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Objective To investigate the efficacy of laparoscopic C-type radical hysterectomy through deep uterine vein approach for the treatment of cervical cancer.Methods From January 2021 to December 2022,58 cases of cervical cancer were treated with deep uterine vein approach laparoscopic C-type radical hysterectomy in our hospital.After establishing the operation channel,the ureter was identified in the posterior lobe of the broad ligament,and the uterine artery was exposed after separating the ureter.The connective tissue was separated along the dorsal side of the uterine artery to gradually expose the deep uterine vein.The parametrial lymph nodes surrounding the deep uterine vein were resected and sent to pathology alone.The deep uterine vein was continuously tracked towards the bladder,and its branches were freed.The deep uterine vein and its tributaries were double clipped by vascular clamp.Results The operation time was(307.2±54.1)min,the median bleeding volume was 50(20,100)ml,the lymph node dissection number was(26.3±6.9),the indwelling catheter time was(20.6±4.7)d,the time to removal of abdominal drainage tube was(9.4±4.1)d,the anal exhaust time was(36.7±4.1)h,the antibiotics use time was(9.2±4.2)d,and the hospital stay was(13.4±2.6)d.The postoperative complication rate was 3.4%(2/58),and the postoperative pathological staging upgrade rate was 22.4%(13/58).The postoperative European Organization of Research and Treatment of Cancer(EORTC)Quality of Life Questionnaire-Core 30(QLQ-C30)score was significantly higher than before surgery[(78.6±10.7)points vs.(47.1±7.6)points,t = 17.177,P = 0.000].All the 58 cases were followed up for 4-25 months(mean,13.5±6.2 months),with no recurrence.Conclusion Laparoscopic C-type radical hysterectomy through deep uterine vein approach is effective,safe,and reliable.
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Objective:To investigate the risk factors for combined coronary microvascular dysfunction (CMD) in patients with ischemia and non-obstructive coronary artery disease (INOCA).Methods:From October 2020 to May 2022, 100 INOCA patients with myocardial ischemic symptoms who underwent coronary angiography (CAG) suggestive of <50% stenosis in all three coronary arteries at the Tenth People′s Hospital of Tongji University were prospectively recruited. Myocardial perfusion imaging (MPI), transthoracic echocardiography and cadmium-zinc-telluride (CZT) SPECT coronary flow quantification were performed in the same month, and 93 INOCA patients (36 males and 57 females, age (63.0±10.9) years) were finally included. CMD was defined as coronary flow reserve (CFR)<2.5. Independent-sample t test, Mann-Whitney U test and χ2 test were used to compare MPI results and left ventricular volume parameters between CMD and non-CMD groups. ROC curve analysis was used to analyze the efficacy of each index in predicting CMD, and independent risk factors for CMD were screened by multivariate logistic regression analysis. Results:Among 93 INOCA patients, 29 were in the CMD group and 64 were in the non-CMD group. The age, proportion of hypertension, left ventricular mass index (LVMI), summed stress score (SSS), summed difference score (SDS), left ventricular internal diameter systolic (LVIDS), interventricular septum thickness (IVST), and left ventricular posterior wall thickness (LVPWT) in the CMD group were higher than those in the non-CMD group ( t values: 2.42-3.76, χ2=8.94, z values: -3.31, -3.41, all P<0.05). ROC curve analysis showed that LVMI, SSS, SDS, LVPWT, IVST and age were significant in predicting CMD (AUCs: 0.67-0.72). Multivariate logistic regression analysis showed that LVMI (odds ratio ( OR)=1.08, 95% CI: 1.01-1.17), SDS ( OR=5.37, 95% CI: 1.95-14.78), hypertension ( OR=5.68, 95% CI: 1.34-24.18) and age ( OR=1.10, 95% CI: 1.03-1.18) were risk factors for CMD. Conclusion:LVMI, SDS, hypertension and age are strongly associated with combined CMD in INOCA patients, which can be used for early risk stratification of INOCA patients.
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With high linear energy transfer (LET) and short transmission distance, targeted α-therapy (TAT), as a specific targeted tumor treatment, can improve the killing effect on microscopic lesions or diffuse micrometastases. It can reduce bone marrow toxicity and overcome the problem of radiotherapy tolerance in hypoxic tumors. α-emitters and their labeled drugs are constantly being studied, and further research is needed to promote the development of clinical applications.
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Objective To investigate the role of P2X7 receptor in learning and memory dysfunction induced by HIV-1 enveloped protein gp120 in rats. Methods The imitating HIV-1 associated dementia (HAD) animal models were established by intracerebroventricular (ICV) infusion of gp120 in rats. The effect of gp120 on the learning and memory dysfunction in rats was evaluated by Morris water maze (MWM) test. The role of P2X7 receptor (P2X7R) was studied by Western blot and PCR assay. Results The ICV infusion of gp120 for 3 days in rats could imitated the HAD animal model. Results of MWM test showed that the rats in the model group had longer escape latencies and errors compared with those in the control group (P < 0.01); Results of Western blot and PCR assay showed that the expressions of P2X7R and P2X7 mRNA in hippocampus of rats in the model group were significantly increased (P < 0.01). Conclusions The ICV infusion of gp120 in rats could imitate the HIV-1 associated dementia (HAD) animal models, and P2X7R may be involved in the pathophysiological process of learning and memory dysfunction caused by gp120.
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HIV-related sensory neuropathy ( HIV-SN) mainly contains the HIV infection-related distal sensory polyneuropa-thy (DSP) and antiretroviral toxic neuropathies (ATN).HIV-DSP is associated with proinflammatory cytokines , chemokines, ros and which is induced by gp 120;and HIV-ATN may be related to mitochondrial toxicity which is induced by the application of anti retroviral drugs, such as ddC, and similar as the molecular mechanism of HIV-DSP, this means that the current conventional method for the treatment of neuropathic pain in AIDS may further aggravate the neuropathic pain of the patient .Therefore, developing the study on the neurochemical and pharmacological mechanisms of HIV-related neuropathic pain will provide novel targets for the new effective drugs .
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The P2X7 receptor (P2X7 R)is a nonselective cation channel activated by extracellular ATP,and it may trigger the se-cretion of several proinflammatory substances,such as IL-1β, IL-18,TNF-α,and nitric oxide.Several preclinical studies have demonstrated that this receptor participates in inflammation and pain mechanisms,and compounds that modulate the function of this receptor show potential as new anti-inflammatory medicines. Therefore,P2X7 receptors play particularly important physiologi-cal roles and have potential clinical application in inflammation and pain,which proves it a therapeutic target for pain manage-ment.