ABSTRACT
Objective:To explore the clinical value of cluster management in secondary hydrocephalus.Methods:Seventy-seven patients with secondary hydrocephalus admitted to Department of Neurosurgery, Shenzhen Second People's Hospital from January 2016 to June 2021 were chosen; they were divided into traditional management group ( n=30) and cluster management group ( n=47) according to different management methods. Patients in traditional management group accepted craniocerebral CT and 3 consecutive times of cerebrospinal fluid tests, and normal results were achieved and then ventriculoperitoneal shunt (VPS) was performed. In patients from the cluster management group, on the basis of management treatment, cranial plain and enhanced MRI and DNA metagenomic next generation sequencing of cerebrospinal fluid were performed before surgery, and rapid test of cerebrospinal fluid and ventriculoscope observation were performed during surgery; after exclusion of intracranial infection, VPS was performed. The differences of shunt failure rate were compared between the two groups and the positive rates of intracranial infection detected by above 4 methods were compared in the cluster management group. Results:There was significant difference in shunt failure rate between the cluster management group and traditional management group (2.1% vs. 20.0%, P<0.05). The positive rates of intracranial infection by DNA metagenomics (61.7%) and ventriculoscopy (68.1%) were significantly higher than those by preoperative cranial plain and enhanced MRI (14.9%) and rapid test of cerebrospinal fluid (6.4%, P<0.05). Conclusion:Cluster management can effectively decrease the VPS failure rate in secondary hydrocephalus; DNA metagenomics and ventriculoscopy have high efficiency in detecting intracranial infection.
ABSTRACT
Objective:To investigate the effects of applying Stent Boost Subtract (SBS) technique during percutaneous coronary intervention in patients with complex coronary lesions.Methods:200 patients with coronary artery disease (CAD) who hospitalized in the department of cardiology in Guangzhou First People′s Hospital from June 2018 to June 2020 were enrolled. The coronary lesions of all patients were corresponding to B2 or C type suggested by American Heart Association (AHA)/American College of Cardiology (ACC) according to coronary angiography and treated with percutaneous coronary intervention (PCI). Patients were randomly divided into SBS group ( n=82, SBS technique was applied during PCI) and IVUS group [ n=118, intravascular ultrasound (IVUS) was applied during PCI]. After stent implantation, quantitative coronary angiography (QCA) automatic analysis system was used to measure the related parameters of stent diameter (including the minimum, maximum and mean value of stent diameter) and calculate the stent eccentricity index. During PCI, stent eccentricity index, post-stent expansion, poorly positioned stent with open lesions, failure of overlapping stent with long lesions, mean cumulative dose (CD), product of total dose area (DAP), X-ray time, operation time and operation cost of each PCI were recorded in the two groups. Patients were followed up for 18 months after PCI, and the occurrence of adverse cardiovascular events (MACE) was recorded during the follow-up period, and the cumulative survival rate without MACE was compared between the two groups. Results:There were no statistically significant differences between the two groups in stent eccentricity index, proportion of guided stent expansion, proportion of poorly positioned stent with open lesions, proportion of stent failure to overlap, with statistically significant difference[(0.12±0.04) vs (0.10±0.03); 80.49% vs 85.49%; 2.44% vs 2.54%; 1.22% vs 2.54%, all P>0.05]. There were no significant differences in CD, X-ray time and DAP in SBS group compared with IVUS group [(1 394.18±42.29)Gy/cm 2 vs (1 391.82±45.06)Gy/cm 2; (18.79±3.01)min vs (18.95±3.12)min, (100.24±5.70)Gy/cm 2 vs (99.47±5.93)Gy/cm 2; all P>0.05]. The operation time in SBS group was shorter than that in IVUS group [(70.91±6.51)min vs (73.89±8.95)min, P<0.05], and the operation cost was less than that in IVUS group [(2.98±0.86)ten thousand yuan vs (3.85±0.81)ten thousand yuan, P<0.05]. After 18 months of follow-up after PCI, Kaplan-Meier survival analysis showed that there was no significant difference in MACE event-free survival between SBS group and IVUS group (91.46% vs 94.07%, Log Rank=0.480, P=0.489). Conclusions:SBS is a kind of convenient and effective technique in guiding PCI in patients with complex coronary lesions without increasing operation time and radiation dose, which can achieve the same effect as IVUS guidance.
ABSTRACT
Objective:To investigate the diagnostic value of bronchial arteriography CT (BA-ACT) combined with bronchoscopy (BS) in bronchial Dieulafoy′s disease (BDD), and the role of bronchial artery embolization (BAE) in the treatment of BDD.Methods:Retrospective analysis was made on the clinical data of 5 patients suspected of being BDD treated by BS in Guangzhou First People′s Hospital or Guangzhou Thoracic Hospital from January 2008 to January 2018 due to hemoptysis. Bronchial arteriography (BAG) and BA-ACT were performed during the operation of interventional embolization. BAG rotary acquisition data were post-processed according to BS findings, and BA-ACT reconstruction images of the diseased bronchi and bronchial arteries were obtained. BS reexamination and clinical follow-up observation were carried out after embolization to analyze the effect of embolization.Results:There were one BDD lesion for the five patients respectively, and the BAG lacked characteristic manifestations. Bronchoscopy revealed BDD foci to present as papillary (case 1-case 3), nodular (case 4), or lirellate (case 5) subbronchial submucosal protrusion lesions. On the BA-ACT reconstruction plot, the BDD lesions of papillary, nodular and carination manifested correspondingly as a bronchial artery branches locally " pointed arch" shaped (cases 1-case 4) or " bead-like" (case 5) fold and protruding toward the bronchial lumen. The BDD lesions of the cases 1-case 4 retraction and disappearance after one BAE were observed by BS examination, and no hemoptysis recurrence during the follow-up period (54-91 months). The ridge like BDD lesion of the case 5 remained unchanged after BAE, and hemoptysis recurred at 71 months after the first BAE; the uncollapsed foci were supplied by two collateral vessels that confirmed by second BAG and BA-ACT, and no hemoptysis for 71 months followed up after second BAE.Conclusions:BA-ACT combined with BS enables a locative and qualitative diagnosis of BDD, and BAE is a very effective treatment method for BDD.
ABSTRACT
Objective:To study the angiographic anatomy of the lateral costal artery (LCA) and its effect on hemoptysis.Methods:The CT data of angiography and angiographic-CT in 303 patients with hemoptysis in Guangzhou First People′s Hospital were analyzed retrospectively. The origin and travel of the lateral costal artery and the blood supply of the LCA involved in the pulmonary lesion were analyzed.Results:In 303 patients with hemoptysis, 30 LCA were detected in 24 cases, including 12 on the left and 18 on the right, 18 on one side and 6 on both sides. All of them were the first branch of the first segment of the internal thoracic artery (ITA). The level of LCA originating from ITA was located in 1(3.3%) branch above clavicle, 27(90.0%) branches behind clavicle and 2(6.7%) branches below clavicle. LCA entered into the chest behind the first anterior rib, and walked along inner surface of the thorax from the anterior and superior direction to the outer and posterior direction, between the rib-intercostal medial muscle and pleura (i.e., anatomical intrathoracic fascia), and mostly terminated at the axillary midline plane. 28 LCA in 23 patients which can be used for morphological analysis, roughly manifested as follow three shapes: ⑴ 13(46.4%) of them were arc-shaped. The developed LCA was longer and showed shallow or deep arc-shaped curve; ⑵ High flat shape, total 11 LCA (39.3%), the LCA were relatively shorter, position higher and more gentle; ⑶ 4(14.3%) were straight and oblique. The developed LCA was relatively long, and the angle between LCA and ITA was linear. 11 vessels (36.67%) of 10 patients participated in the blood supply of pulmonary lesions, among which 2, 5, 1, 2 and 1 vessels were responsible for the first, second, third, fourth and fifth hemoptysis respectively.Conclusions:The LCA is a relatively common blood vessel and it can be well shown by angiography and angiographic CT. It is of great clinical significance to understand LCA.
ABSTRACT
Objective To investigate the risk factors for post-traumatic hydrocephalus ( PTH) after traumatic brain injury ( TBI ) . Methods A retrospective case control analysis was made on the clinical data of 794 patients with acute TBI admitted to Shenzhen Second People's Hospital between January 2007 and January 2017. There were 639 males and 155 females, aged 1-90 years [(40. 5 ± 18. 6)years]. All patients were followed up for 1 years, and the patients were divided into PTH group (n=46) and non-PTH group (n=748) according to their prognosis. The following information including Glasgow coma score ( GCS ) on admission, pupil reflex, midline shift and cistern compression, subarachnoid hemorrhage ( SAH ) , operation method, decompressive craniectomy, hydrocephalus after operation, intracranial infection, timing of cranioplasty were analyzed using univariate analysis and Logistic regression. Results PTH occurred in 46 patients (5. 8％). Univariate analysis showed that GCS, midline shift, decompressive craniectomy, subdural effusion, timing of cranioplasty and SAH were significantly related to PTH (P<0. 05 or 0. 01). Logistic regression identified low GCS (OR=3. 778), decompressive craniectomy (OR=2. 508), subdural effusion (OR=2. 269), timing of cranioplasty (≥3 months)(OR=10. 478) and SAH (OR=23. 391) as the independent risk factors for PTH (P<0. 05 or 0. 01). Conclusion PTH is a common serious complication of traumatic brain injury, affected by low GCS, decompressive craniectomy, subdural effusion, delayed cranioplasty and SAH.
ABSTRACT
Histone deacetylase 1 ( sirtuin 1, SIRT1) is an important member of deacetylase family, and plays an important role in the process of malignant tumor and embryonic development. In this article it was found that overexpression of SIRT1 could accelerate the DNA synthesis in human pancreatic beta cell CRL-1837 and inhibit cell senescence. SIRT1 also could bind to p53 as detected by co-immunoprecipitation and could change the phosphorylation level of p53.
ABSTRACT
AIM:To investigate the expression of long non-coding RNA maternally expressed gene 3 (MEG3) in colorectal cancer ( CRC) cells, and to observe the effect of MEG 3 on the invasion and migration of CRC cells .METH-ODS:The levels of MEG3 in human normal colon cell NCM 460 and CRC cells SW48 and LoVo were detected by real-time PCR.MEG3 was over-expressed by plasmid transfection , and the effects of MEG 3 on the invasion and migration of SW 48 and LoVo cells were analyzed by Transwell assay and wound healing assay .The expression of matrix metalloproteinase ( MMP) family proteins was determined by Western blotting .RESULTS:The level of MEG3 was down-regulated in CRC cells compared with normal colon cell NCM 460.The invasion and migration of CRC cells were reduced after MEG 3 over-ex-pression.Transwell invasion and migration assays showed that the numbers of transmembrane SW 48 and LoVo cells were smaller in MEG3 over-expression group than control group (P<0.05).The cell spaces were broader after MEG3 over-ex-pression in the wound healing assay , indicating that MEG3 over-expression inhibited the mobility of CRC cells .Meanwhile, over-expression of MEG3 reduced the expression of MMP-2 and MMP-9, and elevated the expression of tissue inhibitor of metalloproteinase-2 (TIMP-2).CONCLUSION:The expression of MEG3 is down-regulated in CRC cells.Over-expres-sion of MEG3 inhibits the invasion and migration of CRC cells .TIMP-2, MMP-2 and MMP-9 might play an important role in this regulation .
ABSTRACT
Background: Epigenetic mechanisms of gene transcription, including inactivation of tumor suppressor genes by hypermethylation and activation of oncogenes by hypomethylation, have been shown to contribute to breast tumorigenesis. Phosphatase and tensin homolog deleted on chromosome ten (PTEN) and Spleen tyrosine kinase (SYK) are both tumor suppressor genes and survivin is a novel member of the inhibitor of apoptosis (IAP) family which may promote tumorigenesis.Objective: To investigate the methylation status of PTEN, SYK, and survivin genes in breast cancer derived from Chinese women.Materials and methods: We examined the methylation status of these three genes in 52 paraffin-embedded breast cancer tissues using methylation-specific PCR (MSP) assay in conjunction with sequencing analysis.Results: PTEN and SYK were both methylated in 15.4% (8/52) of breast tumor tissues, while the survivin gene was all demethylated in the examined samples. Random selection of MSP products sequence analyses to three genes all revealed a homogenous methylation status in the CpG sites.Conclusion: The present study showed a moderate methylation status of PTEN and SYK, and an unmethylation status of survivin in breast tumor tissues derived from Chinese women, which suggested methylation mechanisms might be involved in the aberrant expression of these three genes in breast cancer development.
ABSTRACT
BACKGROUND: At present, many scholars make improvements to the UW solution composition, aiming to further explore the principle of organ preservation, improve preservation techniques and to extend the preservation time limit; simplified composition of UW solution can further meet the clinical transport, storage and ease of use; suitable alternatives should be found to reduce the cost of UW solution to satisfy the needs of the market.OBJECTIVE: To discuss the effectiveness of self-prepared PV solution for preserving rat's liver at a lower temperature, and to compare the results with UW solution.METHODS: A total of 90 Wistar rats were randomly divided into three groups: UW group, PV group and normal saline (NS) group. Rats in each group were prepared for non-circulated isolated perfused rat liver models, and preserved for 0, 6,12, 18, and 24 hours respectively, with 6 animals in each subgroup. The changes of hepatic enzymology (alanine aminotransferase, aspartate aminotransferase and lactate dehydrogenase) in corresponding time period, amount of metabolic production of oxyradicals from perfusion effluent liquid, and the bile secretion and changes in hepatic morphology under the microscope were observed. RESULTS AND CONCLUSION: Amounts of alanine aminotransferase, aspartate aminotransferase and lactate dehydrogenase and superoxide dismutase in perfusion effluent liquid were close between the PV group and UW group, and the difference was not significant (P > 0.05). After 6 hours of preservation, tumor necrosis factor a titre in the PV fluid group was greater than that in the UW group (P< 0.05); after 12 hours of preservation, amount of malonaldehyde in the UW group was evidently increased than that in the PV group (P < 0.05); after 18 hours of preservation, bile secretion in the PV group was lower than that in the UW group (P < 0.05); morphological changes of hepatic cells were similar in the two groups under the optical and electron microscope. The results demonstrated that PV solution and UW solution have a similar effect on protecting Wistar rat's liver function, and PV solution is superior to UW solution in antioxidation and scavenging oxygen free radicals.
ABSTRACT
Objective To research the angiographic manifestations of rabbit implanted VX_2 liver carcinoma.Methods 34 New Zealand big white rabbit were implanted VX_2 tumor pieces under orthophoria into liver left middle segment.Angiography of coeliac artery-hepatic artery catheterization via right femoral artery was performed at the third week after inoculation.Results The tumor blood vessel and tumor stain in 6 rabbit could be not showed clearly by digital cinematography mode but which could be showed in 28 rabbit by digital subtraction mode.The tumor angiographic signs included:dilating growth of tumor,the feeding arteria surrounding the tumor surface were resemblance to the clenched fist,embraced globosity and wreath in form;many slender vessels from feeding arteria appeared as small bud form,root form and filose form pushed forward to the center from the surface of tumor.The tumor vascular density in periphery was higher than that in center and formed circular or oval tumor stain which more denser at periphery than center.The tumor node stain was complete with definite margin when tumor size was large or equal to 1 cm in diameter,and the tumor stain appeared as clump with indefinit margin.Conclusion There are abundant vascularity for rabbit implanted liver VX_2 tumor,and more abundant at periphery part than center part, coeliac artery catheterization angiography can show the typical manifestations of tumor clearly.
ABSTRACT
Objective To research the angiographic anatomy of celiac artery in rabbit.Methods 36 New Zealand big white rabbitswere included in this study,the angiography of celiac artery and hepatic artery via right femoral artery was performed,and the branchand diameter of celiac artery system were analysed.Results 66.7% of the celiac arterial opening localized at the level of T_(12) vertebral body low edge,gastrohepatic arterial truncus could been divided into three types : type Ⅰ(47.22%),tree-like branch;type Ⅱ(38.88%),trifurcate branch and type Ⅲ(13.90%),dichotomy branch.The length of proper hepatic artery was from 22.70 to 33.00 mm(26.64 mm?2.28 mm),the inner diameter of proper hepatic artery,left hepatic artery and right hepatic arteria was 0.60~1.20 mm(0.90 mm?0.16 mm),0.60~1.10 mm(0.72 mm?0.09 mm) and 0.50~1.00 mm(0.67 mm?0.09 mm) respectively.The segmental artery of liver could be displaied clearly by proper hepatic artery angiography.Conclusion To realize the angiographic anatomy of rabbit celiac artery would provide a useful help for transhepatic arterial interventional treatment of the liver VX_2 tumor model of rabbit.