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@#Objective To compare clinical effects of enlarged thymectomy for the treatment of myasthenia gravis (MG) complicated with thymoma via subxiphoid and subcostal arch thoracoscopic resection versus median sternotomy resection. Methods We retrospectively analyzed the clinical data of patients with MG complicated with thymoma admitted in Tangdu Hospital of the Air Force Military Medical University between December 2011 and December 2021. Patients who underwent subxiphoid and subcostal arch thoracoscopic enlarged thymectomy were allocated to a SR group, and patients who underwent median sternotomy enlarged thymectomy were allocated to a MR group. Perioperative outcomes were compared between the two groups. Results A total of 456 patients were collected. There were 51 patients in the MR group, including 30 males and 21 females aged 23-66 (49.5±11.8) years. There were 405 patients in the SR group, among whom 51 patients were matched to the MR group by propensity score matching, including 28 males and 23 females aged 26-70 (47.2±12.2) years. The operations were accomplished successfully in all patients, and no conversion to thoracotomy occurred in the SR group. The SR group had advantages in the operation time, intraoperative blood loss, chest drainage duration, hospital stay time, patients’ satisfaction level, pain score and complications (all P<0.05). No statistical difference was found in the number of intraoperative lymph node dissection stations, number of intraoperative lymph nodes dissected or remission of MG between the two groups (P>0.05). Conclusion Subxiphoid and subcostal arch thoracoscopic enlarged thymectomy and lymphadenectomy is a safe, effective and feasible minimally invasive procedure for the treatment of MG complicated with thymoma.
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@#Objective To compare clinical effects of extended thymectomy for the treatment of thymic abnormalities with myasthenia gravis (MG) between subxiphoid and subcostal arch thoracoscopic resection (SR) and the unilateral thoracoscopic resection (UR) by a propensity-score matching analysis. Methods We retrospectively analyzed the clinical data of 612 patients who presented with MG and were admitted to Tangdu Hospital of Air Force Military Medical University between December 2011 and December 2018. Of these patients, 520 patients underwent subxiphoid and subcostal arch thoracoscopic extended thymectomy (a SR group) and 92 unilateral thoracoscopic extended thymectomy (a UR group). Ninety-two patients in the SR group were matched with the UR group by propensity-score matching analysis. There were 52 males and 40 females with an average age of 26-70 (50.2±10.3) years in the SR group, and 47 males and 45 females with an average age of 20-73 (51.5±12.1) years in the UR group. The operation time, intraoperative blood loss, thoracic drainage time, postoperative hospital stay, thorough adipose tissue removal, postoperative remission of MG, patients’ satisfaction score, pain and complications were compared and analyzed between the two groups. Results All operations were accomplished successfully, without conversion to thoracotomy of the two groups. There were statistical differences between the two groups in operation time (46.2±19.5 min vs. 53.4±23.5 min), chest drainage duration (0 d vs. 3.4±1.2 d), hospital stay (2.9±1.9 d vs. 3.6±1.7 d), patients’ satisfaction score (7.9±2.1 points vs. 6.7±1.2 points) and pain scores (all P<0.05). There were no statistical differences between the two groups in intraoperative blood loss (52.2±12.7 mL vs. 51.2±10.3 mL), peripheral adipose tissue removal (8.1±0.6 vs. 7.9±0.9), remission rate of MG (89.1% vs. 85.9%) and rate of postoperative complications (10.9% vs. 6.5%) (all P>0.05). Conclusion Subxiphoid and subcostal arch thoracoscopic extended thymectomy is a safe and feasible minimally invasive procedure for the management of MG with thymic abnormalities.
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OBJECTIVE@#To evaluate the clinical efficacy of weight management combined with pharyngoplasty for treatment of obesity-related obstructive sleep apnea-hypopnea syndrome (OSAHS).@*METHODS@#Sixty obese patients with OSAHS were randomly assigned into the combined treatment group and control group (@*RESULTS@#After 6 months of treatment, the patients receiving the combined treatment showed significant reductions of BMI, neck circumference and waist circumference as compared with the measurements before treatment and with those in the control group (@*CONCLUSIONS@#Weight management combined with uvulopalatopharyngoplasty can produce a good clinical efficacy for treatment of OSAHS with obesity, and the patients should have strengthened continuous family weight management while receiving surgical treatment.
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Humans , Body Mass Index , Obesity/surgery , Plastic Surgery Procedures , Sleep Apnea, Obstructive/surgery , Waist CircumferenceABSTRACT
Objective:To investigate the protective effect of Yiqi Huazhi recipe Quqian granules on rat renal tubular cell apoptosis induced by lead poisoning. Methods:Totally 60 Wistar rats were divided into 2 groups, 12 in the control group and the others in the model group. Chronic lead poisoning model was made by drinking 0. 02% lead acetate water for 60 days. Then the lead poisoning rats were randomly divided into four groups, high-dose Quqian granules group (3. 0 g·kg-1·d-1), low-dose Quqian granules group (0. 6 g·kg-1 ·d-1 ) , positive control group ( calcium disodium edentate plus procaine, im, 50 mg·kg-1 ·d-1 ) and model group. Seven treatment courses were carried out in the first three groups with every 4-d as one course and 4-d withdrawal period between every two courses. After 60 days, the change of lead in blood and kidney was observed by atomic absorption spectrometry,the apoptosis of kidney tissues was studied by TUNEL, the expression of Bcl-2 protein was detected by immunohistochemical methods and the expression of p53 was studied by Western Blotting. Results:Compared with the control group, the body weight, hemoglobin and the expression of Bcl-2 in the model group were decreased significantly(P<0.01)those in, and Pb in blood(0.990 ±0.443)μg·ml-1, Pb in kidney(51.33 ± 5. 16)μg·ml-1 , the apoptosis of tubular epithelial cell(4. 148 ± 0. 414) and the expression of p53 protein (1. 868 ± 0. 139) were significantly higher (P<0. 05). Compared with the those in model group, the body weight, hemoglobin and Bcl-2 in high-dose group were increased significantly(P<0.01), and the blood lead level (0.082 ±0.015)μg·ml-1, the kidney lead level (6.38 ±0.97)μg ·ml-1 , the apoptosis of tubular epithelial cell(1. 412 ± 0. 109) and p53 protein expression(1. 164 ± 0. 172) were significantly lower (P<0. 05). Conclusion:Lead may induce high expression of p53,low expression of Bcl-2 and promote the apoptosis of renal tubular epithelial cells. It is proven that Yiqi Huazhi recipe Quqian granules can inhibit the expression increase of p53 and the expression de-crease of Bcl-2 resulting in the reduction of the renal tubular apoptosis to allivate the renal injury caused by lead.
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Glycoprotein (GP) Ibα ectodomain shedding has important implications for thrombosis and hemostasis. A disintegrin and metalloproteinase 17 (ADAM17) was identified to play an essential role in agonist induced GPIbα shedding. The relationship of GPIbα shedding and ADAM17 in the acute stage of atherosclerotic ischemic stroke (AIS) patients has not been thoroughly studied. A total of 306 patients and 230 controls matched for age, sex, race, history of hypertension and diabetes mellitus were enrolled in the study. GPIbα, ADAM17, glycocalicin were detected by flow cytometry, Western blotting, and enzyme-linked immunosorbent assay (ELISA) respectively. Compared with the control group, the expression of GPIbα in patients with acute ischemic stroke was significantly lower (P=0.000, P<0.01). Plasma glycocalicin and ADAM17 in AIS group were higher than those in control group (P=0.699, P=0.000). Pearson's analysis showed glycocalicin bore no correlation with GPIbα in AIS patients (r=0.095, P>0.05). GPIbα and National Institute of Health Stroke Scale (NIHSS) had negative correlation (r=-0.514, P<0.01). Our findings indicate that ADAM17 may be a risk factor for ischemic stroke in Chinese and the expression of GPIbα can serve as a measure for stroke severity.
Subject(s)
Female , Humans , Male , Middle Aged , ADAM Proteins , Blood , ADAM17 Protein , Biomarkers , Blood , Blood Platelets , Metabolism , Brain Ischemia , Blood , Diagnosis , China , Intracranial Arteriosclerosis , Blood , Diagnosis , Platelet Glycoprotein GPIb-IX Complex , Metabolism , Reproducibility of Results , Sensitivity and Specificity , Severity of Illness Index , Stroke , Blood , DiagnosisABSTRACT
Glycoprotein (GP) Ibα ectodomain shedding has important implications for thrombosis and hemostasis. A disintegrin and metalloproteinase 17 (ADAM17) was identified to play an essential role in agonist induced GPIbα shedding. The relationship of GPIbα shedding and ADAM17 in the acute stage of atherosclerotic ischemic stroke (AIS) patients has not been thoroughly studied. A total of 306 patients and 230 controls matched for age, sex, race, history of hypertension and diabetes mellitus were enrolled in the study. GPIbα, ADAM17, glycocalicin were detected by flow cytometry, Western blotting, and enzyme-linked immunosorbent assay (ELISA) respectively. Compared with the control group, the expression of GPIbα in patients with acute ischemic stroke was significantly lower (P=0.000, P0.05). GPIbα and National Institute of Health Stroke Scale (NIHSS) had negative correlation (r=-0.514, P<0.01). Our findings indicate that ADAM17 may be a risk factor for ischemic stroke in Chinese and the expression of GPIbα can serve as a measure for stroke severity.
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Objective To explore the embolization effect of new platinum coils coated with [4COOH-P (DLLA-co-TMC)] biodegradable polymer and released vascular endothelial growth factor (VEGF) into intracranial aneurysms on rat intracranial aneurysms. Methods A total of 54 adult healthy female SD rats were randomly divided into Group Ⅰ with general platinum coils, Group Ⅱ with polymer-coated platinum coils and Group Ⅲ with platinum coils modified with VEGF (n=18).The right common carotid arteries (CCA) of rats in each group were exposed; and the 8 mm lengths of platinum coil segments were inserted into the ligated right CCA of rats. The distal right CCA was performed ligation and restored the blood flow; 6 rats each time at 15,30 and 90 d after the surgery were chosen;and the distal right CCA was used as aneurysm models,and the left CCA without the coil placement or surgical disruption in Group I with general platinum coil was chosen as normal control.The proliferation and fibrosis of endothelial cells were observed by HE staining; von Willebrand Factor (vWF) expression was detected by immunohistochemical staining; and VEGF expression was examined by Western blotting. Results Cellular proliferation and fibrosis in Group Ⅲ with platinum coils modified with VEGF enjoyed significantly higher grade than those in Group Ⅰ with general platinum coils 10,60 and 90d after the surgery (P＜0.05); Cellular proliferation and fibrosis in Group Ⅲ with platinum coils modified with VEGF enjoyed significantly higher grades than those in Group Ⅱ with polymer-coated platinum coils 30 d after the surgery (P＜0.05).Pathological observations showed that the massive intimal hyperplasia and substantial clot completely occluded the aneurysm lumen in Group Ⅲ with platinum coils modified with VEGF; New small blood vessels having vwf-positive expression were noted in the fiberized tissues;the thrombosis in Group Ⅰ with general platinum coils and Group Ⅱ with polymer-coat platinum coils were not fully organized and showed loose hyperplasia structure with a large number of internal spaces.Western blotting indicated that the VEGF level in Group Ⅲ with platinum coils modified with VEGF were significantly higher than that in other groups 15 and 30 d after the operation,however,the VEGF level in Group Ⅲ with platinum coils modified with VEGF 90 d after the surgery was decreased because the lumen completed fibration and degradation of 4COOH-P (DLLA-co-TMC). Conclusion The VEGF-eontaining biodegradable polymer,by slowly releasing VEGF to modify the surface of platinum coils, could enhance the cellular proliferation, thrombosis and formation of dense fibrous tissue in aneurysm lumen; as compared with general platinum coils,these new platinum coils could occlude the rat aneurysm faster and more completely.
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Objective To investigate the effect of collagen scaffold loaded with collagen-binding domain neurotrophin-3 (CBD-NT3) on the extension of cellular processes of dorsal root ganglions (DRGs), and explore the significance of this kind of combinatorial strategies in the spinal cord injury repair. Methods The tail tendons of SD neonatal rats were performed the removal of cellular components to prepare the collagen scaffold; HE staining was employed to evaluate whether the cells were completely removed from the collagen scaffold. The collagen scaffold was loaded with CBD-NT3,and then, they were co-cultured with primary DRGs for 1, 3 and 5 d, respectively. NT3 and PBS were also co-cultured with primary DRGs for 1, 3 and 5 d, respectively, as controls. Cells on the scaffold were stained by fluorescein diacetate (FDA) for morphology observation and the lengths and angles of the processes in each group were also quantitatively analyzed. Scanning electron microcopy (SEM) was employed to observe the topography of scaffold and the ultrastructure of DRGs 3 d after the co-culture.Results HE staining indicated that the cellular components in the scaffold were removed completely.The length of processes elongation in CBD-NT3 treatment group was significantly longer than that in the controls 3 d after the co-culture (P＜0.05). The 95% confidence interval of the angle between the line which the process emerged from the cell soma to the growing tip of the process and the long axis of fiber was 18.8-20.7 degrees. The results of SEM showed that cells could rely on the topography of the scaffold to anchor and grow. Conclusion The combinatorial strategies of collagen scaffold with CBD-NT3 can play a double function for oriented guiding and inducing extension of cellular processes effectively,which may provide a better therapeutic approach for spinal cord injury repair.
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Objective To explore the clinical factors affecting the prognosis of craniocerebral traffic injuries to provide scientific evidence for ameliorating the prognosis. Methods We retrospectively analyzed the clinical data of 652 patients treated in our hospital for serious injuries in car accidents (Glascow Coma score [GCS] 3～8) between February, 1998 and February, 2008. According to the Glasgow Outcome Scale (GOS) three months after injury, patients were divided into good prognosis and poor prognosis groups. Their gender, age, type of brain injury, admission time, pupil status, blood oxygen saturation, systolic blood pressure, level of blood sugar, Injury Severity Score (ISS) and GCS were compared. Results As compared with the good prognosis group, the poor prognosis group showed a significant low level of blood oxygen saturation and systolic blood pressure, low GCS and pupils status score (P<0.05);it showed a long admission time, a significant high level of blood sugar and high ISS (P<0.05). Bad prognosis appeared in intracranial hematoma, contusion and laceration of the brain. And the level of blood sugar and oxygen, GCS and ISS were the independent factors affected the prognosis. Conclusion The level of oxygen saturation and blood sugar, ISS and GCS can help to evaluate the prognosis of patients with severe brain injury, effectively.
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Objective To evaluate the anti-angiogenic effect of eukaryotic vector containing human VEGF 165 and truncated pseudomonas exotoxin A (PE38) fusion gene on malignant glioma in nude mice, and explore a novel anti-angiogenic therapy for cancer. Methods The models were established through hypodermic injection of human U251 glioma cells into the nude mice and randomly divided into untreated group, PBS group, pIRES2-EGFP group and pIRES2-VEGF165-PE38-EGFP group on the 9th day. H&E staining was performed to observe the morphological changes of the glioma tissues; SP immunohistochemistry was employed to detect the expression of GFAP, CD31 andPE; quantitative pathologic image analysis system was used to investigate the microvessel density (MVD) in the tumor tissues. Results At day 16, the pIRES2-VEGF165PE38-EGFP group showed significantly lower tumor volume of mice and significantly decreased MVD than the other three groups (P<0.05). Positive expression of PE was shown in the pIRES2-VEGF165PE38-EGFP group, but negative in the other three groups. Conclusion The expression products of VEGFJ65-PE38 fusion gene can obviously inhibit the growth and angiogenesis of U2S1 cells in nude mouse flank tumor models, suggesting that it may be a novel therapeutic approach for anti-angiogenic therapy of cancer.
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Objective To construct an aneurismal model with estrogen deficiency and investigate the mechanism of estrogen deficiency in the formation and development of intracranial aneurysm. Methods Female Wistar rats were randomly divided into experimental, sham-operative and blank control groups (n=10). Rats in the experimental group were ovariectomized and those in the sham-operative group were removed the adipose issue nearby the ovary only; while the rats in the blank control group were done nothing. Two weeks after the ovariectomized or sham operation, elastase dropped around the right external carotid artery and the crotch of the carotid artery and the carotid artery was ligated by two lines at 1.5 mm far from the crotch, and then sheared between the two lines to successfully induce the aneurysm. At 6 weeks of the successful construction of aneurysm model, the estrogen was detected and the aneurysm was harvested for pathological staining. Results The experimental group showed a lower estrogen level (105.00±12.96 pmol/L) than the sham-operative group (178.50±25.96 pmol/L) and the blank control group (180.40±18.70 pmol/L, P<0.05). Aneurismal length dilatation rates in the experimental group and the sham-operative group were (131.31±6.63)% and (109.90±3.44) %, respectively (P<0.05). Aneurismal diameter dilatation rates in the experimental group and sham-operative group were (125.10±5.49) % and (106.82±2.49) %, respectively (P<0.05). Conclusion Estrogen deficiency may promote the formation and development of the intracranial aneurysm. This experiment provides a simple model for investigating the relationship between estrogen deficiency and aneurysm development.
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Objecfive To establish a method for in vitro culture and identification of neural stem cells(NSCs)derived from the olfactory bulb(OB)of adult mice and test the possibility of the OB as a new source of seed cells of adult NSCs. Methads NSCs were isolated from the OB of adult mice and cultured in serum-free medium.Clonal culture and BrdU incorporation assay were performed to assess the self-renewal and proliferative activities of the NSCs.Fluorescence immunocytochemistry was carried out to examine the expression of the NSC markers nestin and SOX2,neuronal marker Tujl,astrocyte marker GFAP and oligodendroeyte marker 04. Results NSCs possessing self-renewal and proliferative capacities were obtained from the OB of adult mice,and the cells grew in the form of floating neurospheres in the medium.The neurospheres consisted of cells were positive for NSC markers nestin and SOX2,which Were able to differentiate into Tuj1-positive neurons,GFAP-positive astrocytes and 04-positive oligodendrocytes. Conclusion NSCs are present in the OB of adult mice,and the NSCs isolated from the OB can proliferate and differentiate in vitro with obvious stem cell properties.suggesting the feasibility of using OB as anew source of adult NSCs.
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Objective To observe the tropism ofboue marrow stromal stem cells for malignantglioma in rats. Methods The immunophenotype of in vitro cultureA Fisher344 rat BMSCs wereidentified using flow cytometry. The BMSCs or NIH3T3 cells were cocultured with 9L glioma cells in aTranswell system, and 24 h later, the cell migration rate was calculated. For in vivo experiment, aFisber344 rat model bearing malignant glioma was established by stereotactic injection of 9L glioma cellsinto the brain. After validation of the model 2 weeks after the injection by neurobehavioral test, magneticresonance imaging and HE staining, the BMSCs or NIH3T3 cells were transplanted via the internalcarotid artery in the rats. Two weeks after the transplantation, the rats were sacrificed by routine cardiacperfusion, and BMSCs migration in the brain was detected immunohistochemically. Results Thethird to six passages of the BMSCs were negative for CD34 and CD45 but positive for CD29 and CD44.Transwell assay demonstrated BMSCs tropism for 9L cells in vitro. In Fisher344 rats bearing 9L glioma,neurobehavioral changes characteristic of glioma were observed, and the BMSCs transplanted via theinternal carotid artery were found to migrate to the glioma tissue, residing mostly on the boundarybetween the normal tissue and the tumor tissue. Conclusion Rat BMSCs show a tropism formalignant glioma both in vitro and in vivo, and administration via the internal carotid artery can be aneasy and effective means for BMSCs transplant.
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OBJECTIVE: A series of recent studies have demonstrated the mechanism of migration and nerve net of neural stem cells. These theories have further substantiated neural stem cell transplantation. In view of these new findings, this paper reviewed the mode of migration and information of network. The significance of these theories was discussed.DATA SOURCE: We search on Pubmed with the key words "neural stem cell", "migration", and "nerve net", limiting the language to English and publication date from 1970 to 2004. At the same time we searched on CNKI.STUDY SELECTION: We selected the randomized and non-randomized controlled studies related to migration and nerve net building of neural stem cells. Review articles and articles with repetitive studies were excluded.DATA EXTRACTION: Among 39 papers selected, 16 papers concerning the development of this topic were selected, and the others were excluded.DATA SYNTHESIS: For retrograde lesions and severe injury of nervous system, transplantation of nerve stem cells may replace aging degenerative and dead nerve cells and rebuild neural network for the recovery of cerebral function. Migration of nerve cell and network principle can solve the survival, differentiation, migration and creation of nerve network after transplantation of nerve stem cells so as to realize the recovery and reconstruction of cerebral function.CONCLUSION: Neural stem cells can migrate to intended places and can build nerve net under some conditions, which will be useful for medicine deyelopment.
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By applying the methods of inter—element meter andmean line,decoction solution of 110 recipes were anal-ysed for the characteristics of distribution of inorganicelements.In those recipes containing more warm-heat drugs,the contents of most elements were higherthan the line of average value,while those with morecool—cold drugs,lower than the mean line,suggest-ing that the distribution value of inorganic elementsmay be a determining factor responsible for the cold-heat quality of a recipe.