Auto interpretable depth learning model to analyze the hemodynamic changes and pulmonary complications in laparoscopic gynecologic tumor surgery with nalmefene hydrochloride combined with general anesthesia.

OBJECTIVE: In this work, based on intelligent computing, the biological signals of patients were analyzed to investigate the hemodynamic changes and pulmonary complications of Nalmefene Hcl combined with general anesthesia (GA) in laparoscopic gynecological tumor surgery (GTS). PATIENTS AND METHODS: Eighty computer-aided GTS patients were randomly divided into a control group (n = 40) and an observation group (n = 40). Biomedical electrocardiogram (ECG) signals were detected by wavelet neural network in all patients undergoing laparoscopic gynecological tumor surgery and were computerized according to the android interface definition language model (AIDL). GA was used during surgery. The observation group was injected intravenously with 0.2 µg/kg naproxenacin hydrochloride after operation. The control group was given 1 mL 0.9% sodium chloride solution after operation. Mean arterial pressure (MAP), heart rate (HR), respiratory rate (RR), pulse oxygen saturation (SPO), coma score, and adverse reactions (AR) were compared between the two groups at 10, 20, and 30 minutes after wakefulness. The hemodynamic parameters between the two groups were compared. Serum urocholine (URO) and creatinine (Cre) levels were analyzed in patients without complications. RESULTS: ECG waveform based on wavelet neural network has a high recognition rate and strong generalization ability. 37 patients in the observation group recovered within 10 minutes after surgery, and the recovery rate at 30 minutes was 95%. 30 patients in the control group awoke 10 minutes after the operation, and the recovery rate at 30 minutes m-AR was 75%. The average abstract windows toolkit (AWT) of the observation group and control group was 11.87 ± 5.78 min and 16.46 ± 5.32 min, respectively, and the difference was significant (p < 0.05). There were significant differences in HR, systolic blood pressure (SBP), and diastolic blood pressure (DBP) between the observation group and the control group during the extubation (p < 0.05). Blood gas indexes PaO2, PvO2, PaCO2, and PvCO2 in the observation group were significantly different from those in the control group half an hour after the operation and half an hour after pneumoperitoneum (p > 0.05). CONCLUSIONS: Intelligent computational biological signal detection was beneficial to the development of surgery. Nalmefene Hcl combined with GA on the basis of the AIDL model has a significant effect on the awakening of GTS patients and can shorten sleep time. Patients with underlying cardiac disease were more likely to develop postoperative lung complications.

Comparison of laparoscopic common bile duct exploration and endoscopic retrograde cholangiopancreatography combined with laparoscopic cholecystectomy for patients with gallbladder and common bile duct stones a meta-analysis of randomized controlled trials.

OBJECTIVE: This study aimed to compare the efficacy and safety of laparoscopic common bile duct exploration (LCBDE) and endoscopic retrograde cholangiopancreatography (ERCP) combined with laparoscopic cholecystectomy (LC) to determine which one provides a better outcome for patients with gallbladder and common bile duct stones. MATERIALS AND METHODS: An electronic literature search was undertaken using Embase, Medline, PubMed, and Cochrane Library databases up to April 2022. For quality assessment of included studies, randomized controlled trials (RCTs) were assessed by utilizing the Jadad scale. The primary outcome includes surgical success rate, retained stone rate, stone clearance rate, major morbidity, and mortality. The second outcome includes conversion to open surgery rate, postoperative pancreatitis, bile leakage, cholangitis, hemorrhage, pneumonia, and surgical-site infection. RESULTS: 14 randomized controlled trials with 2,181 patients were included. No significant difference was seen between the two groups in terms of surgical success, stone clearance, retained stones, operation time, and total morbidity. LC-LCBDE had higher rate of bile leakage [relative risk (RR): 4.52; 95% confidence interval (CI): 2.19-9.31] and lower rate of postoperative pancreatitis (RR: 0.25; 95% CI: 0.13-0.46), cholangitis (RR: 0.17; 95% CI: 0.05-0.67), and hemorrhage (RR: 0.18; 95% CI: 0.07-0.42). CONCLUSIONS: Both LC+LCBDE and LC+ERCP are safe, effective, and minimal-invasive treatments for concomitant gallbladder and CBD stones. LC-LCBDE was associated with comparable effects compared with LC+ERCP in terms of surgical success rate, stone clearance rate, retained stones rate, operation time, and total morbidity. At the same time, LC-LCBDE had a higher rate of bile leakage and a lower rate of postoperative pancreatitis, cholangitis, and hemorrhage.

Association between Depressive Symptoms and Risk of Sarcopenia in Taiwanese Older Adults.

OBJECTIVES: Symptoms of depression and high risk of sarcopenia are common among the older population; however, the associations between these remain unclear. Thus, the present study identified whether depressive symptoms are associated with older adults' sarcopenia risks. PARTICIPANTS: This nationally representative study in Taiwan investigated the older adult population ( ≥ 65 years) using a telephone survey conducted between 2019 and 2020. DESIGN: Self-reported data obtained included depressive symptoms (5-item from Center for Epidemiological Studies-Depression scale), sarcopenia risks (SARC-F questionnaire), and individual characteristics. The generalized additive models were used to examine the nonlinear associations between depressive symptoms and the risk of sarcopenia. RESULTS: A total of 1,068 older Taiwanese adults (72.15 ± 5.71 years; 52.7% women) participated in the survey. In the unadjusted model, the results showed a significant nonlinear association between high scores on the CES-D and sarcopenia scores (p < .001). Even after adjusting for covariates (sex, age, residential areas, education, marital status, working status, living status, smoking, drinking, and BMI), it still showed a significant non-linear association (p < .001). CONCLUSION: The results indicated that depressive symptoms were nonlinearly related to older adults' sarcopenia risks. Interventions or programs aiming to alleviate depression can be an effective strategy to prevent sarcopenia in the older adult population.

[Homologous modeling and binding ability analysis of Spike protein after point mutation of severe acute respiratory syndrome coronavirus 2 to receptor proteins and potential antiviral drugs].

OBJECTIVE: To explore the natural mutations in Spike protein (S protein) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the changes of affinity between virus and associated receptors or drug molecules before and after the mutation based on whole length sequencing results. METHODS: In the study, the bioinformatics analysis of all the published sequences of SARS-CoV-2 was conducted and thus the high frequency mutation sites were affirmed. Taking advantages of PolyPhen-2, the functional influence of each mutation in S protein was prospected. The 3D homologous modelling was performed by SWISS-MODEL to establish mutated S protein structural model, in which the protein-docking was then implemented with angiotensin-converting enzyme 2 (ACE2), dipeptidyl peptidase-4 (DPP4) and aminopeptidase N (APN) by ZDOCK, and the combining capacity of each mutated S protein evaluated by FiPD. Finally, the binding ability between mutated S proteins and anti-virus drugs were prospected and evaluated through AutoDock-Chimera 1.14. RESULTS: The mutations in specific region of S protein had greater tendency to destroy the S protein function by analysis of mutated S protein structure. Protein-receptor docking analysis between naturally mutated S protein and host receptors showed that, in the case of spontaneous mutation, the binding ability of S protein to ACE2 tended to be weakened, while the binding ability of DPP4 tended to be enhanced, and there was no significant change in the binding ability of APN. According to the computational simulation results of affinity binding between small molecular drugs and S protein, the affinity of aplaviroc with S protein was significantly higher than that of other small molecule drug candidates. CONCLUSION: The region from 400-1 100 amino acid in S protein of SARS-CoV-2 is the mutation sensitive part during natural state, which was more potential to mutate than other part in S protein during natural state. The mutated SARS-CoV-2 might tend to target human cells with DPP4 as a new receptor rather than keep ACE2 as its unique receptor for human infection. At the same time, aplaviroc, which was used for the treatment of human immunodeficiency virus (HIV) infection, may become a new promising treatment for SARS-CoV-2 and could be a potential choice for the development of SARS-CoV-2 drugs.

MiR-204 promotes fracture healing via enhancing cell viability of osteoblasts.

OBJECTIVE: To investigate the effects and related mechanisms of miR-204 on fracture healing. MATERIALS AND METHODS: Mouse osteoblastic cell line MC3T3-E1 was used in our experiment. Three groups were established to investigate the potential function between miR-204 and osteoblastic cells: miR-NC group (negative control), miR-204 mimics group (MC3T3-E1 cells transfected with miR-204 mimics) and miR-204 mimics + inhibitor group (MC3T3-E1 cells transfected with miR-204 mimics and inhibitor). After incubation, cell viability, activity of caspase-3, and migration ability of MC3T3-E1 cells, were measured. Further, the expression levels of Runt-related transcription factor 2 (RUNX2) and Osterix (OSX) were detected and analyzed. RESULTS: Compared with miR-NC group, the cell viability and migration ability of MC3T3-E1 cells were enhanced while the activity of caspase-3 was respectively mitigated. Besides, the expression level of RUNX2 and OSX was increased by treatment of miR-204 mimics. However, these variations of the indicators were reversed by the intervention using miR-204 inhibitor. CONCLUSIONS: We revealed the promotion effect of miR-204 on fracture healing, indicating that miR-204 could be a potential therapeutic target for the treatment of a fracture.

Transcription factor SPZ1 promotes TWIST-mediated epithelial-mesenchymal transition and oncogenesis in human liver cancer.

The epithelial-mesenchymal transition (EMT) is an important process in the progression of cancer. However, its occurrence and mechanism of regulation are not fully understood. We propose a regulatory pathway in which spermatogenic leucine zipper 1 (SPZ1) promotes EMT through its transactivating ability in increasing TWIST1 expression. We compared the expression of SPZ1 and TWIST1 in specimens of hepatocarcinoma cells (HCCs) and non-HCCs. Expression of SPZ1 exhibited a tumor-specific expression pattern and a high correlation with patients' survival time, tumor size, tumor number and progression stage. Moreover, forced expression and knockdown of SPZ1 in hepatoma cells showed that SPZ1 was able to regulate the cellular proliferation, invasion, and tumorigenic activity in a TWIST1-dependent manner in vitro and in vivo. These data demonstrate that SPZ1, a newly dscribed molecule, transactivates TWIST1 promoters, and that this SPZ1-TWIST axis mediates EMT signaling and exerts significant regulatory effects on tumor oncogenesis.

[Analysis of olfactory dysfunction after endoscopic and microscopic endonasal transsphenoidal surgery for pituitary adenoma].

Objective:To analyze the clinical data of patients with olfactory dysfunction after endoscopic or microscopic endonasal transsphenoidal approach,and to screen out the possible related factors,to guide clinical diagnosis and treatment,and to improve the patients' quality of life.Method:In the retrospective study,we analyze patients' data,and follow up them with telephone,records the olfactory levels before and after surgery. In the prospective study,five odors were applied to test the olfactory function before the surgery,then one week,3 weeks and 6 weeks after that. The results were statistically analyzed.Result:In the retrospective study,olfactory dysfunction occurred in 67.74%,47.37%in MTS group and ETS group. The olfactory disorder had no significant difference (P>0.05) among MTS group and ETS group after surgery. And the analysis of factors showed no significant difference. In the prospective study,there is significant difference between the preoperative results and postoperative results about the operative side and nonoperative side in ETS group and MTS group (P<0.05). In all results,there is no significant difference between operative side and nonoperative side in ETS group and MTS group (P>0.05).Conclusion:There is olfactory dysfunction after transsphenoidal surgery to resect pituitary adenomas. To prepare the nasal condition well preoperatively,protect the nasal structure intraoperatively and aplicate appropriate treatment postoperatively may reduce the incidence of olfactory disorder.

Functional interaction of Ugene and EBV infection mediates tumorigenic effects.

Epstein-Barr virus (EBV) infection is associated with many human neoplasms, in which EBV-derived latent membrane protein-1 (LMP1) appears to be critical, but its exact oncogenic mechanism remains to be defined. To this end, our initial microarray analyses identified a LMP1-inducible gene, Ugene, originally characterized as a binding partner for uracil DNA glycosylase 2, which is highly expressed in malignant colon cancer. In this report, it was found that Ugene, designated herein as LMP1-induced protein (LMPIP), was induced, in a time-dependent manner, in EBV-infected peripheral blood mononuclear cells and LMP1-transfected 293 cells. Functionally, when compared with mock-transfected cells, overexpression of LMPIP in nasopharyngeal carcinoma (NPC) cell lines resulted in a decrease in reactive oxygen species production and maintained mitochondria membrane potential (Δψ) loss induced by H(2)O(2). The NPC cells transfected with LMPIP also showed a decrease in G1 population and an increase in the cell population in sub-G1 and multiploid phase, concomitant with increased levels of cell cycle activators, including cyclin D1 and CDK4. In contrast, silencing of LMPIP expression in the NPC tumor cell lines with short hairpin RNA interference revealed significantly decreased cell population at G1/S phase, while the number of cells in multiploid phase increased. Significantly, NPC cells with LMPIP knock-down also showed a decrease in tumorigenic and transforming activity induced by ectopic LMP1 expression, as determined by analyses of soft agar foci and tumor size in nude mice. Further, elevated LMPIP expression was also noted in cytoplasm and nuclei in EBV-infected NPC tumor cell mass and non-EBV-infected tumor cell lines. These results suggested that LMPIP may have an important mediator role in EBV-mediated neoplasm and may serve as a new target for therapy of tumors induced by EBV infection.

Comparative proteomics analysis of human osteosarcomas and benign tumor of bone.

We conducted comparative proteomic analysis of osteosarcoma, with hopes of identifying the specific protein markers of osteosarcoma and improve the understanding of tumorigenesis and progression of osteosarcoma. Proteins extracted from osteosarcoma tissue and benign bone tumors, including osteoblastoma, chondroblastoma, and giant cell tumor of bone, were examined using two-dimensional gel electrophoresis followed by mass spectrometry analysis and database searches. We also validated the expression levels of interesting proteins by Western blotting assay and immunohistochemical staining. Intensity alterations of 30 spots were detected in osteosarcoma, and 18 of these spots were finally identified, including 12 up-regulated proteins and 6 down-regulated ones. The up-regulated proteins include VIM, TUBA1C, ZNF133, EZR, ACTG1, TF, and so on. The six down-regulated proteins include ADCY1, ATP5B, TUBB, RCN3, ACTB, and YWHAZ. Subsequent immunohistochemical staining and Western blotting assay for TUBA1C and ZNF133 in osteosarcoma samples confirmed the observation obtained by proteomic analysis. Our results suggest that these identified proteins may be potential biomarkers for osteosarcoma tumorigenesis and therapeutics. Aberrant expression of cytoskeletal- and microtubule-associated proteins in osteosarcoma may provide an advantage for tumor invasion and metastasis by affecting the stability of microtubule, which consequently influences the prognosis of patients.

Jejunojejunal intussusception secondary to metastasis from adenocarcinoma of the lung--a case report.

Small intestine metastasis from primary lung cancer is uncommon and jejunojejunal intussusception secondary to metastatic lung cancer is extremely rare. We report a case presenting with a one-week history of abdominal pain associated with poor appetite, vomiting and absent defaecation. Physical examination revealed abdominal distention with decreased bowel sounds. Chest roentgenogram showed a mass lesion in the right upper lung zone. Biopsy of the lung mass lesion confirmed adenocarcinoma of the lung. Computed tomography (CT) of the abdomen demonstrated a "target mass" lesion in the right lower abdomen, representing a small intestinal intussusception. Emergency segmental resection of the affected small intestine with jejunojejunal anastomosis was performed. Histological examination of the specimen revealed metastatic adenocarcinoma of lung origin. The patient had an uneventful postoperative course and was discharged home two weeks after surgery.

Infrared patient positioning for stereotactic radiosurgery of extracranial tumors.

We report on a novel, non-invasive patient positioning system for radiosurgery of extracranial tumors. The system consisted of infrared cameras and reflective markers attached to the skin. Because localization accuracy is critical in radiosurgery, we performed a theoretical analysis of the accuracy of the system. A computer simulation program modeled errors in marker position, and was used to predict errors in targeting and study methods for minimizing errors. The use of redundant markers improved the overall accuracy of targeting. Experimental data was collected using a rigid torso phantom and correlated with theoretical results. The accuracy of the infrared system was compared with existing systems.

[Comparative study on efficacy of qinggan granule and bushen granule in treating chronic hepatitis C].

OBJECTIVE: To evaluate the efficacy of Qinggan Granule (QGG) and Bushen Granule (BSG) in treating chronic hepatitis C (CHC) from blood donors clinically, biochemically and pathologically as well as to explore the therapeutical principle and methods of TCM. METHODS: Sixty-six patients with CHC were divided into three groups, the 36 patients in the QGG group treated with QGG, the 18 patients in the BSG group treated with BSG and the 12 patients in the control group untreated. The dose of QGG and BSG given was 30 g each time, three times per day for 6 consecutive months. Clinical and serum biochemical parameters as well as pathological change of liver biopsy before and after treatment were observed dynamically and compared. RESULTS: After treatment, in the two treated group, clinical symptoms were improved significantly, alanine transaminase (ALT) and aspartate aminotransferase (AST) reduced markedly. Moreover, QGG showed the effects of increasing albumin and lowering alkaline phosphatase (ALP). On the contrary, ALT still remained as before but AST further increased in the control group. Pathological examination showed that the inflammatory grade (IG) decreased in 42.2% and fibrotic stage (FS) decreased 21.2% of the patients in the QGG group, but no significant changes of the two indexes occurred in the BSG group, while in the control group, IG unchanged and FS increased in 3 cases. Chevallier's semi-quantity system analysis showed significant decrease of both scores in the QGG group (P < 0.05), only decrease of IG in the BSG group, and slight raise of IG and significant increase of FS (P < 0.05) in the control group. CONCLUSION: Condition of chronic hepatitis C patient would deteriorate progressively if not treated in time, especially the development of fibrosis. QGG and BSG could improve the clinical symptoms significantly, lower ALT and AST, eliminate inflammatory damage in the liver, slow down or reverse liver fibrosis process with stable long-term effect. Though most of the patients present a Syndrome of Liver-Kidney Yin-deficiency, the effect of QGG is superior to that of BSG, suggesting that the treatment of CHC should mainly be clearing principle, and method of clearing Liver and eliminating Dampness may be more suitable for them.

SDS-induced conformational changes and inactivation of the bacterial chaperonin GroEL.

The inactivation and conformational changes of the bacterial chaperonin GroEL have been studied in SDS solutions with different concentrations. The results show that increasing the SDS concentration caused the intrinsic fluorescence emission intensity to increase and the emission peak to slightly blue-shift, indicating that increasing the SDS concentration can cause the hydrophobic surface to be slightly buried. The changes in the ANS-binding fluorescence with increasing SDS concentration also showed that the GroEL hydrophobic surface decreased. At low SDS concentrations, less than 0.3 mM, the GroEL ATPase activity increased with increasing SDS concentration. Increasing the SDS concentration beyond 0.3 mM caused the GroEL ATPase activity to quickly decrease. At high SDS concentrations, above 0.8 mM, the residual GroEL ATPase activity was less than 10% of the original activity, but the GroEL molecule maintained its native conformation (as indicated by the exposure of buried thiol groups, electrophoresis, and changes of CD spectra). The above results suggest that the conformational changes of the active site result in the inactivation of the ATPase even though the GroEL molecule does not markedly unfold at low SDS concentrations.

Nested PCR-SSCP assay for the detection of p53 mutations in paraffin wax embedded bone tumours: improvement of sensitivity and fidelity.

DNA extraction and PCR amplification from paraffin wax embedded bone tumour specimens present several difficulties, firstly, because of the abundant matrix they contain and, secondly, because decalcification often causes degradation of DNA. In this report, comparative studies were carried out to determine the most efficient method for DNA extraction and PCR amplification from such specimens. The results indicated that nested PCR produced appropriate strong reaction products with minimal background contamination. A method for DNA extraction from paraffin wax embedded bone tissue and a nested PCR-SSCP technique have been developed for use in such diagnostic specimens.

[Clinicopathological analysis, immunohistochemical study and electron microscopic observation of chondroblastoma of bone].

A series of 73 cases of chondroblastoma of bone, a rare benign tumor, was subjected to clinicopathological analysis, 50 cases of it were studied by immunohistochemistry and affinity histochemistry and 3 cases were observed by electron microscopy. In this series, chondroblastomas were found nearly in patients of all age groups, with the peak incidence occurring in the second decade of life. The lesions were more commonly located in long bone metaphyseal portion, especially in the upper end of femur and the head and neck of femur. It was easily misdiagnosed as giant cell tumor of bone, chondroma, and osteochondroma by clinic and radiography. There was gradual transition from a few chondroblasts to a small focus of clear cells in 3 cases, therefore, chondroblastoma may transform into clear cell chondrosarcoma by anaplastic change of chondroblast, which is one of malignant chondroblastomas. Our immunohistochemistry and affinity histochemistry results supported the point of view of chondroblast originated from epiphyseal chondrocytes. Immunohistochemical assessment of S-100 protein may be one useful parameter for differentiating chondroblastoma from giant cell tumor of bone and aneurysmal bone cyst ultrastructurally, chondroblasts had characteristic lobulated nuclei, compact zones under nuclear membrane, and microvilli on cells surface. In most cells, the Golgi apparatus and RER were inconspicuous without.

Clear cell chondrosarcoma of bone. A report of three cases with immunohistochemical and affinity histochemical observations.

Clear cell chondrosarcoma, a subtype and separate entity from the traditional chondrosarcoma, is characterized by its special histologic features, site of predilection, slow growth and better prognosis. Three cases are presented with elucidation of clinicopathologic correlation and detection by the ABC immunohistochemical method using several antibodies. The observation of positive reaction to S-100 protein (S-100), vimentin (Vim), alpha 1-antichymotrypsin (AACT) and lysozyme (Lyso) by the tumor cells of clear cell chondrosarcoma, similar to traditional chondrosarcoma and chondroblastoma, proves that this tumor has its origin in the cartilaginous tissue. It was found for the first time that the clear cell chondrosarcoma was positive for wheat germ agglutinin (WGA) and concanavalin A (Con A). The authors believe that clear cell chondrosarcoma may result from the anaplastic changes of chondroblastoma cells into another subtype of that tumor. The osteoclast-like multinucleated giant cells (MGC), retaining the antigens of phagocytes, are not considered to be neoplastic.

Bronchial carcinoid tumors in pediatric patients.

Bronchial carcinoid tumors (BCT) are the most frequent primary pulmonary neoplasms of childhood. Seventeen of 208 patients diagnosed as having BCT at the Massachusetts General Hospital were between 10 and 21 years of age. We reviewed our records of the 17 patients and 8 other pediatric cases and compared their findings with those of seven large series of adults. Distribution was equal between the sexes. The average age at diagnosis was 17 years; 4 patients were < or = 15 years old. The duration of symptoms prior to diagnosis varied from 2 weeks to 2.6 years, with a median duration of 8.5 months. In contrast to adults, no child was asymptomatic. The majority of children presented with wheezing and atelectasis in addition to the characteristic adult triad of cough, hemoptysis, and pneumonitis. Five patients presented with weight loss and one patient presented with hoarseness. One of the 17 pediatric patients presented with Cushing's syndrome and a functional BCT. Twelve of 14 patients were disease free for 9 months to 34 years after surgical resection. We conclude that BCT should be suspected in children with pneumonitis resistant to therapy, atelectasis, wheezing, and hemoptysis. Surgical resection will result in symptom-free recovery in the majority of cases in spite of low-grade malignancy.

[Immunohistochemical study on clear cell chondrosarcoma].

Clear cell chondrosarcoma, a subtype and separate entity from the conventional chondrosarcoma, is characterized by its special histologic features, site of predilection, slow growth and better prognosis. Three cases are presented with elucidation of clinicopathologic correlation and detection by ABC immunohistochemical method using several antibodies. The observation of positive reaction to S-100 protein, vimentin, anti-alpha-chymotrypsin and Lysozyme by the tumor cells of clear cell chondrosarcoma, similar to chondrosarcoma and chondroblastoma, proves that this tumor has its origin from the cartilaginous tissue. It was found for the first time that the clear cell chondrosarcoma was positive for wheat germ agglutinin and concanavalin A. The authors believe that clear cell chondrosarcoma may result from the anaplastic change of chondroblastoma cells into another subtype of that tumor. The osteoblastlike multinucleated giant cells, retaining the antigens of phagocytes, are not considered to be neoplastic.

[Hepatobiliary tuberculosis].

An analysis of 423 cases with hepatic and biliary tuberculosis was reported. The hepatic tuberculosis may be divided into miliary, nodular and abscess type, the biliary tuberculosis may be divided into cholecystic and biliary type.