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Objective To explore the effect of sorafenib on HeLa cell proliferation by inducing cell apoptosis and autophagy and its impact on drug resistance.Methods The drug-resistant cell strains were constructed through in-termittent induction method,with concentrations of 0,2.5,5.0,7.5,10.0,15.0,20.0 μmol/L.HeLa cells were incubated with increasing concentrations of sorafenib with each concentration for 1 week.The drug-resistant cell strains with stable passages were collected.MTT assay was used to detect the effect of sorafenib on cell prolifer-ation.Cell cycle distribution was analyzed by flow cytometry.The change in the expression of drug-resistant and ap-optotic genes in the parents and drug-resistant cell strains under different drug concentrations was examined by semi-quantitative PCR.The changes of apoptotic related marker proteins LC3-Ⅰ and LC3-Ⅱ were detected by Westernblot.Results Stable drug-resistant strains were successfully obtained;Drug-treated cells were more blocked in the G1 phase.In drug-resistant cells,the expression of apoptosis suppressor gene Bcl-2 was significantly decreased and the apoptotic gene Bax as well as the drug-resistant genes were all significantly increased(P＜0.05).The LC3-Ⅱ/LC3-Ⅰ ratio of drug-resistant cells was significantly higher than that of parent cells(P＜0.05).Conclusions Sorafenib may block the cell cycle,suppress malignant cell proliferation and promote autophage.On one hand,autophagy participates in the development of cell drug resistance and promotes cell survival.On the other hand,drug-induced autophagy may activate some of apoptotic signaling pathway in drug-resistant cells and promote the reversal of cell drug resistance.
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Objective To explore the relationship between serum miRNA-21 and miR-27b levels and prognosis of patients with renal clear cell carcinoma.Methods A total of 118 patients with renal clear cell carcinoma admitted to the Qinghai University Hospital from February 2019 to April 2021 were selected as the study subjects,and another 118 healthy patients in the same period as the control group.Real time fluorescence quantitative polymerase chain reaction(PCR)was used to detect the expression of miR-21 and miR-27b in the serum of all subjects.The relative expression levels of serum miR-21 and miR-27b between the patients with renal clear cell carcinoma and healthy control patients were compared.The expression and correlation of serum miR-21 and miR-27b in the patients with renal clear cell carcinoma of different pathological stages and Fuhrman grading were analyzed.The relationship between the expression of serum miR-21 and miR-27b and the survival and prognosis of the patients was explored as well.Results The expression levels of serum miR-21 and miR-27b in the patients with renal clear cell carcinoma were higher than those in the healthy control group(P＜0.05).The serum miR-21 expression level in stage Ⅲ patients was higher than in stageⅠ(P＜0.05),while the serum miR-21 expression level in the stage Ⅳ patients was higher than that in stagesⅠ,Ⅱ,and Ⅲ(P＜0.05).The expression level of miR-27b in the serum of patients gradually increased across the four stages,with a significant difference(P＜0.05).The pathological staging was positively correlated with the expression of miR-21 and miR-27b(P＜0.001).The expression levels of miR-21 and miR-27b in serum of patients gradually increased across grades Ⅰ,Ⅱ and Ⅲ by Fuhrman grading,with significant difference(P＜0.05).Fuhrman grading was positively correlated with the serum miR-21 and miR-27b expression(P＜0.001).There was a statistically significant difference in the survival curve between the miR-21 high expression group and the low expression group(P＜0.05).There was a statistically significant difference in the survival curve between the high expression group and the low expression group of miR-27b(P＜0.05).Conclusion The expression levels of serum miR-21 and miR-27b in patients with renal clear cell carcinoma is indicative of the progression and prognosis of the patient's condition.
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Objective:To systematically evaluate the risk factors of implantable venous access port-related bloodstream infections and provide basis for prevention of catheter-related bloodstream infection in tumor patients.Methods:The Cochrane Library, PubMed, EMBASE, Web of science, CNKI, Wanfang database, VIP database, CBM, Chinese and English Clinical trials Registry (ChiCTR) were searched to collect the literature on risk factors for implantable venous access port-related bloodstream infections in tumor patients from the establishment of the database to April 2022. Two evaluators independently screened and extracted the obtained literature according to the inclusion and exclusion criteria, and used the Newcastle-Ottawa Scale for quality evaluation. Meta-analysis was conducted by RevMan 5.3 software and Stata SE/MP(14.0 version).Results:A total of 13 studies were included, including 23 related risk factors. Among them, prolonged use of catheters, palliative treatment, hematological tumors, neutropenia, hospitalized patients, and chemotherapy were risk factors for implantable venous access port-related bloodstream infections in tumor patients, with statistically significant differences ( OR values ranging from 0.26 to 8.77, all P<0.05). Conclusions:The long time of catheter use, palliative treatment, hematological tumor, neutropenia and chemotherapy were the risk factors of implantable venous access port-related bloodstream infection in patients with tumor, Medical personnel should make a good assessment and strengthen health education to minimize the chances of infection and effectively reduce the incidence of infection related to the infusion port.
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Objective:To prepare a recombinant hemagglutinin trimer (HA-Tri) vaccine against influenza viruses and to study its immunogenicity in a mouse model.Methods:A stable CHO cell line that could express HA-Tri was constructed. Western blot, single radial immunodiffusion, protein particle size detection and N-glycosylation site analysis were performed for qualitative and quantitative analysis of the recombinant protein. According to the different treatment conditions such as dosage and adjuvant, BALB/c mice were divided into 11 groups and subjected to consistent immunization procedures. Serum neutralizing antibody titers were measured on 56 d after the first immunization to evaluate the immunogenicity of HA-Tri.Results:The constructed CHO cells could secret and express HA-Tri proteins. The HA-Tri proteins were biologically active and capable of forming precipitation rings in the single radial immunodiffusion. The particle size of HA-Tri was approximately 18.79 nm and 10 N-glycosylation sites were detected, including high mannose, complex glycoforms and heterozygous glycoforms. After prime-boost immunization, there was no statistically significant difference in the titers of neutralizing antibodies induced in mice by 3.75 μg of HA-Tri in combination with RFH01 adjuvant and 15 μg of monovalent vaccine stock solution ( P=0.431 2, U=36). Serum antibody titers in the HA-Tri+ RFH01 groups were higher than those in the corresponding HA-Tri groups without RFH01 adjuvant, and the highest titer was induced in the 15 μg HA-Tri+ RFH01 group, which was 1 280. Conclusions:The recombinant HA-Tri protein was successfully prepared. HA-Tri in combination with RFH01 adjuvant could induce humoral immune responses against influenza viruses in BALB/c mice, which would provide reference for the development of influenza virus recombinant subunit vaccines.
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Objective:To evaluate the immunogenicity of a quadrivalent subunit vaccine combined with RFH01 adjuvant in a mouse model.Methods:Identification tests were performed on four monovalent influenza virus subunit vaccine stock solutions according to the methods described in Part 3 of the Chinese Pharmacopoeia 2020 Edition. In the study of the quadrivalent subunit vaccine combined with RFH01 adjuvant, 460 female BALB/c mice (6-8 weeks old) were randomly divided into 46 groups including experimental groups, vaccine control group, negative control group and blank group with 10 mice in each group. In the study of the quadrivalent subunit vaccine in old and young mice, 80 female 10-month-old and 80 female 10-week-old BALB/c mice were randomly divided into 16 groups ( n=10) including monovalent influenza virus vaccine group, quadrivalent subunit vaccine group, quadrivalent subunit vaccine+ RFH01 adjuvant group, chicken embryo quadrivalent split vaccine control group and PBS group. All mice were immunized by intramuscular injection. At 21 d after the primary immunization, a booster immunization was conducted using the same strategy. Blood samples were collected at 21 d and 42 d after the primary immunization for serum separation. Haemagglutination inhibition (HI) test was performed to detect the antibody levels in mouse serum samples. Results:After the booster immunization, the positive conversion rates in all vaccine+ RFH01 adjuvant groups reached 100%, and the geometric mean titers (GMTs) of serum antibodies were significantly higher than those of the vaccine groups without RFH01 adjuvant. There were significant differences in serum antibody titers between the monovalent/quadrivalent subunit vaccine groups with and without RFH01 adjuvant. After the booster immunization, the titers of serum antibodies against H1N1, H3N2, B/Victoria and B/Yamagata in the 10-week-old mice were significantly higher than those in the 10-month-old mice.Conclusions:The monovalent and quadrivalent influenza virus vaccines in combination with RFH01 adjuvant could elicit higher antibody titers in young (6-10 weeks old) and old (10 months old) mice, showing good immunogenicity.
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【Objective】 To reduce the incidence of postoperative intestinal obstruction, we tried to improve surgical techniques by closing the cavity formed during radical cystectomy + ileal passage (Bricker) via laparoscopy to prevent the formation of abdominal hernia. 【Methods】 During Oct.2018 and Feb.2022, 41 patients were involved (conventional group). After standard laparoscopic radical cystectomy + pelvic lymphadenectomy, the ileum channel was established. The right medial retroperitoneum was sutured to cover the mesothelium and end of the ileum channel under open operation or endoscope. The space between the ureter and mesothelium of the ileum channel was sealed, and the end of the ileum channel and both ureters were externalized. During Feb.2022 and Dec.2022, 15 patients were involved (modified group). The right inner and outer lateral peritoneums below the ileal conduit were sutured to "bottom out" the gap between the ileal conduit and the right abdominal wall in addition to standard procedures. The recovery of intestinal function and incidence of bowel obstruction were compared between the two groups. 【Results】 In the conventional group, the intestinal function recovered within 2 to 6 days after surgery, with a median ventilation time of 3 days. Intestinal obstruction occurred in 3 patients, 2 of whom improved after conservative treatment while 1 underwent surgical exploration after ineffective conservative therapy. There were no significant differences in the time of discharge and ventilation between the two groups, but no intestinal obstruction occurred in the modified group. 【Conclusion】 Peritoneal externalization at the end of ileal passage can reduce the incidence of intra-abdominal hernia and postoperative intestinal obstruction, which is worthy of clinical application.
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Acute radiation dermatitis (ARD) is one of the most common toxicities of radiotherapy. Currently, there is still no standardised protocol and guideline on the prevention and treatment of ARD. Photobiomodulation therapy (PBMT) has the functions of stimulating wound healing, reducing inflammatory reaction and mitigating pain, etc. Consequently, recent research progress at home and abroad in the application of PBMT for the prevention and treatment of acute radiation skin reactions was reviewed, aiming to provide reference for clinical application of PBMT in radiation protection.
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Chronic kidney disease (CKD) is a serious health problem worldwide, whereas there is still no efficient cure. The gut microbiota plays a crucial role in maintaining human health and disease resistance, and multiple studies have confirmed that the gut microbiota is closely related to the occurrence and development of CKD. Starting from the "gut-kidney axis" theory, this article provides a systematic review of the changes in gut microbiota composition and function in patients with CKD, such as a decrease in the abundance of butyrate-producing bacteria Roseburia and Faecalibacterium prausnitzii. Besides that, the article explores the mechanisms by which the gut microbiota affects CKD progression, such as inflammation and immunity, and also describes the application methods of using the gut microbiota as a therapeutic target for CKD, such as fecal microbiota transplantation, microecologics, and dietary therapy, in order to provide microbial- based targets for the clinical diagnosis and treatment of CKD.
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The main function of vitamin D is to regulate calcium homeostasis and bone metabolism, but in recent years, it has also been confirmed that it can participate in mitochondrial metabolism and autophagy, and further affect skeletal muscle cells, liver cells, nerve cells, etc. This article mainly discusses the effect of vitamin D on diabetic neuropathy by improving mitochondrial function and regulating autophagy, so as to provide a theoretical basis for the clinical application of vitamin D.
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Objective @#To explore the characteristics of impaired attention network function in chronic insomnia pa- tients．@*Methods @#Polysomnography ( PSG) ，sleep scale ，attention network test ( ANT) and neuropsychological cognitive scale were used to evaluate the sleep quality，attention network function and cognitive function of 73 pa- tients with chronic insomnia and 65 healthy subjects.@*Results @#Compared with normal control group，the scores of pittsburgh sleep quality index(PSQI) and insomnia severity index (ISI) in the chronic insomnia group increased， total sleep time reduced，sleep latency prolonged，sleep efficiency decreased，wake after sleep onset and arousal index increased，the proportion of non-rapid eye movement sleep stage 1 increased，the proportion of non-rapid eye movement sleep 3 and the proportion of rapid eye movement sleep decreased，and differences were statistically sig- nificant (all P＜0．05) ．In the attention network test，the efficiency of executive control network decreased in the chronic insomnia group，and the difference was statistically significant (all P＜0. 05) ．In neuropsychological tests， patients in the chronic insomnia group had spent more time on the Stroop color word test-word and trail making test- B．Correlation analysis showed that executive control function was associated with decreased non-rapid eye move- ment sleep stage 3 andincreased PSQI scores in chronic insomnia group．@*Conclusion @#Chronic insomnia patients have a certain degree of cognitive impairment，mainly executive control network impairment，which is associated with slow-wave sleep reduction.
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Osteoporosis is one of the common complications of type 2 diabetes mellitus (T2DM). Recent studies have shown that glucagon-like peptide-1 receptor agonists (GLP-1RAs) can promote bone formation and inhibit bone resorption, suggesting that this hypoglycemic drugs may benefit T2DM patients with osteoporosis and high fracture risk, but its underlying mechanism is not fully understood, and different GLP-1RAs exhibit different skeletal effects and molecular mechanisms. In this paper, the effects of several GLP-1RAs on bone metabolism are reviewed.
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@#Atrial fibrillation (AF) is the most common type of cardiac arrhythmia. The metabolic changes of atrial myocytes, especially lipid metabolism, have a significant impact on the electrical signals and structural remodeling of atrial tissue, and play an important role in the occurrence and development of AF. The reduction of fatty acid oxidation ratio and increased aerobic glycolysis ratio are characteristic changes of tissue metabolic remodeling in AF. In this review, we will introduce the latest research status of lipid metabolism in AF from aspects of AF metabolism, clinical treatment and diagnosis and prognosis.
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Moschus chrysogaster (sifanicus) viral hemorrhagic disease (McVHD) is an acute and highly lethal infectious disease caused by Moschus chrysogaster hemorrhagic disease virus (McHDV) whose genome sequence is highly homologous with rabbit hemorrhagic disease virus. To screen the protective antigen of McHDV and set the basis for study of McVHD vaccine, the antigen epitope of major structural protein VP60 of McHDV was analyzed, and the specific primers were designed to obtain three amplified DNA sequences encoding the main antigen epitope of VP60 from McHDV by using RT-PCR. Then the three DNA fragments were sequenced and cloned to prokaryotic expression vector with pET-28a(+) by using overlap extension PCR, and finally the prokaryotic expression plasmid pET-truncated-VP60 was constructed. Subsequently, the pET-truncated-VP60 was transformed into Escherichia coli BL21(DE3), and the recombinant proteins were expressed by IPTG induction. Finally, the expressed protein was purified and applied to immunize that without immunizing with RHD vaccine, then the antiserum titers were evaluated by the hemagglutination inhibition test, and the immune-protective efficacy of the recombinant proteins was observed and analyzed through animal challenge test. The results showed that the multi-epitope DNA fragments of VP60 of McHDV was successfully expressed in the form of inclusion bodies in E. coli, and the relative molecular weight of recombinant proteins is about 45 kDa. After immunized with the recombinant proteins, 100% of New Zealand white rabbits were resistant to attack of McHDV, which indicates efficient immune-protective efficacy of chosen epitope recombinant protein. The study laid a foundation for the development of the new subunit vaccines of McVHD.
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Objective@#To explore the efficacy of thematic health education on breast cancer patients with whole course of disease management.@*Methods@#According to the order of admission into the hospital, 100 breast cancer patients were randomly divided into two groups: the control group and the observation group. In the control group, clinical nursing pathway was adopted when health education was conducted. In the observation group, thematic health education based on the whole course of disease management was carried out. Mastery of disease knowledge, health-promoting behaviors and degree of anxiety were compared between the two groups.@*Results@#The total score of the survey on the observation group and the scores of Disease Risk Factors, Functional Training and Observation and Protection of Complication (90.00±11.75, 18.05±4.33, 19.01±4.20, 18.68±0.07) were all higher than those of the control group (86.68±9.340, 16.12±2.86, 17.22±2.83, 15.43±6.78); the differences were statistically significant (t=2.641-9.171, P<0.05) .The total score of the observation group in The Healthy Living Style Scale and the scores in different dimensions were all higher than those of the control group; the differences were statistically significant (t=2.347-6.653, P<0.05 or 0.01) .The score of the Self-rating Anxiety Scale of the observation group after completing all the chemotherapy periods (48.20±4.03) was lower than that of the control group after three chemotherapy periods (53.56±2.84) ;the differences were statistically significant (t=7.028, P<0.05) ; in these two tests, the group differences in scores between the two groups are also statistically significant (t=2.050, 11.560, P<0.05 or 0.01) .@*Conclusion@#Conducting thematic health education on the breast cancer patients based on the whole course of disease management can effectively improve the patients′ mastery of disease knowledge, improve their health-promoting behaviors, relieve their anxiety and help them recover physically and mentally.
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BACKGROUND: Zinc, an inorganic antibacterial material, has a suitable degradation rate and good antibacterial property. Adding alloying elements can improve the mechanical properties and biocompatibility of the material, which is the development direction of novel medical biodegradable metal materials. There is still lack a comparable research on the antibacterial properties among zinc-based materials. OBJECTIVE: To investigate the antibacterial properties of pure zine and zinc-based alloys in vivo. METHODS: Eighty Sprague-Dawley rats, SPF grade, were randomized into two groups (n=40/group) , and all rats were injected with Staphylococcus aureus or Escherichia coli solution to prepare infection models. Different materials (Zn, ZnAl, ZnSr, Zn3 Mg, Zn3 Ag, Zn3 Ca and Zn4 Cu; five rats for each material) were implanted into the medullary cavity of femur. The control group without any material was set. At 1, 4, 7 and 14 days after implantation, the changes of body temperature, white blood cell count, serum tumor necrosis factor α and serum zinc content in rats were detected. The secretions and tissues of the surgical site were collected to identify the bacterial species. RESULTS AND CONCLUSION: (1) The body temperature in all the rats was increased to different extents after bacterial infection, but the temperature of the rats implanted with zinc and zinc alloys was always lower than that in the control group at 7 and 14 days (P < 0.05) . The temperature in the Zn3 Ag group was significantly lower than that in the other groups at 7 and 14 days (P < 0.05) . (2) The white blood cell count and tumor necrosis factor α level in the zinc and zinc alloys groups were significantly lower than those in the control group at 7 and 14 days after implantation (P < 0.05) . The white blood cell count and tumor necrosis factor α level in the Zn3 Ag group were significantly lower than those in the other groups (P < 0.05) . (3) The serum zinc content in all groups has no significant difference (P> 0.05) . (4) The bacterial culture results showed S.aureus (+) in the Staphylococcus aureus infection group and E.coli (+) in the Escherichia coli infection group. (5) To conclude, degradable zinc-based alloys exert marked antibacterial effects, and Zn3 Ag alloys have the best antibacterial activity.
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Objective To investigate the effect of nutritional intervention upon the clinical efficacy of chemoradiotherapy in patients diagnosed with esophageal carcinoma. Methods A total of 46 patients who were diagnosed with esophageal cancer in Anhui Cancer Hospital from November 2016 to August 2017 were enrolled in this prospective study. All patients were randomly and evenly divided into the nutritional intervention (NI) and routine treatment (RT) groups. The changes in body mass index (BMI),PG-SGA, serum albumin ( ALB), hemoglobin ( HB), white blood cell ( WBC) and other objective nutritional parameters and the incidence of chemoradiotherapy-induced complications were recorded before and after chemoradiotherapy. Results Prior to chemoradiotherapy,age,sex,BMI,ALB,PLT and clinical staging did not significantly differ between two groups (all P>0. 05).In the NI group,the BMI was (21.52±2. 67) after chemoradiotherapy,significantly higher than (21.13±2. 73) before radiotherapy (P= 0. 000).Moreover,the PG-SGA score after chemoradiotherapy was significantly lower compared with that before chemoradiotherapy (P= 0. 000).In the RT group,the BMI,Hb,ALB,PLT and WBC after chemoradiotherapy were significantly lower than those before radiotherapy, and thePG-SGA score was worse after chemoradiotherapy ( all P<0. 05).In the NI group, the incidence of grade 3 myelosuppression was 4. 34％, significantly lower than 8. 68％ in the RT group ( P= 0. 000 ). Conclusions Patients with esophageal cancer treated with chemoradiotherapy have a high nutritional risk. Nutritional intervention can improve the nutritional status, reduce the incidence of chemoradiotherapy-induced complications,and probably improve the quality of life and clinical prognosis.
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Objective To identify the phenotype of CD8αα+ T cells locally infiltrating psoriatic skin lesions,and to investigate their role in the occurrence of psoriasis.Methods Skin lesions were obtained from 8 patients with confirmed plaque psoriasis in the progressive stage,who visited the Department of Dermatology in Xijing Hospital affiliated to the Fourth Military Medical University from January to December in 2017.Of the 8 patients,4 were male and 4 were female,with ages ranging from 24 to 50 years.Normal skin tissues were obtained from discarded skin tissues of 8 healthy controls in plastic surgery.Of the 8 healthy controls,4 were male and 4 were female,with ages ranged from 23 to 46 years.Immunofluorescence technique was used to investigate the distribution of CD8αα+ T cells,determine the proportion of CD8αα+ T cell subsets,identify the immunological phenotype of CD8αα+ T cells and measure the expression of interleukin-17A (IL-17A).Results Infiltration of CD8 + T cells was observed in the dermis and epidermis of the 8 psoriatic skin lesions,and the proportion of CD8αα+ T cells was 88.48％ ± 7.39％.However,only a few CD8+ T cells locally infiltrated the control skin tissues,and the proportion of CD8αα+ T cells was 14.43％ ± 13.14％.There was a significant difference in the proportion of CD8αα+ T cells between the psoriatic skin lesions and control skin tissues (t =11.5,P ＜ 0.01).CD8αα+ T cells in the psoriatic epidermis expressed CD103 (a marker of tissue-resident cells),while CD8αα+ T cells in the psoriatic dermis did not express CD103.CD8αα+ T cells in the psoriatic lesions were identified as CD45RA CCR7 effector T cells,and did not express Foxp3,CD25 and CD122 (markers of CD8+ regulatory T cells).The proportion of CD8αα+ T cells producing IL-17A in the psoriatic lesions was 24.85％ ± 4.25％,while CD8αα+ T cells in the control skin tissues did not produce IL-17A.There was a significant difference in the proportion of CDSαα+ T cells producing IL-17A between the psoriatic skin lesions and control skin tissues (t =5.853,P ＜ 0.01).Conclusion CD8αα+ T cells infiltrating psoriatic lesions are effector memory T cells,and may contribute to the occurrence and development of psoriasis by producing IL-17A.
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Objective To investigate the effect of nucleus localization signal linked nucleic kinase substrate short peptide-conjugated chitosan (NNSCS)-mediated human miR-140 gene local transfection on the repair of articular cartilage defect in rabbits.Methods Eukaryotic expression plasmid GV268-miR-140 was constructed,and then negative controls GV268 and GV268-miR-140 were respectively combined with NNSCS to form NNSCS/GV268 and NNSCS/GV268-miR-140 complexes.Eighteen healthy male New Zealand white rabbits were randomly divided into transgenic group (Group A),negative control group (Group B),and sham operation group (Group C),with 6 rabbits per group.Both Groups A and B were prepared for the total cartilage damage model of femur trochlear,and Group C only exposed the articular surface of the femur trochlear.One week after operation,Group A was treated with NNS CS/GV268-miR-140 complex,Group B was given NNS CS/GV268 complex,and Group C was given equal amount of isotonic saline,twice a week for 7 weeks.The experimental animals were sacrificed at the end of the eighth week after operation.Real time fluorescence quantitative PCR (RT-qPCR) was used to detect the expression of miR-140,Sox9,Aggrecan and Hdac4 in the defect area.HE staining,safranine O/fast green staining,and Aggrecan immunohistochemical staining were used to evaluate cartilage repair in the defect area.Results RT-qPCR showed the expression of miR-140 in Group A (3.16 ± 0.37) was significantly higher than that in Group B (1 ± 0.24) and in Group C (1.24 ± 0.18) (P ＜ 0.05).The miR-140 expression in Group A obviously up-regulated the expression of SOx9 gene (4.38 ± 0.66) compared with Group B (1.04 ± 0.04) and Group C (1.19 ± 0.3),(P ＜ 0.05).The miR-140 expression in Group A obviously up-regulated the expression of Aggrecan gene (3.63 ± 0.58) (P ＜0.05) compared with Group B (1.21 ± 0.14) and Group C (1.34 ± 0.13).The miR-140 expression in Group A obviously down-regulated the expression of Hdac4 (0.37 ±0.06) compared with Group B (0.81 ± 0.06) (P ＜ 0.05).According to results of HE staining,safranine O/fast green and Aggrecan,cartilage repair was evident in Group A,while fibrous tissue proliferation and inflammatory cell infiltration were seen in the defect region in Group B,showing no cartilage repair.Conclusions NNS CS can carry exogenous genes into chondrocytes and the genes can abundantly express locally.High expression of miR-140 might significantly improve the repair of articular cartilage defect in vivoby up-regulating expressions of Aggrecan and Sox9 as well as down-regulating Hdac4 expression.
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Objective To investigate the predictors of early neurological deterioration (END) in patients with acute ischemic stroke (AIS). Methods From January 2015 to April 2018, patients with AIS without receiving thrombolytic therapy and endovascular treatment admitted to the Department of Neurology, the First Affiliated Hospital of Nanjing Medical University were collected retrospectively. END was defined as National Institutes of Health Stroke Scale (NIHSS) score increased by ≥2 within 7 days after onset from baseline. The baseline clinical data, imaging examinations, and laboratory findings were compared in patients of the END group and the non-END group. Multivariate logistic regression analysis was used to determine the independent predictors of END. Results A total of 652 patients with AIS were enrolled,including 437 males (67. 0％). There were 247 patients (37. 9％) in the END group and 405 (62. 1％) in the non-END group. There were significant differences in low-density lipoprotein cholesterol, fasting blood glucose, homocysteine, lipoprotein (a), neutrophil percentage, and NIHSS scores between the 2 groups (all P < 0. 05). There were significant differences in the proportion of severity of stroke, serious lesion of the guilty vessels, watershed infarction, etiologic classification of stroke, Oxfordshire Community Stroke Projects classification, and taking statins before onset between the 2 groups (all P < 0. 05 ). Multivariate logistic regression analysis showed that lipoprotein (a) (odds ratio [OR] 1. 001, 95％ confidence interval [CI] 1. 000-1. 002; P = 0. 021), total anterior circulation infarcts (OR 3. 842, 95％CI 1. 383-10. 671; P =0. 003), and partial anterior circulation infarcts (OR 2. 642, 95％CI 1. 486-4. 695; P = 0. 001) were the independent risk factors for END, and prior statin use was an independent protective factor of END (OR 0. 222, 95％CI 0. 072-0. 679; P = 0. 008). Conclusion Lipoprotein (a), total anterior circulation infarcts, and partial anterior circulation infarcts were the independent risk factors for END. Taking statins before onset was an independent protective factor of END.
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Objective To study clinical data retrospectively and demonstrate the optimal injection site of adductor canal block by performing a cadaveric study.Methods Clinical part:clinical data from 19 patients,11 males and 8 females,aged 21 85 years,ASA physical status Ⅰ-Ⅲ,who received ultrasound guided adductor canal block were retrospectively collected.Among whom 9 received a mid-distance injection of 10 ml of 0.5％ ropivacaine and 10 received an injection of the same medication at the outlet of adductor canal.The primary endpoint was complete absence of cold sensation to ice cube on the medial side of calf at 30 minutes and 24 hours after injection.Cadaveric part:40 lower limbs,20 males and 20 females,were finally analyzed in the study.The distances from the anterior superior iliac spine (ASIS) to the medial tibial condyle,from ASIS to the entrance of the adductor canal,from ASIS to the exit of the canal (adductor tendinous opening),from ASIS to the site where sa phenous nerve emerges through the aponeurotic covering were measured respectively.The length of adductor canal,the relative location of adductor canal and the site where saphenous nerve pierces in the lower limbs were calculated.Results Clinical part:all 19 cases were successfully recorded with complete absence of cold sensation at 30 minutes after injection of local anesthetic and complete sensory recovery at 24 hours after injection.Cadaveric part:in all specimens,saphenous nerve enters adductor canal and coursed down until emerging at very close to the distal end of the canal with the saphenous branch of descending genicular artery.The length of the adductor canal was (10.0±2.1) cm.The entrance and the exit of adductor canal and the emerging site of the saphenous nerve located along the (54.7±3.0) ％,(76.0％±3.8) ％ and (74.1±3.2) ％ of sartorius muscle,respectively.Conclusion Performing ultrasound-guided adductor canal block at either the outlet of adductor canal or mid-distance of thigh can achieve comparable blockade of saphenous nerve.Cadaveric study implicated that the optimal injection site for adductor canal block should be the lower one-third of sartorius muscle.Ultrasound-guided injection of local anesthetics next to the descending genicular artery may possibly become a promising new method of saphenous nerve block.