[Finite element analysis of the stability of Mason type â ¢ radial head fracture fixed with three cross-bridge headless compression screw and locking plate].

OBJECTIVE: To compare the biomechanical stability of three cross-bridge headless compression screws and locking plates in the fixation of Mason type Ⅲ radial head fractures by finite element method. METHODS: Using reverse modeling technology, the radial CT data and internal fixation data of a healthy 25-year-old male were imported into the relevant software. Three-dimensional finite element model of 3 cross-bridge headless compression screws and locking plates for MasonⅢ radial head fractures were established, and the radial head was loaded with 100 N axial loading. The maximum displacement, maximum Von Mises stress and stress distribution of the two groups were compared. RESULTS: The maximum displacements of the three cross-bridge screws group and locking plate group were 0.069 mm and 0.087 mm respectively, and the Von Mises stress peaks were 18.59 MPa and 31.85 MPa respectively. The stress distribution of the three screws group was more uniform. CONCLUSION: Both internal fixation methods can provide good fixation effect. CoMPared with the locking plate fixation method, the 3 cross-bridge headless compression screws fixation is more stable and the stress distribution is more uniform.

Effect of Different Administration Routes of Dexmedetomidine on Postoperative Delirium in Elderly Patients Undergoing Elective Spinal Surgery: A Prospective Randomized Double-Blinded Controlled Trial.

BACKGROUND: Intravenous dexmedetomidine has been reported to decrease the occurrence of postoperative delirium (POD) in elderly patients. Nevertheless, some previous studies have indicated that intratracheal dexmedetomidine and intranasal dexmedetomidine are also effective and convenient. The current study aimed to compare the effect of different administration routes of dexmedetomidine on POD in elderly patients. METHODS: We randomly allocated 150 patients (aged 60 years or more) scheduled for spinal surgery to receive intravenous dexmedetomidine (0.6 µg/kg), intranasal dexmedetomidine (1 µg/kg) before anesthesia induction, or intratracheal dexmedetomidine (0.6 µg/kg) after anesthesia induction. The primary outcome was the frequency of delirium during the first 3 postoperative days. The secondary outcomes were the incidence of postoperative sore throat (POST) and sleep quality. Adverse events were recorded, and routine treatment was performed. RESULTS: Compared with the intranasal group, the intravenous group had a significantly lower occurrence of POD within 3 days (3 of 49 [6.1%] vs 14 of 50 [28.0%]; odds ratio [OR], 0.17; 95% confidence intervals [CIs], 0.05-0.63; P < .017). Meanwhile, patients in the intratracheal group had a lower incidence of POD than those in the intranasal group (5 of 49 [10.2%] vs 14 of 50 [28.0%]; OR, 0.29; 95% CI, 0.10-0.89; P < .017). Whereas, there was no difference between the intratracheal and intravenous groups (5 of 49 [10.2%] vs 3 of 49 [6.1%]; OR, 1.74; 95% CI, 0.40-7.73; P > .017). The rate of POST was lower in the intratracheal group than that in the other 2 groups at 2 hours after surgery (7 of 49 [14.3%] vs 12 of 49 [24.5%] vs 18 of 50 [36.0%], P < .017, respectively). Intravenous dexmedetomidine had the lowest Pittsburgh Sleep Quality Index score on the second morning after surgery (median [interquartile range {IQR}]: 4 [3-5] vs 6 [4-7] vs 6 [4-7], P < .017, respectively). Compared with the intranasal group, the intravenous group had a higher rate of bradycardia and a lower incidence of postoperative nausea and vomiting ( P < .017). The intranasal group was associated with the highest incidence of hypertension ( P < .017). CONCLUSIONS: For patients aged ≥60 years undergoing spinal surgery, compared with the intranasal route of dexmedetomidine, intravenous and intratracheal dexmedetomidine reduced the incidence of early POD. Meanwhile, intravenous dexmedetomidine was associated with better sleep quality after surgery, and intratracheal dexmedetomidine resulted in a lower incidence of POST. Adverse events were mild in all 3 administration routes of dexmedetomidine.

mRNA vaccines for infectious diseases: research progress and applications / 生物工程学报

Messenger RNA (mRNA) vaccines emerge as promising vaccines to prevent infectious diseases. Compared with traditional vaccines, mRNA vaccines present numerous advantages, such as high potency, safe administration, rapid production potentials, and cost-effective manufacturing. In 2020, two COVID-19 vaccines (BNT162b2 and mRNA-1273) were approved by the Food and Drug Administration (FDA). The two vaccines showed high efficiency in combating COVID-19, which indicates the great advantages of mRNA technology in developing vaccines against emergent infectious diseases. Here, we summarize the type, immune mechanisms, modification methods of mRNA vaccines, and their applications in preventing infectious diseases. Current challenges and future perspectives in developing mRNA vaccines are also discussed.

Exploration of acupuncture treatment for insomnia induced by mental retardation: based on "trinity theory of shaoyang, sanjiao and haishi" / 中国针灸

Insomnia induced by mental retardation is related to the synergistic dysfunction of "shaoyang, sanjiao and haishi (the period of the day from 9 pm to 11 pm) " in pathogenesis. Based on "trinity theory of shaoyang, sanjiao and haishi ", the acupoints of hand and food shaoyang meridians on the head and face (Fengchi [GB 20], Sizhukong [TE 23] and Jiaosun [TE 20]) and those on the four limbs (Sanyangluo [TE 8], Zhongzhu [TE 3], Qiuxu [GB 40] and Xiaxi [GB 43]) are selected to regulate the pivot function of shaoyang. Front-mu and back-shu points (Sanjiaoshu [BL 22], Danzhong [CV 17] and Tianshu [ST 5]), as well as auricular points (Gan [CO12], Dan [CO11] and Sanjiao [CO17]) are chosen to promote qi circulation of shaoyang and sanjiao meridians. In association with the relevant knowledge of time acupuncture at haishi, the circadian rhythm of sleep is set up and the appropriate sleep pattern is developed.

Minimally modified low-density lipoprotein upregulates mouse mesenteric arterial 5-HT1B receptor in vivo via activation of the JAK2/STAT3 pathway.

OBJECTIVES: To explore whether minimally modified low-density lipoprotein (mmLDL) upregulates mesenteric arterial 5-hydroxytryptamine 1B (5-HT1B) receptor expression by activating the JAK2/STAT3 signaling pathway. METHODS: Mice were randomly divided into the following groups: the normal saline (NS), LDL, mmLDL, mmLDL+galiellactone (GL, a JAK2/STAT3 pathway inhibitor), and mmLDL+DMSO groups. The dose-response curve of mesenteric arterial ring constriction after administration of 5-carboxamidotryptamine (5-CT), an agonist of 5-HT1B, was recorded with a microvascular tensiometer. JAK2, p-JAK2, STAT3, p-STAT3, and 5-HT1B receptor protein expression levels were determined by Western blotting. 5-HT1B receptor mRNA levels were measured by RT-PCR. 5-HT1B receptor protein expression was determined by immunofluorescence. RESULTS: Injection of mmLDL into the tail vein significantly increased the contractile dose-response curve after 5-CT stimulation, as the Emax was 82.15 ±â€¯6.15% in the NS group and 171.88 ±â€¯5.78% in the mmLDL group (P < 0.01); significantly elevated 5-HT1B receptor mRNA and protein expression levels; and significantly increased p-JAK2 and p-STAT3 protein expression levels. After intraperitoneal injection of GL, the vasoconstrictive response was significantly reduced compared with that in the mmLDL group, as the Emax was decreased to 97.14 ±â€¯1.20% (P < 0.01); 5-HT1B receptor mRNA and protein expression levels were significantly reduced; STAT3 phosphorylation and p-JAK2 and p-STAT3 protein expression were not significantly changed; and 5-HT1B receptor expression was altered via inhibition of p-STAT3 binding to DNA, which suppressed transcription. CONCLUSIONS: mmLDL can upregulate 5-HT1B receptor expression in mouse mesenteric arteries by activating the JAK2/STAT3 signaling pathway.

Clinical characteristics and prognosis of middle-aged and elderly in-patients with acute decompensated and mid-range ejection fraction heart failure in the medical alliance setting / 中华老年医学杂志

Objective:To investigate the clinical characteristics and the risk of major adverse cardiac events within 1 year of middle-aged and elderly in-patients with acute decompensated and mid-range ejection fraction heart failure(HF)in the medical alliance setting.Methods:A retrospective cohort study was conducted among a total of 180 in-patients with acute decompensated heart failure in Cardiovascular Hexi Hospital Consulting Area of Tianjin Chest Hospital.According to ejection fraction measured by echocardiogram, the in-patients were classified into three groups: heart failure with reduced ejection fraction(HFrEF)group(n=70, 38.9%), HFmEF group(n=50, 27.8%), and heart failure with preserved ejection fraction(HFpEF)group(n=60, 33.3%). Clinical feature and 1-year prognosis between different groups were compared.Results:Univariate Cox regression analysis of 1-year all-cause death and cardiovascular death showed that there was no significant difference between HFrEF group and HFmEF group, HFpEF group and HFmEF group(all P>0.05); 1-year readmission analysis of heart failure showed that 47.1%(33 cases)of HFrEF group was higher than 24.0%(12 cases)of HFmEF group, 48.3%(29 cases)of HFpEF group was higher than HFmEF group( HR=2.307, 2.368, 95% CI: 0.187-4.480, 1.207-4.644, respectively, all P<0.05); The major 1-year cardiovascular events were 57.1%(40 cases)higher in the HFrEF group than 34.0%(17 cases)in the HFmEF group( HR=2.053, 95% CI: 0.187-4.408, P< 0.05). Multivariate analysis showed that the 1-year risk of major cardiovascular events was significantly different between HFmEF group and HFpEF group( HR=0.477, 95% CI: 0.241-0.941, P< 0.05). Pulmonary heart disease( P< 0.05), atrial flutter and/or atrial fibrillation( P< 0.01), New York Cardiology class Ⅳ( P< 0.01)were risk factors for death.Hypertension and cor pulmonale were the risk factors for readmission in patients with heart failure(all P< 0.01). Conclusions:The clinical characteristics of inpatients with HFmEF in the medical alliance setting tended to be consistent with those with HFrEF, while the feature of ischemic heart disease was more prominent in HFmEF.The 1-year risk of heart failure readmission in HFmEF group was significantly lower than that in HFpEF and HFrEF group, and the risk of all-cause mortality and cardiovascular mortality at 1 year was not significantly different among the three groups.

The value of combined measurement of soluble growth stimulation expressed gene 2 protein, interleukin-6 and tumor necrosis factor-α in peripheral blood in evaluating the prognosis of elderly patients with heart failure / 中华老年医学杂志

Objective:To investigate the predictive value of measuring soluble growth stimulation expressed gene 2 protein(sST2), interleukin-6(IL-6)and tumor necrosis factor-α(TNFα)as individual parameters or as a test panel in the prognosis of elderly patients with heart failure.Methods:A total of 128 elderly patients with heart failure hospitalized at the Cardiology Department of the Medical Alliance of Chest Hospital and Hexi Hospital between April 2019 and April 2020 were retrospectively selected.Based on heart failure readmissions, all-cause deaths and cardiovascular death events within a one-year follow-up, the patients were divided into a good prognosis group(n=60)and a poor prognosis group(n=68).The general condition and routine laboratory examination test results were recorded.At admission, blood samples were taken to measure sST2, IL-6 and TNFα.The individual parameters, combinations of two parameters and the combination of all three parameters were used to draw receiver operating characteristic curves(ROCs)and their value in evaluating the prognosis of heart failure patients was analyzed.Results:In the poor prognosis group, sST2, IL-6 and TNFα levels were(29.4±7.7)mg/L, (23.1±45.7)ng/L and(30.9±82.1)ng/L, respectively, higher than those in the good prognosis group[(25.0±9.1)mg/L, (22.5±49.1)ng/L, (13.5±22.3)ng/L, t=2.42, -2.32, -2.37, all P<0.05)].The area under ROC(AUC)values of sST2, IL-6 and TNFα were 0.636, 0.619 and 0.622, respectively(all P>0.05).The specificity of sST2(56.7%)was higher than that of IL-6(51.7%)and of TNFα(46.7%), and the difference was statistically significant( P<0.05).The sensitivity of TNFα(80.9%)was higher than that of sST2(64.7%)and of IL-6(79.4%), and the difference was statistically significant( P<0.05); As the combinations of two parameters, the predictive power of the sST2+ TNFα combination was higher than that of the other two combinations, based on AUC values(both P<0.05).The AUC and specificity of the sST2+ IL-6+ TNFα combination were higher than those of any two-parameter combination(both P<0.05). Conclusions:The combined detection of sST2+ IL-6+ TNFα has a good performance in predicting the one-year prognosis of elderly patients with heart failure and can be easily implemented in clinical practice.

Effect of phacoemulsification with different corneal micro-incision sizes on postoperative corneal healing / 中华实验眼科杂志

Objective:To investigate the effect of phacoemulsification using different corneal micro-incision sizes on the postoperative corneal healing.Methods:A non-random controlled study was performed.Seventy-six patients (76 eyes) with age-related cataract who underwent phacoemulsification and cataract extraction combined with intraocular lens (IOL) implantation in Yanbian University Hospital from May 2016 to May 2017 were enrolled.The subjects were divided into 2.2 mm incision group (37 eyes) and 1.8 mm incision group (39 eyes) according to corneal incision size.The intraoperative cumulative dissipated energy (CDE) and ultrasound time of the two groups were measured and compared.The corneal incision structure and corneal thickness of operative eyes were measured by anterior segment optical coherence tomography before surgery and at postoperative 1 day, 1 week and 1 month.The corneal endothelial cells count, the central corneal thickness (CCT), and the corneal volume in the central corneal diameters of 3.0 mm (CV3) and 10.0 mm (CV10) were measured by Pentacam.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of the Yanbian University Hospital (No.2015153), and written informed consent was obtained from all subjects before surgery.Results:There were statistically significant differences in the corneal endothelial cells count, CCT, CV3, CV10, and corneal thickness at epithelial side of the incision between pre-operation and post-operation in each group ( Ftime=17.717, 67.356, 17.577, 13.559, 80.076; all at P<0.01).But there was no statistically significant difference in the indexes between the two groups ( Fgroup=0.788, 0.706, 3.692, 4.341, 4.182; all at P>0.05).The number of corneal endothelial cells in the two groups was gradually decreased after surgery, and was significantly reduced at one month after surgery in comparison with the pre-operation, and the differences were statistically significant (both at P<0.05).At 1 day after surgery, the CCT, CV3, CV10, and corneal thickness at epithelial side of the incision in the two groups were increased significantly in comparison with the pre-operation and the differences were statistically significant (all at P<0.05), and the differences were not statistically significant between preoperative and postoperative 1 week or 1 month (all at P>0.05).With time going by, the indexes were back to normal gradually.The incidence of endothelial gaping and dislocation at the corneal incision in the 1.8 mm incision group was 12.8% (5/39) and 5.1% (2/39), which were significantly higher than 0.0% (0/37) and 2.7% (1/37) in the 2.2 mm incision group, and the differences were statistically significant ( χ2=5.078, P=0.024; χ2=0.295, P=0.590).At 1 day after surgery, corneal thickness at the endothelial side in the 1.8 mm incision group was significantly thicker than that in the 2.2 mm incision group, and the difference was statistically significant ( P=0.042), and the corneal thickness at endothelial side of the incision was positively correlated with CDE in the two groups ( r=0.231, P=0.025; r=0.347, P=0.003). Conclusions:Compared with 2.2 mm incision, 1.8 mm corneal incision results in higher incidence of endothelial gaping and dislocation at the corneal incision, greater corneal thickness at endothelial side of the incision and slower recovery.

[Curative effect comparison for fixation of fibula or not for the treatment of middle and lower 1/3 fractures of tibia and fibula with intramedullary nail].

OBJECTIVE: To analyze and compare the effect of fibular plate fixation on the treatment of tibial and fibular fractures. METHODS: From July 2016 to September 2018, 65 cases of middle and lower 1/3 fractures of tibia and fibula were retrospectively analyzed, including 46 males and 19 females, aged 22 to 61 years old. There were 37 cases in fibular fixation group (27 males and 10 females) , 28 cases in fibular non fixation group (19 males and 9 females) . By comparing the operation time, intraoperative bleeding, fracture healing time, ankle rotation and valgus angle, postoperative complications, last follow-up ankle mobility and Baird Jackson score, the operation effect was evaluated. RESULTS: All patients were followed up for 12 to 16 months with an average of (13.67±1.23) months. There were 3 cases of infection of the fibular incision, all of which healed in the first stage without incision dehiscence, and 4 cases of delayed union without nonunion. In the fibula fixation group, the external rotation of ankle joint increased (7.16±1.36) ° and the valgus angle increased (3.35±1.16) °; while in the non fixation group, the external rotation increased (10.25±1.58) ° and the valgus angle increased (6.46±1.23) ° with statistical significance (P<0.05) . There was no significant difference in ankle joint activity, fracture healing time and complication rate between two groups (P>0.05) ; there was significant difference in operation time, intraoperative hemorrhage and Baird Jackson score at the latest follow-up (P<0.05) . CONCLUSION: The fibular plate fixation can prevent the ankle joint from malrotation and valgus deformity, and can obtain better surgical effect and functional prognosis.

Innovation and integration of visual case and PAD class in medical English teaching / 中华医学教育探索杂志

Visual case teaching, based on mini-lesson video, can restore the real context of language use, providing sufficient materials without time and location restriction for language teaching. PAD Class is to allocate traditional teaching steps, which are divided into three parts (presentation-assimilation-discussion) in class. The teacher's presentation and students' discussion are separated to cultivate students' ability to think. The combination of visual case and PAD class can achieve the purpose of advantage complementation: improving comprehensive English skills, acquiring professional knowledge, developing critical thinking and enhancing teaching result of ESP.

New insight into BIRC3: A novel prognostic indicator and a potential therapeutic target for liver cancer.

BACKGROUND: Prognosis of hepatocellular carcinoma (HCC) remains poor due to high recurrence rate and ineffective treatment options, highlighting the need to better understand the mechanism of recurrence and metastasis in HCC. METHODS: We first collected messenger RNA (mRNA) expression data from 442 cases of HCC patients from The Cancer Genome Atlas (TCGA) database as well as 251 HCC patients from Zhongshan Hospital during 2009 and 2010 to analyze the expression pattern from tissue microarray (TMA) of baculoviral IAP repeat containing 3 (BIRC3). Then, we used BIRC3 gain-of-function (overexpression) and loss-of-function (knockdown) studies to examine the effect of BIRC3 on HCC cell proliferation and invasion. In addition, we also investigated the undying mechanism by which BIRC3 contributes to HCC tumor progression. Functionally, we also used a BIRC3-specific inhibitor AT-406 in HCC xenograft model to explore the potential therapeutic benefit of targeting BIRC3 in liver cancer. RESULTS: BIRC3 serves as a novel prognostic indicator for HCC patients undergoing curative resection. BIRC3 promotes HCC epithelial-mesenchymal transition (EMT), cell migration, and metastasis via upregulating MAP3K7, therefore, inducing ERK1/2 phosphorylation. The specific BIRC3 inhibitor AT-406 can inhibit HCC cell proliferation and reduce pulmonary metastases. CONCLUSION: BIRC3 induces tumor proliferation and metastasis in vitro and in vivo. BIRC3 may serve as a novel therapeutic target for liver cancer.

Changes of chemokine receptors expression in the conjunctival epithelial cells and Th-17 cell number in tears of diabetic dry eye disease / 中华实验眼科杂志

Objective To explore the expression of chemokine receptor 6 (CCR6) and T helper cell 17 (Th-17) in the epithelial cells and tears in diabetic patients with dry eye disease.Methods Prespective study was performed.Ninety-one type 2 diabetic patients with dry eye disease and 102 normal subjects were involved from January to July in 2017 in Affiliated Hospital of Yanbian University.Ocular Surface Disease Index (OSDI)questionnaire survey score,Break-up time of tear film (BUT),Schirmer Ⅰ test (S Ⅰ t) and fluorescein corneal stainning (FLS) were performed on both groups.The conjunctival epithelial cells of both groups were obtained by impression cytology.The expression of the chemokine receptors (CCR) 4,CCR5 and CCR6 in conjunctival epithelial cells and the number of Th-17 cells in tears were detected by flow cytometry.This study was approved by the ethics committee of Affiliated Hospital of Yanbian University (2014053),and all the patients signed informed consent.Results The OSDI questionnaire scores,BUT,S Ⅰ t and FLS were significantly different between diabetic dry eye group and normal control group (all at P＜0.05).The ratio of CCR4+ CD4+ T cells,CCR5+ CD4+ T cells and CCR6+CD4 +Tcells was (1.1±0.9)％,(2.1±1.7)％ and (5.2±2.4)％ in the normal control group,(1.2±0.8)％,(9.5±5.3)％ and (19.2±5.7)％ in the diabetic dry eye group,respectively.The ratios of CCR5+CD4+ T cells and CCR6+CD4+ T cells in the diabetic dry eye group were significantly higher than those in the normal control group (both at P＜0.05).The proportion of Th-17 cell in tears of diabetic dry eye group was significantly higher than that in the normal control group (P＜0.001).Conclusions CCR5,CCR6 and Th-17 cells may play a key role in the pathogenesis of diabetic patients with dry eye.

Correlation of transcription factor Sp1 expression with clinical and pathological characteristics and prognosis of hepatocellular carcinoma / 中国肿瘤临床

Objective: To explore the clinical significance of transcription factor Sp1 expression in hepatocellular carcinoma (HCC) and association between Sp1 expression and survival in HCC patients. Methods:With the use of immunoreactivity, Sp1 expres-sion and its correlation with other clinicopathological characteristics were examined in a tissue microarray that contains samples from 98 HCC patients. Results:HCC tissues expressed markedly higher levels of Sp1 than did adjacent normal liver tissues. Sp1 expression was closely associated with microvascular invasion, which suggests that HCC with more microvascular invasion is prone to have in-creased Sp1 expression. Overexpression of Sp1 correlates with significantly shorter overall survival and higher recurrence rates in HCC patients after curative resection. Conclusion:Transcription factor Sp1 may be an independent prognostic factor for both overall surviv-al and cumulative recurrence rate.

Theoretical and clinical application of insomnia caused by "stomach disorder could lead to excess of yang-qiao meridian" / 中国针灸

To explore the mechanism of insomnia caused by "stomach disorder could lead to excess of yang-qiao meridian" and clinical application of treating insomnia with acupoints in qiao meridian as the main points. From meridian theory, intersection between stomach meridian of Foot-Yangming and yang-qiao meridian is through Chengqi (ST 1). Qiao meridian for sleep is mainly because it is connected with eyes through the Bladder Meridian of Foot-Taiyang. For Stomach Meridian of Foot-Yangming is intersected with the Bladder Meridian of Foot-Taiyang in Jingming (BL 1), and intersected with yin and yang qiao meridian beside the mouth and under the eye, once functional disorder of the stomach, it can affect qi movements of the whole body and give rise to various pathological changes that cause insomnia. Meanwhile examples are given to explain the clinical application of treating subborn insomnia with corresponding acupoint of stomach and yang-qiao meridian.

[Activation of nuclear factor kappaB signaling pathway in human osteoblasts responses to Staphylococcus aureus in vitro].

OBJECTIVE: To investigate whether S. aureus could activate NF-κB signaling pathway in human osteoblasts. METHODS: Immunoblot and electrophoretic mobility shift assay were used to detect the degradation of I-κBα and activation of NF-κB in human osteoblasts following infection with S.aureus, respectively, and there were investigated the activated state of NF-κB signaling pathway in human osteoblasts. In addition, enzyme-linked immunosorbent assay was used to measure the secretion of IL-6 in culture supernatants, which was represented as one of important cytokines in osteomyelitis, and an inhibitor of NF-κB, SN50, which was added to human osteoblasts culture prior to 1 hour at 50 µmol/L before the infection of S.aureus, was used to determine whether S.aureus-activated NF-κB signaling pathway regulates IL-6 secretion of human osteoblasts. RESULTS: S.aureus could induce the degradation of I-κBα (I-κBα(15 min)/I-κBα(0 min) = 0.409 ± 0.245 and I-κBα(30 min)/I-κBα(0 min) = 0.061 ± 0.010) and activation of NF-κB in human osteoblasts in a time and dose-dependent manner following infection. In addition, the secretion of IL-6 in the supernatants of human osteoblasts ((2.17 ± 0.11) µg/L) was suppressed by 50 µmol/L SN50 compared to without the addition of SN50 ((3.58 ± 0.31) µg/L) (F = 174.25, P < 0.05). CONCLUSIONS: S.aureus could activate NF-κB signaling pathway in human osteoblasts, which could regulate cytokines secretions of human osteoblasts.

Treatment of super obesity by laparoscopic Roux-en-Y gastric bypass: experience of 42 cases / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the feasibility and efficacy of laparoscopic Roux-en-Y gastric bypass(LRYGB) for super obesity(BMI≥50 kg/m(2)).</p><p><b>METHOD</b>Clinical data of 42 patients undergoing LRYGB in the First Affiliated Hospital of Jinan University between 2004 and 2008 were analyzed retrospectively.</p><p><b>RESULTS</b>All the LRYGB procedures were successfully performed with no conversion to open surgery. Average operation time was 145.1 minutes, volume of blood loss during the surgery was 25.0 ml, and length of postoperative hospital stay was 9.9 days. The cases were followed up for 1 month to 30 months. Body weight and BMI decreased significantly 1 month after the operation and reached a minimum level after 2 years then became stable while excess body weight loss rate(EWL) increased(P<0.05). All the obese-related symptoms were relieved significantly. Four cases(9.5%) showed complications during perioperative period including 1 case of respiratory failure, 2 cases of gastrojejunal anastomotic bleeding, 1 case of umbilical wound infection, and 11 developed long-term complications. All of them were cured by conservative treatment.</p><p><b>CONCLUSIONS</b>Treatment of super obesity by LRYGB is feasible with significant short-term results. But due to the difficulty of the operation and postoperative complications, comprehensive treatment from experienced bariatric surgical team is needed. The long-term outcome needs for further observation.</p>

The effect of Staphylococcus aureus on apoptosis of cultured human osteoblasts.

OBJECTIVE: To investigate the effect of Staphylococcus aureus (S. aureus) on cultured human osteoblast apoptosis and the corresponding mode of action. METHODS: Transmission electron microscopy (TEM), assessment of DNA laddering, and flow cytometry assays were used to investigate human osteoblast apoptosis following infection with S. aureus. RESULTS: TEM examination and DNA laddering assessment indicated that S. aureus can induce cultured human osteoblast apoptosis. Flow cytometry assays showed that human osteoblast apoptosis occurs in a dose-dependent manner following infection with S. aureus. In addition, compared with under co-culture conditions, inhibition of invasion by S. aureus resulted in a 64.62% reduction in the percentage of early apoptotic cells (P < 0.01); 7.09% ± 1.21% of human osteoblasts under indirect co-culture with S. aureus at a multiplicity of infection of 250 showed an early apoptotic profile compared with uninfected controls(P < 0.01). CONCLUSIONS: S. aureus induces cultured human osteoblast apoptosis in a dose-dependent manner. Intracellular S. aureus is mainly responsible for cultured human osteoblast apoptosis following infection; secreted soluble factor(s) of S. aureus playing a minor role in this process.

High expression of thrombin receptor PAR1 in peritumoral liver tissue is associated with poor survival after curative resection of hepatocellular carcinoma in early stage / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To evaluate the relationship between PAR1 (Protease-Activated Receptor 1) expression and the clinicopathologic features and to investigate the prognostic value of PAR1 expression in hepatocellular carcinoma (HCC) in early stage after curative resection.</p><p><b>METHODS</b>Real-time PCR was used to detect PAR1 expression in 41 pairs of tumors and matched peritumoral samples of HCC in early stage. Prognostic value of PAR1 mRNA expression was evaluated. Meanwhile, another 49 tissue paraffin slices of HCC were tested using immunohistochemistry (Envision) and the prognostic value of PAR1 expression and other clinicopathologic factors were evaluated.</p><p><b>RESULTS</b>Peritumoral PAR1 mRNA expression was significantly increased in HCCs from the patients with tumor recurrence as compared with those without recurrence (P < 0.05). Peritumoral PAR1 protein expression was related to tumor differentiation (P < 0.05). Kaplan-Meier analysis showed that Peritumoral PAR1 protein expression was associated with the overall survival (OS) (P < 0.05) of HCC patients and the time to recurrence (TTR) (P < 0.05). The 1, 3 and 5 -year overall survival time and the cumulative recurrence time in the high PAR1 protein expression group were significantly lower as compared to the low PAR1 expression group in the peritumoral liver tissue.</p><p><b>CONCLUSIONS</b>Peritumoral PAR1 expression is closely associated with the prognosis of early stage HCC patients after curable surgery. PAR1 may be involved in thrombin-mediated invasion process and may be used as a prognostic marker for HCC.</p>

Techniques of anatomical liver resection for hepatocellular carcinoma:a report of 125 cases / 中华消化外科杂志

Objective To summarize the techniques of anatomical liver resection for the treatment of hepatocellular carcinoma(HCC).Methods The clinical data of 125 patients with solitary HCC who underwent anatomical liver resection at the Zhongshan Hospital from January 2005 to December 2006 were retrospectively analysed.The inflow and outflow of hepatic segments to be resected were selectively clamped,then the main branches of portal vein and hepatic artery were ligated,and the ischemic hepatic segments were resected en bloc.Kelly forceps were used to crash and clamp the liver cut surface.The stumps of left and right hepatic ducts were continuously sutured with Prolene sutures.For tumors with the size above 10 cm in diameter,hepatectomy with anterior approach and liver hanging maneuver were adopted.Bile leakage was checked by injecting methylene blue or covering a gauze on the liver cut surface.Results The mean blood loss of all patients was 250 ml(100-6000 ml),and 32 of them needed blood transfusion.The morbidity was 23%(29/125).No patient died within 30 days after the operation,and 6%(5/83)of patients were found with residual tumor by postoperative arteriography.Conclusion Anatomical liver resection may improve the safety of operation,prevent the injury of great vessels and thus improve the efficacy.

Electrophysiological changes of bone marrow mesenchymal stem cells following the differentiation into neuron-like cells / 中国组织工程研究

BACKGROUND:Previous in vitro studies mainly focused on morphological and nerve marker aspects in the study of bone marrow mesenchymal stem cells (BMSCs)-derived neuron-like cells,but less focused on the olectrophysiological properties of neuron-like cells following differentiation.OBJECTIVE:To study the electrophysiological changes of differentiation from BMSCs into neuron-like cells after induction by brain-derived neurotrophic factor (BDNF)/basic fibroblast growth factor (bFGF)/alltrans-retinolc acid (AT-RA).DESIGN,TIME AND SETTING:The cytological comparative in vitro study was performed at the Department of Neural Cell Laboratory,Tianjin Huanhu Hospital and College of life Science of Nankai University from June 2005 to October 2007.MATERIALS:Totally 3 male Wistar rats (6-week old,weighing about 160 g) were used in this study.METHODS:BMSCs were cultured and purified by their characteristic of plastic adhesion in vitro,and then induced by BDNF,bFGF and AT-RA,and differentiate into neuron-like cells.Whole-cell patch damp technique was used to detect cell membrane current prior to and 3 days following induction.MAIN OUTCOME MEASURES:MSC phenotype was determined by flow cytometry.Cell morphology was observed under the inverted microscope before and after differentiation.Neuron specific enolase expression was assessed by immunocytochemistry.Whole-cell current results were measured.RESULTS:Flow cytometry results demonstrated that CD90 positive rate (99±3)%,CD31 (3.4±0.8)%,and CD34 (0.3±0.1)%.This indicated that these cells were undifferentiated stem cells,with purity of 95%.Undifferentiated MSCs under the optical microscope were mostly fiat cells with processes,similar to fibroblast-like cells.Neuron-like cells appeared 3 days following induction.Immunocytochemistry results showed that MSCs before induction were weakly positive for neuron specific enolase,but strongly positive for neuron specific enolase.At 72 hours,the differentiated rate was (24.01±3.76)%.The peak currents of outward currents in neuron-like cells were significantly higher in the induction group compared with the control group (P ＜ 0.05),but no inward Na~+ current was detected.CONCLUSION:(bFGF & BDNF)/AT-RA could induce the differentiation of MSCs into neuron-like cells.These cells showed the tendency to differentiate into mature neurons,though having no electrophysiological properties of mature neurons.