precision medicine and development of novel therapies are largely hampered by many obstacles. Their low incidence and drastic regional disparities result in the difficulty of informative evidence-based diagnosis and subtyping. Sample exhaustion due to difficulty in diagnosis also leads to a lack of recommended therapeutic strategies in clinical guidelines, insufficient biomarkers for prognosis/efficacy, and inability to identify potential novel therapies in clinical trials. Herein, by reviewing the epidemiological data of Chinese solid tumors and publications defining rare tumors in other areas, we proposed a definition of rare tumor in China, including 515 tumor types with incidences of less than 2.5/100 000 per year. We also summarized the current diagnosis process, treatment recommendations, and global developmental progress of targeted drugs and immunotherapy agents on the status quo. Lastly, we pinpointed the current recommendation chance for patients with rare tumors to be involved in a clinical trial by NCCN. With this informative report, we aimed to raise awareness on the importance of rare tumor investigations and guarantee a bright future for rare tumor patients.

Noninvasive prenatal prediction of fetal haplotype with Spearman rank correlation analysis model.

BACKGROUND: Noninvasive prenatal testing (NIPT) has been widely used clinically to detect fetal chromosomal aneuploidy with high accuracy rates, gradually replacing traditional serological screening. However, the application of NIPT for monogenic diseases is still in an immature stage of exploration. The detection of mutations in peripheral blood of pregnant women requires precise qualitative and quantitative techniques, which limits its application. The bioinformatic strategies based on the SNP (single nucleotide polymorphism) linkage analysis are more practical, which can be divided into two types depending on whether proband information is needed. Hidden Markov Mode (HMM) and Sequential probability ratio test (SPRT) are suitable for families with probands. In contrast, methods based on databases and population demographic information are suitable for families without probands. METHODS: In this study, we proposed a Spearman rank correlation analysis method to infer the fetal haplotypes based on core family information. Allele frequencies of SNPs that were used to construct parental haplotypes were calculated as sets of nonparametric variables, in contrast to their theoretical values represented by a fetal fraction (FF). The effects on the calculation of the fetal concentration of two DNA enrichment methods, multiple-PCR amplification, and targeted hybrid capture, were compared, and the heterozygosity distribution of SNPs within pedigrees was analyzed to reveal the best conditions for the model application. RESULTS: Predictions of the paternal haplotype inheritance were in line with expectations for both DNA library construction methods, while for maternal haplotype inheritance prediction, the rates were 96.55% for method multiple-PCR amplification and 95.8% for method targeted hybrid capture. CONCLUSION: Positive prediction rates showed that the maternal haplotype prediction was not as accurate as paternal one, due to the large amount of maternal noise in the mother's peripheral blood. Although this model is relatively immature, it provides a new perspective for noninvasive prenatal clinical tests of monogenic diseases.

Application of Different Ventilation Modes Combined with AutoFlow Technology in Thoracic Surgery.

To investigate the effect of AutoFlow on airway pressure and hemodynamics in mechanical ventilation constant volume-control ventilation mode, 100 patients receiving mechanical ventilation were randomly divided into observation group (SIMV-PSV-PEEP + AutoFlow) and control group (SIMV-PSV-PEEP). The results showed that the peak airway pressure and average airway pressure decreased with different flow rate settings and automatic flow conversion (P < 0.05). The peak airway pressure and mean airway pressure decreased with different resistance settings (P < 0.05). With different compliance settings, the peak airway pressure and average airway pressure decreased after being assisted with an automatic converter (P < 0.05). Adding AutoFlow on the basis of SIMV-PSV mode can significantly reduce peak inspiratory pressure (PIP), mean airway pressure (Pmean), and airway resistance (R). There was no significant difference in hemodynamic monitoring results between the observation group and the control group. It is proved that the SIMV constant volume-controlled ventilation mode combined with AutoFlow can not only ensure tidal volume but also avoid excessive airway pressure, which has little effect on hemodynamics.

A reinforced suture method for stapled gastrointestinal anastomosis to reduce gastrointestinal hemorrhage during Whipple operation in laparoscopy

Purpose@#Laparoscopy is being increasingly accepted for pancreaticoduodenectomy. Stapled anastomosis (SA) is used extensively to facilitate laparoscopic pancreaticoduodenectomy (LPD); however, the incidence of anastomotic bleeding after stapled gastrointestinal anastomosis is still high. @*Methods@#One hundred and thirty-nine patients who underwent LPD using Whipple method were enrolled in our study. We performed the SA with our reinforced method (n = 68, R method) and without the method (n = 71, NR method). We compared the clinical characteristics and anastomosis methods of patients with or without gastrointestinal-anastomotic hemorrhage (GAH), and operative parameters were also compared between the anastomotic methods. @*Results@#Of the 139 patients undergoing LPD, 15 of them developed GAH. The clinical characteristics of patients with or without GAH were not significantly different except in the anastomotic method (P < 0.001). In the univariate logistic regression analyses, only the anastomotic method was associated with GAH. Furthermore, patients with the NR method had significantly higher incidences of GAH (P < 0.001) and Clavien-Dindo grade ≥ III complications (P < 0.001). @*Conclusion@#Our retrospective analysis showed that the SA performed with reinforced method might be a reform of SA without the reinforcement, as indicated by the lower incidence of GAH. However, further research is necessary to evaluate the utility of this reinforced method.

Application of different posture fixation methods in radiotherapy of breast cancer / 中华放射医学与防护杂志

Objective:To study the inter-fraction setup errors, intra-fraction movement of patients and its influence on dosimetry, position repeatability of the supraclavicular area, and the plastic stability of the vacuum cushion and styrofoam when one of the three fixation method are applied in the clinical radiotherapy of breast cancer. The three fixation method include acuum negative pressure pad (VP), acuum negative pressure pad combined with a breast bracket (VB), and polyurethane styrofoam combined with a breast bracket (PB).Methods:A total of 96 breast cancer patients who received radiotherapy at Jiangsu Cancer Hospital during 2019-2021 were collected prospectively for study. They were randomly divided into three groups (VP, VB, and PB). Cone-Beam CT and a planning system were used to obtain inter-fraction setup errors, intra-fraction movement of patients and its influence on dosimetry, position repeatability of supraclavicular area, and the plastic stability of vacuum pad and polyurethane tyrofoam.Results:In the left-right (LR) direction, there were no statistical differences in the inter-fraction setup errors among the three groups. In the superior-inferior (SI) direction, inter-fraction setup errors of the PB group were smaller than those of the VB group (3.02 ± 2.04, 3.65 ± 2.64, t=2.35, P=0.031). In the anterior-posterior (AP) direction, the inter-fraction setup errors of both the VB and PB groups were smaller than those of the VP group (3.36 ± 2.93, 3.14 ± 0.98, 4.03 ± 2.55, t=2.29, 3.11, P< 0.05). In the AP direction, the intra-fraction movement of patients of the VP and PB groups were less than that of the VB group (1.31 ± 0.95, 1.24 ± 0.89, 1.88 ± 1.33, t=-2.04, -2.31, P< 0.05). Moreover, the intra-fraction movement of patients had no statistical effect on the dosimetric distribution ( P> 0.05), and the breast bracket did not improve the position repeatability of the supraclavicular region ( P>0.05). In addition, the plastic stability of polyurethane styrofoam was significantly better than that of the acuum negative pressure pad ( t=2.43-5.63, P< 0.05). Conclusions:The inter-fraction setup errors and intra-fraction movement of patients with breast cancer can be reduced by using PB. Compared to an acuum negative pressure pad, polyurethane styrofoam can keep plastic stability throughout the treatment of the patients.

Interleukin-1β mediates the effect of macrophage androgen receptor on hyperphosphate-induced vascular smooth muscle cell calcification / 中华肾脏病杂志

Objective:To investigate whether it is by regulating interleukin 1β ( IL-1β) gene expression that androgen receptor (AR) in macrophages affects hyperphosphate-induced vascular smooth muscle cell calcification. Methods:The chromatin immunoprecipitation (ChIP) experiment was used to determine whether AR was bound to the androgen receptor element (ARE) sequence of IL-1β promoter in THP-1 cells. Whether the AR regulated IL-1β gene expression was detected by luciferase assay experiments. AR of THP-1 cells was silenced and transfected by lentivirus with vector or shRNA. Flow cytometry was used to select positive transfected cells THP-1ARsc (control) and THP-1ARsi (AR silencing) with fluorescent markers. Western blotting was used to detect AR protein levels of THP-1ARsc (control) and THP-1ARsi cells (AR silencing in monocytes). Macrophages MФARsc (control) or MФARsi (AR silencing) were induced by 50 ng/ml phorbol ester. Enzyme-linked immunosorbent assay was used to detect IL-1β expression levels of MФARsc or MФARsi conditioned medium. The human aortic smooth muscle cells (HASMC) were cultured in MФARsc or MФARsi conditioned medium with phosphate (2.5 mmol/L final concentration of sodium dihydrogen phosphate), and Alizarin red S staining was used to analyze HASMC calcification degree. Western blotting was used to detect the expression levels of RUNX2 (osteoblast marker) and SM22α (HASMC marker), and neutralization assay was performed to test IL-1β-mediating effect of macrophages AR on HASMC calcification. Results:AR was bound to ARE sequence of IL-1β promoter and regulated IL-1β gene expression. The expression level of IL-1β protein in conditioned medium of MФARsi cells decreased significantly compared to MФARsc cells ( P<0.001). Compared with MФARsc conditioned medium group, HASMC calcium deposition in MФARsi conditioned medium group decreased significantly, RUNX2 protein decreased and SM22α protein increased (all P<0.05). The degree of HASMC calcification in the MФARsi conditioned medium+IgG antibody group decreased than that in the MФARsc conditioned medium+IgG antibody group significantly, and the degree of HASMC calcification in the MФARsc conditioned medium+IL-1β antibody group decreased significantly than that in the MФARsc conditioned medium+IgG antibody group; while the degree of HASMC calcification in the MФARsi conditioned medium+IgG antibody group and MФARsi conditioned medium+IL-1β antibody group decreased than that in the MФARsc conditioned medium+IL-1β antibody group (all P<0.05). Conclusions:Macrophage AR regulates IL-1β expression by binding to ARE sequence within IL-1β promoter, and IL-1β mediates the effect of macrophage AR on hyperphosphate-induced HASMC calcification.

Uniportal thoracoscopic decortication for stage Ⅲ tuberculous empyema of 158 cases / 中华外科杂志

Objective: To examine the safety and feasibility of uniportal video-assisted thoracoscopic (VATS) decortication in patients presenting with stage Ⅲ tuberculous empyema. Methods: From August 2017 to July 2020, 158 patients of stage Ⅲ tuberculous empyema underwent uniportal VATS decortication with partial rib resection and customized periosteal stripper in Department of Thoracic Surgery, Shanghai Pulmonary Hospital. There were 127 males and 31 females, aged (M(IQR)) 32(28) years (range:14 to 78 years). Follow-up was performed in the outpatient clinic or via social communication applications, at monthly thereafter. If there was no air leak and chest tube drainage was less than 50 ml/day, a chest CT was performed. If the lung was fully re-expanded, chest tubes were removed. All patients received a follow-up chest CT 3 to 6 months following their initial operations which was compared to their preoperative imaging. Results: There was one conversion to open thoracotomy. The operative time was 2.75 (2.50) hours (range: 1.5 to 7.0 hours), and median blood loss was 100 (500) ml (range: 50 to 2 000 ml). There were no perioperative mortalities. There were no major complications except 1 case of redo-VATS for hemostasis due to excessive drainage and 1 case of incision infection, The incidence of prolonged air leaks (>5 days) was 80.3%(126/157). The postoperative hospital stay was 5.00 (2.25) days (range: 2 to 15 days). All patients were discharged with 2 chest tubes, and the median duration drainage was 21.00 (22.50) days (range: 3 to 77 days). Follow-up was completed in all patients over a duration of 20 (14) months (range: 12 to 44 months). At follow-up, 149 patients(94.9%) recovered to grade Ⅰ level, 7 patients to grade Ⅱ level, and 1 patient to grade Ⅲ level. Conclusion: Uniportal VATS decortication involving partial rib resection and a customized periosteal stripper is safe and effective for patients with stage Ⅲ tuberculous empyema.

Research progress of circumferential tracheal reconstruction via tissue-engineered trachea / 中华外科杂志

Tissue engineering, as a new technology, provides a new avenue for the reconstruction of circumferential tracheal defects, which has always been a tremendous challenge for surgeons around the world. Recently, technologies such as decellularization, 3-dimensional printing, electrospinning and cell sheet have significantly enhanced the chondrification. Implantation of epithelial cells or transplantation of epithelial cell sheets also has accelerated the process of epithelialization. And pedicle muscle flap proved to be a reliable strategy for vascularization of tissue-engineered trachea. But it is still a huge challenge to achieve circumferential tracheal functional reconstruction. The key difficulty lies in how to simultaneously realize the functional regeneration of cartilage, blood vessels and epithelial tissues of tissue-engineered trachea. Therefore, how to integrate the above schemes and finally realize segmental tracheal reconstruction needs further research. This article reviews the research progress of repairing circumferential tracheal defects based on tissue engineering technology.