[Efficacy analysis of fully endoscopic microvascular decompression in primary trigeminal neuralgia via keyhole approach].

Objective: To explore the efficacy and technical features of fully endoscopic microvascular decompression(MVD) in primary trigeminal neuralgia(PTN) via keyhole approach. Methods: The clinical data of 97 patients with PTN underwent fully endoscopic MVD via keyhole approach in the Department of Neurosurgery, Beijing Shijitan Hospital, Capital Medical University from December 2014 to February 2019 was collected. During fully endoscopic MVD in PTN via keyhole approach, performer use natural clearance without grinding except developed rock bone crest or excessive retraction of the brain tissue, visually and panoramically observe and evaluate the CPA area, accurately identify the responsible vessels, to avoid the omission of responsible vessels or insufficient decompression. And the use of preplaced technology, bridging technology and submersible technology, ensure the efficacy of surgery and reduce the surgical side injuries.Barrow Neurological Institute (BNI) pain score was used to evaluate the efficacy and identify the recurrence. The surgical efficacy was analyzed. Results: The offending vessels were identified under endoscope in 96 cases. Among them, arterial compression was found in 77 cases, venous compression in 6 cases, and both arterial and venous compression in 13 cases. About the pain outcomes, 87 cases had immediate and complete relief of pain, 5 cases had almost relief of pain, 4 cases had partial relief of pain, and still needed medication control, but the dose was lower than that before operation, and 1 case had no obvious relief of pain. About complications, there were 4 cases of temporary facial numbness, 1 case of temporary hearing loss, both of them recovered after symptomatic treatment. There was no cerebral infarction or hemorrhage, intracranial or incision infection. All cases were followed up for 3.0-38.0 months with a median period of(22.4±2.2) months. During the follow-up periods, postoperative recurrence occurred in 3 cases. Conclusion: Fully endoscopic MVD for PTN through keyhole approach, provides panoramic view to avoid omission of offending vessels and reduce complications, seemed to be a safe and effective surgical method.

[Value of dynamic MRI in monitoring the microenvironmental changes of anti-vascular therapy in a xenograft model].

Objective: To explore the feasibility of dynamic-enhanced magnetic resonance imaging (DCE-MRI) and blood oxygen level-dependent MRI (BOLD-MRI) in assessing the hemodynamics and tumor aggressiveness during treatment. Methods: The colon cancer xenograft model was established in BALB/C nude mice with HCT116 cell line. Sixteen nude mice were randomly divided into treatment and control groups (aged 6 to 8 weeks, weighted 15 to 18 g, Certificate No. 11400700325797), which were treated with bevacizumab and saline by intraperitoneal injection on the 1st, 4th, 7th, 10th and 13th day. DCE-MRI and BOLD-MRI were performed before and on the 3th, 6th, 9th, 12th, and 15th day after treatment. The vascular maturity and microenvironment hypoxia were confirmed by pathology. Results: The tumor volume of treatment group was significantly smaller than that of control group after 15 days ((712±43) vs (1 051±112) mm(3),P<0.01).The measurements of K(trans) were (0.135±0.005),(0.147±0.006),(0.175±0.009),(0.161±0.006), (0.140±0.005),(0.116±0.008)/min (F=81.386, P<0.01); K(ep) were (0.788±0.030),(0.804±0.036),(0.983±0.059), (1.105±0.091),(0.840±0.047),(0.786±0.041)/min(F=45.901,P<0.01);Ve were (0.652±0.006), (0.559±0.026), (0.466±0.016), (0.286±0.027), (0.363±0.020), (0.246±0.033) (F=384.290, P<0.01) and R2* values were (24.813±0.961), (24.675±1.070), (21.425±1.371), (17.850±0.885), (24.613±0.640), (27.013±0.734)/s (F=89.323, P<0.01) showed different trends with time in the treatment group, and the differences were statistically significant. The K(trans) values and tumor vessel maturity index (VMI) were higher than baseline values during 3-12 d after treatment. CD31 positive staining rate and VMI had the strongest correlations with K(trans) values (r=0.854 and 0.795), followed by AUC(180) (r=0.750 and 0.808), Ve (r=0.744 and 0.712) and K(ep) values (r=0.729 and 0.758), all P<0.05. R2* value positively correlated with the positive staining rate of HIF-1α and fibronectin (r=0.810 and 0.816), all P<0.05. Conclusion: DCE-MRI and BOLD-MRI are adequate to observe the tumor perfusion and hypoxia during anti-vascular treatment, and the R2* value can predict the tumor metastatic potential during the process of vascular normalization.

[Application of complete endoscopic technique in microvascular decompression related tovertebrobasilar artery compression].

Objective: To study the operative method, special technique and curative effect of complete neuroendoscopic microvascular decompression(MVD) related to vertebrobasilar artery compression. Methods: Thirteen patients with functional cranial nerve disease caused by vertebrobasilar artery as direct or indirect responsible vessel accepted complete endoscopic MVD, including 11 patients with hemifacial spasm and 2 patients with trigeminal neuralgia. The procedure and curative effect of endoscopic surgery were analyzed retrospectively. Results: All procedures of complete neuroendoscopic MVD were successfully completed.Intraoperative observation by endoscope showed that 6 cases were oppressed directly by vertebral artery, 2 cases were oppressed directly by basilar artery, 5 cases were combined oppressed by displaced basilar artery and other vessels (1 case was superior cerebellar artery and 4 cases were anterior inferior cerebellar artery). During the operation, Teflon sheets was placed directly into the compression point in 2 cases, the "Pre-placed" technique was used to place Teflon sheets in 7 cases, and the "Set up bridge" technique was used to place Teflon sheets in 4 cases. Follow-up for 8-38 months,the symptoms disappeared completely in 12 cases and improved in 1 case. No deaths and severe complications occurred, such as postoperative bleeding, cerebellar infarction and intracranial infection. Conclusion: MVD related to vertebrobasilar artery compression can be performed by complete neuroendoscopic technique, which can achieve sufficient decompression effect and curative effect.Flexible use of the special technology of placing Teflon sheets by single-hand under endoscope, such as the "Pre-placed" and "Set up bridge" technique, is an important technical guarantee for the successful completion of endoscopic MVD.

Effect of propofol on myocardial ischemia/reperfusion injury in rats through JAK/STAT signaling pathway.

OBJECTIVE: The aim of this study was to investigate the influences of propofol on myocardial ischemia/reperfusion injury in rats through the Janus kinase/signal transducers and the activators of transcription (JAK/STAT) signaling pathway. MATERIALS AND METHODS: A total of 48 Sprague-Dawley (SD) rats were randomly divided into four groups, including: the sham-operation group (n=12), the model group (n=12), the propofol group (n=12) and the inhibitor group (n=12). The rats in the sham-operation group only received thoracotomy, without the modeling of the ischemia/reperfusion injury. The model of myocardial ischemia/reperfusion injury was established in the rats of the model group, and the rats were given normal saline for intervention. The rats in the propofol group were utilized to prepare the model of myocardial ischemia/reperfusion injury and were intervened with propofol. Meanwhile, the rats in the inhibitor group received intervention with AG490 after the establishment of myocardial ischemia/reperfusion injury model. Immunohistochemistry was applied to detect the expressions of B-cell lymphoma-2 (Bcl-2) and Bcl-2-associated X protein (Bax). Western blotting was utilized to measure the relative protein expressions of phosphorylated JAK2 (p-JAK2) and p-STAT3. The messenger ribonucleic acid (mRNA) expressions of Bax and Bcl-2 were determined via quantitative Polymerase Chain Reaction (qPCR). Furthermore, cell apoptosis was examined using terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay. RESULTS: Immunohistochemistry results showed that compared with the sham-operation group, the positive expression of Bax remarkably increased (p<0.05), while Bcl-2 notably decreased (p<0.05) in the model group, propofol group, and inhibitor group. The propofol group and inhibitor group showed a significant lower positive expression of Bax (p<0.05) and evident higher positive expression of Bcl-2 (p<0.05) when compared with the model group. However, there were no significant differences in the positive expressions of Bax and Bcl-2 between the propofol group and inhibitor group (p>0.05). According to the results of Western blotting, the relative protein expression levels of p-JAK2 and p-STAT3 proteins were remarkably elevated in the model group, propofol group and inhibitor group in comparison with those in the sham-operation group (p<0.05). Propofol group and inhibitor group exhibited remarkably lower protein expression levels of p-JAK2 and p-STAT3 compared with the model group (p<0.05). However, no significant differences were observed in the protein expressions of p-JAK2 and p-STAT3 between propofol group and inhibitor group (p>0.05). The results of qPCR manifested that the mRNA expression of Bax was notably higher (p<0.05), whereas Bcl-2 was significantly lower (p<0.05) in the model group, propofol group and inhibitor group than those of the sham-operation group. Compared with the model group, the mRNA expression of Bax was evidently declined (p<0.05), while Bcl-2 was significantly elevated (p<0.05) in the propofol group and inhibitor group. Meanwhile, there were no evident differences in the mRNA expressions of Bax and Bcl-2 between the propofol group and inhibitor group (p>0.05). Subsequent TUNEL assay indicated that the model group, propofol group, and inhibitor group showed remarkably higher apoptosis rate than the sham-operation group (p<0.05). Moreover, the apoptosis rate was remarkably reduced in the propofol group and inhibitor group in comparison with the model group (p<0.05). However, no significant difference was observed in the apoptosis rate between propofol group and inhibitor group (p>0.05). CONCLUSIONS: Propofol inhibits myocardial cell apoptosis after myocardial ischemia/reperfusion injury by repressing the JAK/STAT signaling pathway.

Knockdown of MiR-140-5 promotes osteogenesis of adipose-derived mesenchymal stem cells by targeting TLR4 and BMP2 and promoting fracture healing in the atrophic nonunion rat model.

OBJECTIVE: This study aims to assess the effect and mechanism of genetically modified adipose-derived mesenchymal stem cells (ASCs) with recombinant lentiviruses mediated knockdown of miR-140-5p in ASCs' osteogenesis in vitro and atrophic nonunion rat model. MATERIALS AND METHODS: This study included 36 male adult Sprague-Dawley (SD) rats weighing 400 g to 450 g from the experimental animal facility of our university. Approval was obtained from the University Animal Care Committee before the study. Rats' ASCs were prepared and genetically modified with lentivirus (Lv)-empty (NC) or Lv-miR-140-5p-TuD (inhibitors). After that, the expressions of RUNX2 and osteocalcin (OCN) were detected in the ASCs. To confirm the mechanisms of miR-140-5p in ASCs, we predicted the target genes by bioinformatics analysis and then the target genes were verified by luciferase reporting assay. The artificial atrophic nonunion was created in the rat's femoral bone. Animals were randomly divided into three groups according to the material implanted into bone defects space: AT scaffolds (AT group, n=12), AT scaffold with Lv-NC modified (AT+ASCs+Lv-NC group, n=12), AT scaffold with the Lv-miR-140-5p-TuD modified ASCs (AT+ASCs+Lv-miR-140-5p-TuD group, n=12). After four weeks, the rats were euthanized for the following radiographic examination, histologic study and biomechanical testing. RESULTS: MiR-140-5p was down-regulated during osteogenic differentiation of ASCs, and inhibition of MiR-140-5p promoted osteogenesis of ASCs in vitro. Inhibition of MiR-140-5p promoted osteogenesis of ASCs and enhanced fracture in the atrophic nonunion rat model: AT+ASCs+Lv-NC group, AT+ASCs+Lv-miR-140-5p-TuD group resulted in a better bone formation and higher BMD and BMC than AT group, while excellent bone formation and the highest BMD and BMC were observed in AT+ASCs+Lv-miR-140-5p-TuD group. Both AT+ASCs+Lv-NC group and AT+ASCs+Lv-miR-140-5p-TuD group presented more mature characteristics in the micro-architecture than AT group, whereas AT+ASCs+Lv-miR-140-5p-TuD group presented the highest BV/TV, Tb.Th and Tb.N as well as the lowest Tb.Sp. The peak load of the operated femur increased by 94.43% AT+ASCs+Lv-miR-140-5p-TuD group, 50.68% in AT+ASCs+Lv-NC group compared to the control AT group, respectively. The result of luciferase reporting assay showed that miR-140-5p could directly target TLR4 and BMP2. CONCLUSIONS: This study demonstrates that lentiviruses-mediated knockdown of miR-140-5p can significantly promote osteogenesis of ACSs by directly regulating its' target genes, TLR4 and BMP2, and that combined adipose scaffold with genetically modified ASCs can significantly enhance fracture-healing and bone formation in the atrophic nonunion rat model.

[Efficacy analysis of soft neuroendoscopic techniques in the treatment of chronic subdural hematoma].

Objective: To investigate the efficacy of soft neuroendoscopic techniques in the treatment of chronic subdural hematoma (CSDH). Methods: A retrospective analysis of 201 cases of CSDH diagnosed and treated at Beijing Shijitan Hospital (CMU) from January 2006 to December 2017 was conducted. From January 2006 to December 2010, 126 cases of CSDH were treated with skull drilling and drainage (non-endoscopic group). From January 2011 to December 2017, 75 cases of CSDH were treated with soft neuroendoscopy (endoscopic group). The operation time of the non-endoscopic and endoscopic groups, the hematoma clearance rate on the first day after surgery, the time of the drainage tube, the length of hospital stay, the incidence of complications, mortality and recurrence rate were compared. Results: There were no deaths in both groups. The average operation time of the non-endoscopic group was 43 min, compared with the average operation time of the endoscopy group of 50 min, there was no significant difference (P>0.05). The average hematoma clearance rate on the first day after surgery in the endoscopy group (98.2%) was significantly higher than that in non-endoscopic group (87.3%) (P<0.01). The average time of drainage tube in the endoscopy group (23 h) was significantly shorter than that in the non-endoscopic group (50 h) (P<0.01). On the first postoperative day, the proportion of patients with mRS≤3 in the endoscopic group was significantly higher than that in the non-endoscopic group (P<0.01). At the time of discharge, the proportion of patients with mRS≤3 in the endoscopy group was also significantly higher than that in the non-endoscopic group, P<0.05. There was no significant difference in the average hospital stay between endoscopy group (7 d) and non-endoscopic group (8 d) (P>0.05). The postoperative complication rate in the endoscopy group was significantly lower than that in the non-endoscopic group (P<0.01). During 0.5-8 years of follow-up, the recurrence rate of CSDH in the endoscopic group (5.33%) was significantly lower than that in the non-endoscopic group (15.07%) (P<0.01). Conclusion: The application of visualization features of soft neuroendoscopy in the treatment of CSDH can significantly improve hematoma clearance, shorten the time of drainage tube, reduce postoperative complications and recurrence rate, and improve surgical outcomes.

Down-regulation of LncRNA NR027113 inhibits cell proliferation and metastasis via PTEN/PI3K/AKT signaling pathway in hepatocellular carcinoma.

OBJECTIVE: Hepatocellular Carcinoma (HCC) is a worldwide common and malignant tumor. It is discovered in recent years that long non-coding RNAs (lncRNAs) participate in many biological processes of HCC. However, their specific role in HCC has not been entirely clarified yet. In this research, we aimed to explore biological functions, clinical significance and the underlying molecular mechanisms of lncRNA NR027113 in HCC. PATIENTS AND METHODS: qRT-PCR was performed to test the expression of NR027113 in HCC tissue samples and HCC cell lines. The association of NR027113 expression with overall survival, disease-free survival and clinicopathological factors was analyzed. MTT assays, Colony formation assay, flow cytometry and transwell invasion assays were performed to determine the effect of NR027113 in the regulation of biological behaviors of HCC cells. Western blot was performed to determine the activation of the PTEN/PI3K/AKT signaling pathway. RESULTS: In the present study, we proved that is significantly up-regulated in HCC tissues and cell lines. HCC patients with higher NR027113 expression were associated with significantly shorter overall survival and disease-free survival. NR027113 knockdown inhibited the proliferation and metastasis of HCC cells in vitro. In addition, NR027113 knock-down was found to inhibit the activity of the PI3K/Akt signaling pathway and restrain the EMT process. Furthermore, we found that PTEN silencing could reverse the inhibitory effect of NR027113 knockdown on Akt phosphorylation and HCC cells function. CONCLUSIONS: A brand new lncRNA NR027113 was found, which can promote the proliferation, invasion and metastasis of HCC via the PTEN/PI3K/AKT signaling pathway, and may be a potential therapeutic target in the future treatment of HCC.

GACAT3 promoted proliferation of osteoarthritis synoviocytes by IL-6/STAT3 signaling pathway.

OBJECTIVE: Osteoarthritis (OA) is one of the most common chronic joint diseases, caused by lesions in articular cartilage and synovial membranes. Synovitis is a major characteristic of OA, due to the proliferation of synoviocytes. Long noncoding RNAs (lncRNAs) have implicated to play an important role in many different diseases. The aim of this study was to verify the role of lncRNA gastric cancer-associated transcript 3 (GACAT3) in osteoarthritis. MATERIALS AND METHODS: We utilized the qRT-PCR to detect the expression of lncRNA GACAT3 in osteoarthritis synoviocytes (OAS) and normal synoviocytes (NS). The cell proliferation in NS and OAS after transfection with lncRNA-NC or lncRNA-GACAT3 was detected. The cell cycle and apoptosis rate in NS and OAS were measured by the Flow cytometry analysis. Western blot was used to analyze the possible related mechanism that GACAT3 regulated the cells proliferation in osteoarthritis. RESULTS: We found that GACAT3 expression was significantly increased in OAS compared with NS. GACAT3 expression was decreased in OAS after transfection with siRNA and the cell proliferation in OAS after transfection with siRNA was significantly inhibited. The cell cycle was arrested in G0/G1 phase and the apoptosis rate was increased in OAS after transfection with siRNA. Moreover, GACAT3 could impact the proliferation of OAS by interleukin-6/signal transducer and activator of transcription-3 (IL-6/STAT3) signaling pathway. CONCLUSIONS: In this study, we found that lncRNA GACAT3 was closely related to the osteoarthritis. GACAT3 may be involved in the development and progression of osteoarthritis and become a potential target for treating.

Clinical effects and safety evaluation of dexmedetomidine hydrochloride combined with etomidate fat emulsion in patients undergoing interventional treatment of stroke during anesthesia.

OBJECTIVE: Stroke patients are often elderly and afflicted with comorbidities that can make them more susceptible to surgical complications during anesthesia, such as respiratory depression. This study examined the clinical effects of dexmedetomidine hydrochloride combined with etomidate fat emulsion in patients undergoing interventional treatment of stroke during anesthesia. PATIENTS AND METHODS: 90 patients with stroke admitted at the Second Hospital of Dalian Medical University between February 2015 and March 2016 were selected for interventional treatment in the study. The patients were randomly divided into three different treatment groups, with 30 patients in each group. Group A patients were treated with dexmedetomidine hydrochloride, group B patients were treated with etomidate fat emulsion, and group C patients were treated with dexmedetomidine hydrochloride combined with etomidate fat emulsion. Mean arterial blood pressure (MAP), heart rate (HR), wake-up time, and extubation time were compared and analyzed for the patients of each group at different time points. RESULTS: MAP and HR of patients in group C were notably decreased after anesthesia, and were significantly lower than patients in groups A and B (p<0.05). MAP and HR of the patients in groups A and B did not significantly change over the different time points. The three groups also did not show dramatic changes when patients were extubated after 3 min (p>0.05). Further data on wake-up time, extubation, and spontaneous breathing recovery time among the patients did not show any significant differences in the three groups (p>0.05). However, the prevalence of complications in group C was lower than in groups A and B (p<0.05). CONCLUSIONS: Dexmedetomidine hydrochloride combined with etomidate fat emulsion in patients undergoing interventional treatment of stroke during anesthesia has potential value in clinical applications, through the maintenance of ideal hemodynamics and a reduction in complications.

[Value of bedside echocardiography in diagnosis and risk assessment of in-hospital death for patients with Stanford type A aortic dissection].

Objective: To investigate the value of bedside echocardiography in diagnosis and risk assessment of in-hospital death of patients with Stanford type A aortic dissection. Methods: The clinical data of 229 patients with Stanford type A aortic dissection diagnosed by CT angiography in Zhongshan Hospital affiliated to Fudan University between January 2009 and January 2016 were retrospectively analyzed. The patients were divided into survival group(191 cases)and non-survival group(38 cases)according to presence or absence of in-hospital death. The bedside echocardiography features were analyzed, and influence factors of in-hospital death were determined by multivariate logistic regression analysis. Results: (1) Compared with the survival group, the non-survival group had lower surgery rate (60.52%(23/38) vs. 85.34%(163/191), P<0.01). Age, gender and Debakey classification were similar between survival group and death group (all P>0.05). (2) The bedside echocardiography results showed that prevalence of aortic valve involvement(65.79%(25/38) vs.34.03%(65/191), P<0.01) and severe aortic regurgitation (44.74%(17/38) vs. 14.14%(27/191), P<0.01) were significantly higher in non-survival group than in survival group. The non-survival group had larger aortic root diameter than the survival group ((55.5±6.4)mm vs. (42.3±7.8)mm, P<0.01). There were no significant differences in pericardial effusion, expansion of aortic sinus, and left ventricular ejection fraction between survival group and non-survival group (all P>0.05). (3) The multivariate logistic regression analysis showed that aortic valve involvement(OR=3.275, 95%CI 1.290-8.313, P<0.05), aortic root diameter(OR=1.202, 95%CI 1.134-1.275, P<0.01), and surgery (OR=0.224, 95%CI 0.079-0.629, P<0.01) were independent risk factors for in-hospital death in patients with Stanford type A aortic dissection. Conclusions: Bedside echocardiography has significant diagnostic value for Stanford type A aortic dissection. Aortic valve involvement, enlargement of aortic root diameter and without surgery are independent risk factors for patients with Stanford type A aortic dissection.

Controlled defect creation and removal in graphene and MoS2 monolayers.

It is known that defects strongly influence the properties of two-dimensional (2D) materials. The controlled creation and removal of defects can be utilized to tailor the optical and electronic responses of these 2D materials for optoelectronic and nanoelectronic applications. In this study, we developed an efficient approach to reversibly control the defect states in mechanically exfoliated graphene and molybdenum disulfide (MoS2) monolayers. The defects were created by aluminium oxide (Al2O3) plasmas and removed by moderate thermal annealing at up to 300 °C. We employed Raman and photoluminescence (PL) as well as electrical characterization to monitor the variation of the defect level in graphene and MoS2. For graphene, Raman spectra indicate that the Al2O3 plasma induced sp3-type defects with a controlled concentration, which have been substantially removed after thermal annealing. A similar trend was also observed in monolayer MoS2, as revealed by the defect-related emission peak (Xb) in the PL spectra. We further showed that the defects induced by the Al2O3 plasma in both 2D materials can be restored to any intended level via annealing under well-controlled conditions. Our work presents a new route to the functional design of the optical and electronic properties of graphene and MoS2-based devices through defect engineering.

[Relationship between multi-slice spiral CT angiography imaging features and in-hospital death of patients with aortic dissection].

Objective: To explore the imaging manifestations of multi-slice spiral CT angiography (CTA) and relationship with in-hospital death in patients with aortic dissection (AD). Methods: The clinical data of 429 patients with AD who underwent CTA in Zhongshan Hospital of Fudan University between January 2009 and January 2016 were retrospectively analyzed. AD patients were divided into 2 groups, including operation group who underwent surgery or interventional therapy (370 cases) and non-operation group who underwent medical conservative treatment(59 cases). The multi-slice spiral CTA imaging features of AD were analyzed, and multivariate logistic regression analysis was used to investigate the relationship between imaging manifestations and in-hospital death in AD patients. Results: There were 12 cases (3.24%) of in-hospital death in operation group, and 28 cases (47.46%) of in-hospital death in non-operation group(P<0.001). AD involved different vascular branches. Multi-slice spiral CTA can clearly show the dissection of true and false lumen, and intimal tear was detected in 363 (84.62%) cases, outer wall calcification was revealed in 63 (14.69%) cases, and thrombus formation was present in 227 (52.91%) cases. The multivariate logistic regression analysis showed that the number of branch vessels involved (OR=1.374, 95%CI 1.081-1.745, P=0.009) and tearing false lumen range(OR=2.059, 95%CI 1.252-3.385, P=0.004) were independent risk factors of in-hospital death in AD patients, and the number of branch vessels involved (OR=1.600, 95%CI 1.062-2.411, P=0.025) was independent risk factor of in-hospital death in the operation group, while the tearing false lumen range (OR=2.315, 95%CI 1.019-5.262, P=0.045) was independent risk factor of in-hospital death of non-operation group. Conclusions: Multi-slice spiral CTA can clearly show the entire AD, true and false lumen, intimal tear, wall calcification and thrombosis of AD patients. The number of branch vessels involved and tearing false lumen range are the independent risk factors of in-hospital death in AD patients.

Significance of platelet distribution width as a severity marker of erectile dysfunction.

Mean platelet volume (MPV) and Platelet distribution width (PDW) are potential markers in platelet activation. In present study, we aimed to evaluate MPV and PDW as potential severity markers for those patients who are complaining erectile dysfunction (ED). A total of 358 participants were enrolled in this study. The whole cohort was asked to complete the International Index of Erectile Function-5 (IIEF-5) questionnaire. The participants were classified into 3 groups: control group (n = 120), mild ED (n = 118) and severe ED (n = 120). We found in our cohort MPV and PDW were significantly higher in both mild ED group and severe ED group than control group (9.24 ± 0.70 and 9.71 ± 0.80 versus 8.56 ± 0.62 for MPV; 14.48 ± 1.29 and 14.98 ± 1.60 versus 12.86 ± 1.13 for PDW respectively). The MPV and PDW increased as the disease progressed. In the mild and severe ED groups, a significant inverse correlation was detected between the mean values of IIEF-5 score and PDW. Furthermore, in the receiver operating characteristic curve analysis, the area under the curve of the MPV and PDW to predict severe ED was 0.818 and 0.848 respectively. Our study establishes a dose-dependent association between the PDW and ED. Therefore, the PDW can serve as a potential marker for predicting the severity of ED.

[The application value of two-dimensional image technology and three-dimensional visualization technology in hepatocellular carcinoma treated by associating liver partition and portal vein ligation for staged hepatectomy: a preliminary study].

OBJECTIVE: To preliminarily explore the application value of two-dimensional image technology and three-dimensional visualization technology in hepatocellular carcinoma(HCC) treated by associating liver partition and portal vein ligation for staged hepatectomy(ALPPS). METHODS: Clinical data of nineteen HCC patients treated by ALPPS were retrospectively analyzed in Sun-Yat-Sen Memorial Hospital of Sun Yat-Sen University from August 2013 to May 2015.Preoperative assessment, surgical planning and intraoperative guidance were assisted by traditional two-dimensional imaging technology(group 2D) in 15 cases, and the rest 4 cases were assisted by three-dimensional visualization technology(group 3D). RESULTS: Three-dimensional visualization technology offered precise, visual, and distinct images, calculated the liver volume precisely, achieved virtual simulation operations, and assisted the formulation of intraoperative decisions.The mean operation time of the first stage were(331.3±61.7)minutes and (261.3±21.4)minutes in group 2D and group 3D, and the mean volume of intraoperative bleedings were (360.7±51.9)ml and (300.0±40.8)ml, respectively.The mean operation time of the second stage were (199.3±41.0)minutes and (170.0±29.4)minutes in group 2D and group 3D, and the mean volume of intraoperative bleedings were (285.3±132.6)ml and (257.5±99.5)ml, respectively.The mean interval time between two stages of operations were (15.3±6.5)d and (13.8±5.1)d in group 2D and group 3D, and the mean hospital stays were (39.3±5.8)d and (31.5±7.5)d, respectively.There were 4 cases and 12 cases who accepted the second stage operation in group 2D and group 3D respectively.There were 7 cases(4 with grade A, 2 with grade B, 1 with grade C) and 2 cases(1 with grade A, 1 with grade B) with post-hepatectomy liver failure and 9 cases(4 with grade Ⅰ, 2 with grade Ⅱ, 1 with grade Ⅲ, 2 with grade Ⅳ) and 3 cases (1 with grade Ⅰ, 1 with grade Ⅱ, 1 with grade Ⅲ)with postoperative complications in group 2D and group 3D respectively.There were 2 cases and 0 case died after operation in group 2D and group 3D respectively.There were 3 cases and 1 case who were recurrent and 4 cases and 1 case died 6 months after surgery in group 2D and group 3D respectively. CONCLUSION: Three-dimensional visualization technology assisted the formulation of preoperative assessments and surgical planning individually and precisely, which displayed potential application value in HCC treated by ALPPS.

Therapeutic efficacy of percutaneous microwave coagulation versus liver resection for single hepatocellular carcinoma ≤3 cm with Child-Pugh A cirrhosis.

AIMS: This study aimed to compare the therapeutic efficacy of liver resection (LR) and percutaneous microwave coagulation therapy (PMCT) for single hepatocellular carcinoma ≤3 cm (HCC) in cirrhotic livers. METHODS: In this study, 190 patients with single HCC ≤3 cm and Child-Pugh A cirrhosis were retrospectively reviewed. Among these patients, 122 patients underwent LR, and 68 patients received PMCT. The therapeutic efficacy and complications were compared between the two procedures. RESULTS: There was no treatment-related hospital mortality in either group. Major complications were significantly more frequent in the LR group compared to the PMCT group (22.1% vs 5.9%, p = 0.004). The 1-, 3-, and 5-year OS rates for the LR group and PMCT group were 98.4%, 93.6%, 55.2% and 97.1%, 87.7%, 51%, respectively. There was no significant difference in OS rates between the LR group and PMCT group (p = 0.153). The 1-, 3-, and 5-year DFS rates were 96.7%, 70.5% and 43.7%, respectively, in the LR group, which were significantly higher compared to the PMCT group (92.6%, 50.5% and 26.3%, p = 0.006). Subgroup analyses revealed that HCC patients with portal hypertension (PH), OS and DFS were similar between the two groups. CONCLUSIONS: LR may provide better DFS and lower recurrence rates than PMCT for single HCC ≤3 cm and Child-Pugh A cirrhosis. For HCC patients with PH, PMCT may provide therapeutic effects that are similar to LR.

Fabrication and biological characteristics of beta-tricalcium phosphate porous ceramic scaffolds reinforced with calcium phosphate glass.

The fabrication process, compressive strength and biocompatibility of porous beta-tricalcium phosphate (beta-TCP) ceramic scaffolds reinforced with 45P(2)O(5)-22CaO-25Na(2)O-8MgO bioglass (beta-TCP/BG) were investigated for their suitability as bone engineering materials. Porous beta-TCP/BG scaffolds with macropore sizes of 200-500 muicrom were prepared by coating porous polyurethane template with beta-TCP/BG slurry. The beta-TCP/BG scaffolds showed interconnected porous structures and exhibited enhanced mechanical properties to those pure beta-TCP scaffolds. In order to assess the effects of chemical composition of this bioglass on the behavior of osteoblasts cultured in vitro, porous scaffolds were immersed in simulated body fluid (SBF) for 2 weeks, and original specimens (without soaked in SBF) seeded with MC3T3-E1 were cultured for the same period. The ability of inducing apatite crystals in simulated body fluid and the attachment of osteoblasts were examined. Results suggest that apatite agglomerates are formed on the surface of the beta-TCP/BG scaffolds and its Ca/P molar ratio is approximately 1.42. Controlling the crystallization from the beta-TCP/BG matrix could influence the releasing speed of inorganic ions and further adjust the microenvironment of the solution around the beta-TCP/BG, which could improve the interaction between osteoblasts and the scaffolds.

Mechanisms of survival prolongation of murine cardiac allografts using the treatment of CTLA4-Ig and MR1.

BACKGROUND: [corrected] The present study was undertaken to determine the role of costimulatory blockade in a murine cardiac transplant model. MATERIALS AND METHODS: We blocked the CD28/B7 and CD154/CD40 costimulatory pathways by transient administration of CTLA4-Ig and MR1 antibody to study the effects on allograft survival time, deviation of Th1 and Th2 cytokine secretion, and other mechanisms related to prolonged survival. RESULTS: Costimulatory blockade prolonged the mean survival time (MST) of cardiac allografts to 43 days for the treated group vs 8 days for the untreated group (P < .01). The costimulatory blockade down-regulated the expression of 2 Th1 cytokines (interferon-gamma [IFN-gamma] and interleukin-2 [IL-2]) and 2 Th2 cytokines (IL-4 and IL-10), reduced the numbers of graft-infiltrating CD4+ and CD8+ lymphocytes, and inhibited the expression of both perforin/GrB and FasL in allografts. CONCLUSIONS: Combined administration of CTLA4-Ig/MR1 inhibited acute rejection reactions in murine cardiac allografts, prolonging the survival of cardiac grafts through several mechanisms, including inhibition of Th1 and Th2 cytokine expression, graft infiltration by CD4+ and CD8+ T lymphocytes, and reduced both perforin/GrB and Fas-FasL.

Preparation of ZnO colloids by aggregation of the nanocrystal subunits.

Colloidal ZnO particles with narrow size distribution were prepared via a sol-gel process by base-catalyzed hydrolysis of zinc acetate. The morphology of ordered arrays of the particles was recorded by SEM. SEM also reveals that these uniform particles were composed of tiny ZnO subunits (singlets) sized of several nanometers. The size of the singlets, which is confirmed by X-ray diffraction and UV-vis absorption spectra, increases as the aging time is prolonged. The size-selective formation of colloids by aggregation of nanosized subunits is proposed to consist of two-stage growth by nucleation of nanosized crystalline primary particles and their subsequent aggregation into polycrystalline secondary colloids. The aggregates are all spherical because the internal rearrangement processes are fast enough. The ZnO colloids, i.e., the aggregates, tend to self-assemble into well-ordered hexagonal close-packed structures. Room-temperature photoluminescence was characterized for green and aged ZnO.