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Objective:To explore the risk factors for malnutrition after a tracheotomy and to construct a predictive model useful for its prevention through early intervention.Methods:Clinical data describing 440 tracheotomy patients were subjected to a retrospective analysis. The variables examined were age, sex, etiology, Glasgow Coma Score (GCS), activities of daily living (ADL) score, age-corrected Charlson comorbidity index (aCCI), food intake, swallowing function, incidence of infections, as well as any history of diabetes mellitus, hypertension, smoking or alcohol consumption. Patients identified as being at risk of malnutrition (NRS-2002≥3) were screened using the Nutritional Risk Screening tool (NRS-2002) and the European Society of Clinical Nutrition and Metabolism′s ESPEN2015 criteria. The subjects were thus categorized into a malnutrition group of 343 and a control group of 97. Unifactorial and multifactorial logistic regression analyses were performed, and stepwise regression was applied to include the factors found significant in the unifactorial analysis into the multifactorial logistic regression analysis, and to construct a column-line graph prediction model. The clinical utility of the model was assessed by applying the receiver operator characteristics (ROC) curves, calibration plots and decision curve analysis (DCA).Results:Of the 440 persons studied, 343 (78%) were malnourished. The multivariate logistic regression analysis showed that pulmonary infection, dysphagia, low GCS score and high aCCI score were significant risk factors for malnutrition after a tracheotomy. A prediction nomograph was constructed. After fitting and correcting, the area under the curve (AUC) of the prediction model′s ROC curve was 0.911, the specificity was 80.4%, and the sensitivity was 91.3%. That was significantly higher than the AUCs for pulmonary infection (0.809), dysphagia (0.697), aCCI (0.721) and GCS (0.802). Bootstrap self-sampling was used to verify the model internally. After 1000 samples the average absolute error between the predicted risk and the actual risk was 0.013, indicating good prediction ability. The DCA results demonstrated that the model has substantial clinical applicability across a range of nutritional interventions, particularly for threshold probability values ranging from 0 to 0.96.Conclusion:Pulmonary infection, dysphagia, low GCS score, and high aCCI score are risk factors for malnutrition among tracheotomy patients. The nomogram model constructed in this study has good predictive value for the occurrence of malnutrition among such patients.
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In view of the current norms and demands of human gene editing technology at home and abroad, the paper explained that the regulatory difficulties faced by human gene editing technology were due to the conflict between economic interests and moral bottom line by constructing a game model in a hypothetical way. On this basis, the ideas of the supervision mode of human gene editing technology were put forward: establish unified international standards based on the country as the main body, enact more stringent and effective laws, to jointly deal with the behavior of genetic manipulation of human gametes, zygotes and embryos for the purpose of reproductive, and ensure the normalization and legalization of gene editing technology to avoid technology abuse.
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BACKGROUND:Establishing a nomogram prediction model for postoperative pulmonary infection in hip fractures and taking early intervention measures is crucial for improving patients'quality of life and reducing medical costs. OBJECTIVE:To construct a nomogram risk prediction model of postoperative pulmonary infection in elderly patients with hip fracture,and provide theoretical basis for feasible prevention and early intervention. METHODS:Case data of 305 elderly patients with hip fractures who underwent surgical treatment at Wuxi Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine between January and October 2020(training set)were retrospectively analyzed.Using univariate and multivariate logistic regression analysis and Hosmer-Lemeshow goodness of fit test,receiver operating characteristic curve was utilized to analyze the diagnostic predictive efficacy of independent risk factors and joint models for postoperative pulmonary infections.Tools glmnet,pROC,and rms in R Studio software were applied to construct a nomogram model for predicting the risk of postoperative pulmonary infection in elderly patients with hip fractures,and calibration curves were further drawn to verify the predictive ability of the nomogram model.Receiver operating characteristic curves,calibration curves,and decision curves were analyzed for 133 elderly patients with hip fractures(validation set)receiving surgery at the same hospital from November 2022 to March 2023 to further predict the predictive ability of the nomogram model. RESULTS AND CONCLUSION:(1)The postoperative pulmonary infection rate in elderly patients with hip fractures in this group was 9.18%(28/305).(2)Single factor and multivariate analysis,as well as forest plots,showed that preoperative hospitalization days,leukocyte count,hypersensitive C-reactive protein,and serum sodium levels were independent risk factors(P<0.05).The Hosmer-Lemeshow goodness of fit test showed good fit(χ2=4.57,P=0.803).Receiver operating characteristic curve analysis was conducted on the independent risk factors and their joint models mentioned above,and the differentiation of each independent risk factor and joint model was good,with statistical significance(P<0.05).(3)The graphical calibration method,C-index,and decision curve were used to validate the nomogram prediction model.The predicted calibration curve was located between the standard curve and the acceptable line,and the predicted risk of the nomogram model was consistent with the actual risk.(4)The validation set used receiver operating characteristic curve,graphic calibration method,and decision curve to validate the prediction model.The results showed good consistency with clinical practice,indicating that the model had a good fit.The nomogram risk prediction model constructed for postoperative pulmonary infection in elderly patients with hip fractures has good predictive performance.The use of the nomogram risk prediction model can screen high-risk populations and provide a theoretical basis for early intervention.
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Objective:To investigate the effect of hepatocyte nuclear factor 4 gamma(HNF4G)on the proliferation,migration,cell cycle and apoptosis of gallbladder cancer cells and the underlying molecular mechanisms. Methods:The expression levels of HNF4G mRNA and protein in gallbladder cancer cell lines(GBC-SD,NOZ and ZJU-0430)were examined by real-time fluorescence quantitative PCR and Western blotting,respectively.Stable HNF4G-silencing or overexpressing GBC-SD,NOZ and ZJU-0430 cell lines were established by lentiviral infection.Then,the effect of HNF4G silencing or overexpression on the proliferation,migration,cell cycle and apoptosis of gallbladder cancer cell lines were evaluated by CCK-8 assay,colony formation assay,Transwell assay and FCM assay.The effect of changes in HNF4G gene expression level on the expression levels of cell cycle associated proteins(Cyclin A2 and Cyclin B1),apoptotic proteins(Bax and Bcl-2),epithelial-mescenchymal transition associated proteins(E-cadherin,N-cadherin,vimentin,Snail and Slug)as well as ErbB2 and phosphorylated AKT in the ErbB2/PI3K/AKT signaling pathway was examined by Western blotting. Results:Real-time fluorescence quantitative PCR and Western blotting results demonstrated that the expression level of HNF4G mRNA and protein in NOZ cells was significantly lower than that in GBC-SD and ZJU-0430 cells(P＜0.001).The successful establishment of HNF4G-sliencing and HNF4G-overexpressing gallbladder cancer cell lines was verified by Western blotting analysis.Over expression of HNF4G could enhance the proliferation and migration of GBC-SD,NOZ and ZJU-0430 cells(P＜0.001),promote the transition of S-phase to G2/M-phase,and inhibit the apoptosis of these gallbladder cancer cell lines.Western blotting analysis showed that overexpression of HNF4G could increase the expression of Cyclin A2,Cyclin B1,Bcl-2,N-cadherin,Vimentin,Snail,Slug,ErbB2 and phosphorylated AKT,and decrease the expression of Bax and E-cadherin(P＜0.001).In contrast,HNF4G silencing could induce the opposite changes in the biological behaviors and protein expression in GBC-SD cells. Conclusion:HNF4G affects the proliferation and migration of gallbladder cancer cells by participating in the regulation of the epithelial-mescenchymal transition and ErbB2/PI3K/AKT signaling pathway.The influence of HNF4G on gallbladder cancer cells suggests that HNF4G may be a potential gene target for gallbladder cancer treatment.
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Objective:The safety and effectiveness of the enhanced recovery after surgery (ERAS) in the treatment of distal pancreatectomy (DP) were evaluated by meta-analysis.Methods:Pancreatic body and tail resection, distal pancreatic resection, ERAS, rapid recovery after surgery, pancreatectomy, DP and ERAS were used as key words, and the network database such as Chinese journal full-text database, Wanfang data knowledge service platform, Weipu database, Chinese biomedical literature database, Pubmed, Embase, Cochrane library, Web of science, Sciencedirect and so on were searched. The retrospective literatures published from the database establishment to May 2022 were retrieved from the network database, and the papers were screened and the quality was evaluated according to the pre-set inclusion and exclusion criteria; and important data were extracted. The software Review Manager 5.4 was used for meta-analysis.Results:9 papers were finally included, and a total of 650 patients with DP were enrolled (311 in the ERAS group and 339 in the NO-ERAS group). Meta-anaysis showed that compared with NO-ERAS group, ERAS group could reduce intraoperative bleeding ( MD=-73.88, 95% CI -121.21--26.55, P=0.002), decrease the incidence of postoperative complications ( OR=0.48, 95% CI 0.32-0.72, P<0.001) and pulmonary complications ( OR=0.47, 95% CI 0.24-0.93, P=0.030), shorten the postoperative exhaust time (MD=-8.76, 95% CI -11.23--6.29, P<0.001), postoperative length of hospital stay ( MD=-2.65, 95% CI -3.06--2.07, P<0.001) and abdominal drainage tube removal time ( MD=-1.45, 95% CI -1.81--1.09, P<0.001). However, ERAS could not shorten the operative time ( MD=6.25, 95% CI -4.56-17.07, P=0.260), reduce the incidence of postoperative pancreatic fistula ( OR=0.92, 95% CI 0.53--1.60, P=0.780) and the re-admission rate within 30 days after surgery ( OR=1.00, 95% CI 0.47-2.11, P=0.990). Conclusions:ERAS is safe and effective for patients undergoing DP, because it can reduce intraoperative bleeding and postoperative complications, shorten postoperative hospital stay and postoperative abdominal drainage tube removal time.
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Objective:To investigate the effects and molecular mechanism of neuropilin and tolloid-like 2 (NETO2) on proliferation, migration, cell cycle, and apoptosis in gallbladder cancer (GBC).Methods:The NETO2 mRNA and protein expression in GBC-SD, ZJU-0430, NOZ GBC cells were detected by quantitative real-time polymerase chain reaction and Western blot. NETO2 overexpression and knockdown stable cell lines were constructed by plasmid transfection. Cell counting kit-8 assay, colony formation assay, transwell assay, flow cytometry and WB assay were performed to evaluate proliferation, migration, cell cycle, apoptosis, epithelial-mesenchymal transition (EMT) and changes of phosphatidylinositol-3 kinase/protein kinase B (PI3K/Akt) signaling pathway.Results:GBC-SD and ZJU-0430 cells with NETO2 gene overexpression and NOZ cells with NETO2 gene knockdown were effectively constructed. NETO2 overexpression in gallbladder cancer cell lines significantly improved cell proliferation and migration, advanced cell cycle progression from G0/G1 to S phase, and inhibited cell apoptosis. In the ZJU-0430 and GBC-SD cells, the clone number increased from (78.5±9.2), (217.0±6.4) to (213.5±10.3), (296.3±9.3)( t=10.98, 6.51; P=0.008, 0.023); The number of migrating cells increased from (198.6±8.4), (233.3±11.0) to (382.7±12.4), (379.0±7.3) ( t=16.98, 16.85, both P<0.001); The total apoptosis rate reduced from (29.7±0.9)%, (35.6±1.1)% to (19.2±0.5)%, (29.1±0.4)% ( t=9.74, 9.05; both P<0.001); The expression of EMT related proteins such as N-cadherin, Vimentin, Snail, and Slug were upregulated, while E-cadherin expression was downregulated. Phosphorylated PI3K (p-PI3K) and Akt (p-Akt) protein expression were significantly increased (all P<0.05). In contrast, NETO2 knockdown had the opposite effect on all these parameters. Conclusion:NETO2 influences the EMT process by regulating the PI3K/Akt signaling pathway, thus promotes GBC cell proliferation, migration and cell cycle progression, and inhibits cancer cell apoptosis.
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In view of the current norms and demands of human gene editing technology at home and abroad, the paper explained that the regulatory difficulties faced by human gene editing technology were due to the conflict between economic interests and moral bottom line by constructing a game model in a hypothetical way. On this basis, the ideas of the supervision mode of human gene editing technology were put forward: establish unified international standards based on the country as the main body, enact more stringent and effective laws, to jointly deal with the behavior of genetic manipulation of human gametes, zygotes and embryos for the purpose of reproductive, and ensure the normalization and legalization of gene editing technology to avoid technology abuse.
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Objective:To explore the effects of intermittent oral-esophageal tube feeding (IOE) on cerebral hemorrhage (CH) survivors receiving a tracheotomy.Methods:A total of 126 CH patients undergoing tracheotomy were randomly divided into an IOE group ( n=65) and a nasogastric tube feeding (NGT) group ( n=61). The feeding continued for 4 weeks along with medication and thorough rehabilitation interventions (including hemiplegic limb training, swallowing training, and pulmonary function training). Before and after the treatment, the body mass index, hemoglobin, albumin, proalbumin, creatinine height index, extubation rate and intubation time of the tracheotomy, as well as the incidence of complications were evaluated for both groups. Both groups were also assessed using the clinical pulmonary infection scale (CPIS) and National Institutes of Health stroke scale (NIHSS). Results:After the 4 weeks the nutrition indexes, average extubation rate (90.76%) and intubation time [(15.96±3.86)d], CPIS score (3.00±1.69), NIHSS score (11.86±4.08) and the overall incidence of complications in the IOE group were all significantly better than the NGT group′s averages.Conclusions:Where feasible, intermittent oro-esophageal tube feeding is superior to nasogastric tube feeding of cerebral hemorrhage patients undergoing tracheotomy. It reduces the risk of pulmonary infection and other complications, resulting in early removal of the tracheotomy cannula and quicker recovery.
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Objective:To observe the effect of intermittent oro-esophageal tube feeding (IOE) on dysphagia patients with cerebral small vessel disease.Methods:Sixty such patients were randomly divided into an experimental group ( n=30) and a control group ( n=30). In addition to the routine basic treatment and swallowing function training, the control group was given nasogastric tube feeding, while the experimental group was provided with IOE. Before and after two weeks of the treatment the swallowing function and nutritional status of both groups were evaluated along with the incidence of pneumonia, ability in the activities of daily living and general quality of life. Results:Before the intervention, there were no significant differences between the two groups in any of the measurements. Afterward significant improvements were observed in all of the measurements in both groups, but the experimental group had improved significantly more than the control group in terms of each measure.Conclusions:IOE is superior to NG in improving the nutrition and swallowing function of patients with dysphagia and cerebral small vessel disease. It betters their ability in daily life activities and their quality of life.
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Objective To observe the OCT image characteristics of the posterior cortical anterior vitreous capsular bag (PPVP) in human eyes.Methods A retrospective clinical study.From May 2012 to February 2017,107 PPVP patients (173 eyes) diagnosed by OCT in Ophthalmology Department of The Third People's Hospital of Chengdu were included in the study.One hundred and three eyes underwent examination of frequency-domain OCT (SD-OCT) and 70 eyes underwent examination of frequency-scanning light source OCT (SS-OCT),respectively.SD-OCT the German Heidelberg Spectralis OCT instrument.SS-OCT was performed by the vitreous enhancement scan mode of Japan's Topcon DRI OCT instrument.The differences of different types of PPVP OCT imaging and image characteristics were observed.Results SD-OCT and SS-OCT showed that the PPVP structure was clear and manifested as macular weakly reflective in the shape of a boat-shaped cavity,the front boundary was vitreous collagen,and the rear boundary was vitreous cortex.There was a weakly reflective Martegiani area on the nasal side of PPVP,and there was a connection channels between them.The two examinations showed a similar pattern,but SS-OCT with the clearer imaging of PPVP.Conclusions The OCT image of PPVP in the human eye is characterized by an anterior weakly reflecting boat-shaped cavity in the macula,with anterior border of vitreous collagen and posterior border of vitreous cortex.Martegiani area is located on the nasal side.
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Objective:To explore the correlation between serum high mobility group protein B1 (HMGB1) and severity of coronary artery disease.Methods:From January 2018 to March 2019, 170 patients who underwent coronary angiography and were definitely diagnosed with coronary heart disease in Beijing Anzhen Hospital were divided into single-vessel lesion group(65 cases), double-vessel lesion group(55 cases) and three-vessel lesion group(50 cases) according to the results of coronary angiography.Sixty healthy persons in the same period were set as the control group.The serum levels of HMGB1, endothelin-1, C-reaction protein (CRP), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) were detected, and the severity of coronary artery disease was evaluated according to Gensini score standard.Results:The serum HMGB1 of patients with single vessel disease was (7.35±0.75) μg/L, that of double vessel disease group was (11.56±1.16) μg/L, that of three vessel disease group was (14.36±1.46) μg/L, and that of control group was (3.22±1.52) μg/L.The difference between the two groups was statistically significant ( F=14.235, P<0.001). The serum endothelin-1 in single vessel disease group was (198.56±19.86) ng/L, that in double vessel disease group was (226.54±22.64) ng / L, that in three vessel disease group was (435.65±43.95) ng/L, and that in control group was (120.47±13.27) ng/L.The difference between the two groups was statistically significant ( F=16.337, P<0.001). The serum CRP of patients with single vessel disease was (6.21±0.61) ng/L, that of double vessel disease group was (8.54±0.84) ng/L, that of three vessel disease group was (11.36±1.16) ng/L, and that of control group was (3.39±1.56) ng/L.The difference between the two groups was statistically significant ( F=15.206, P<0.001). Serum LDL-C was (3.23±0.33) mmol/L in single vessel disease group, 4.12±0.42 mmol/L in double vessel disease group, (6.23±0.63) mmol/L in three vessel disease group and (2.25±1.45) mmol/L in control group.The difference between the two groups was statistically significant ( F=22.017, P<0.001). Serum HDL-C was (4.02±0.42) mmol/L in single vessel disease group, (2.35±0.25) mmol/L in double vessel disease group, (1.79±0.29) mmol/L in three vessel disease group and (4.60±1.69) mmol/L in control group.The difference between the two groups was statistically significant ( F=18.564, P<0.001). The Gensini score of single vessel disease group was (10.36±2.26), that of double vessel disease group was (16.74±1.04) and that of three vessel disease group was (23.36±2.36). The difference between the two groups was statistically significant ( F=23.014, P<0.001). The levels of HMGB1, endothelin-1, CRP and LDL-C in patients with coronary heart disease were significantly higher than those in the control group, while the levels of HDL-C were significantly lower than those in the control group (all P<0.05). The higher the number of diseased vessels, the higher the levels of HMGB1, endothelin-1, CRP, LDL-C and Gensini score, the lower the level of HDL-C.Multiple linear regression analysis showed that HMGB1, endothelin-1, CRP and LDL-C were risk factors of Gensini score (standard coefficient was 0.480, 0.087, 0.173, 0.197, t=8.351, 9.047, 12.476, 11.692, all P<0.01); HDL-C level was a protective factor of Gensini score (standard coefficient -0.352, t value was 16.582, P<0.001). Pearson linear correlation analysis showed that serum HMGB1 level was positively correlated with endothelin-1, CRP and LDL-C ( r=0.536, 0.659, 0.724, all P<0.05), and negatively correlated with HDL-C ( r=-0.669, P<0.05). Conclusion:There are obvious inflammatory reaction and lipid metabolism disorder in patients with coronary heart disease.The level of HMGB1 in peripheral blood is closely related to the severity of coronary artery disease.
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Objective To study the clinical value of rapid prototyping oriented template for total hip replacement in patients with adult developmental dysplasia of the hip .Methods Totally 51 cases with adult developmental dysplasia of the hip who were admitted into our hos -pital from January 2014 to March 2015 were randomly divided into the observation group and the control group .The observation group were treated by total hip arthroplasty assisted with rapid prototyping oriented template , while the control group were treated with traditional surgical method for total hip replacement.The curative effect, operation time, amount of bleeding, hospitalization time and satisfaction rate were compared between the two groups .Results The operation time , intraoperative blood loss and length of hospital stay of the observation group were significantly lower than those in the control group , and the differences were statistically significant (P<0.01).The Harris hip function score and satisfaction rate of the observation group were significantly higher than those in the control group with statistically significant differ -ences (P<0.05).Conclusion Total hip arthroplasty assisted with rapid prototyping oriented template could shorten the operation time , re-duce the intraoperative blood loss , cut down the hospitalization time , quicken the hip joint function recovery , and improve the satisfaction rate of patients .
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Objective To prepare 3D printed tracheal graft and investigate its cellular biocompatibility and biomechanical properties.Methods Bone marrow was isolated from tibial plateau of young New Zealand white rabbit,and bone mesenchymal stem cells (BMSCs) were obtained by whole bone marrow culture method and adherent purification method.Biomechanical test was performed for 3D printed trachea graft.After co-cultured of 3D printed trachea graft and BMSCs,cell morphology was observed and the proliferation index of the cells on 3D printed trachea graft was quantified using sulforhodamine B (SRB) assay.Results 3D printed trachea graft showed excellent biomechanical properties.Cell morphology was normal and cells grew well after co-culture with 3D printed trachea graft.The SRB assay indicated good proliferation of BMSCs on 3D printed trachea graft.Conclusions 3D printed trachea graft shows favorable cellular biocompatibility and biomechanical properties,and therefore can be used as a scaffold material for tissue-engineered trachea.
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Objective To explore the diagnosis and management of functional pancreatic endocrine tumor.Methods Clinical data of 19 cases of functional pancreatic endocrine tumor were retrospectively analyzed.Results 15 cases of insulinoma,2 cases of gastrinoma and 2 cases of glucagonoma were qualitatively diagnosed.The positive rate of preoperative diagosis for type B ultrasonic inspection,CT,MRI,EUS,selective portovenous sampling and intraoperative type B ultrasonic inspection was 15.8％ (3/19),67.5％ (10/16),71.4％ (5/7),87.5％ (7/8),100％(2/2) and 85.7％(6/7) respectively.Of the total 19 cases,7 cases underwent open surgery,11 cases unde rwent laparoscopic surgery,and one case didn't undergo any surgery as liver metastasis had occurred when glucagonoma was diagnosed.The operation methods included tumor enucleation (n=13),distal pancreatic resection (n=3),distal pancreatic resection plus splenectomy (n=1),and pancreatic head resection with duodenum preserved (n=1).Conclusions The measurement of serum insulin,gastrin and glucagon is the main basis for qualitative diagonosis of pancreatic endocrine tumor.Two stage spinal CT thin scanning is the main method for tumor location.Intraoperative type B ultrasonic inspection is the supplement to preoperative location.Tumor enucleation is the main choice of treatment.
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In recent years, scientists paid close attention to the studies of 3D printing in cardiovascular tissue engineer-ing, which has made some advances.But how to promote cardiovascular tissue engineering for clinical application still needs deeper research.Here we discussed from three cardiovascular tissues ( myocardial tissue, heart valves, coronary) , which at-tempted to retrospect the current progress of 3 D printing in cardiovascular tissue engineering and provided a guidance of further investigations.
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Nanoscale biomaterials,due to their excellent mechanical,chemical and biological properties,are now being applied in regenerative medicine.Nanoscale materials incorporation into 3D synthetic organ scaffolds has had a breakthrough in tissue engineering.This review provides an update report on the use of nanomaterials in 3D scaffolds of tissue engineering,including fabrication methods of 3D scaffolds of nanomaterials and their physicochemical properties,biocompatibility and degradability.
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In recent years,Scientists paid close attention to the studies and applications of tissue-engineered trachea,which have made some advances.But how to promote tissue-engineered trachea for clinical application still needs deeper research.Here we discussed from three key aspects of tissue-engineered trachea (Scaffold,Cell,Bioreactor),which attempted to retrospect the current progress in tissue-engineered trachea and provided a guidance of further investigations.
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Objective To explore whether fluid-attenuated inversion recovery can be used to estimate the onset time of acute ischemic stroke (ALS) based on the analysis of signal strength through the fluid-attenuated inversion-recov?ery (FLAIR)and volume of interest (ROI) in ALS patients with known time of onset. Method Forty-seven AIS patients who met the inclusion criteria were recruited from Baotou Central Hospital, Department of Neurology from January 2011 to December 2012. The patients had stroke onset within 12 hours and completed MRI scan including diffusion-weighted imaging DWI, apparent diffusion and coefficient ADC FLAIR. Based on MRI findings, patients were divided into, three groups:0~180 min, 180~360 min and 360~720 min groups. Signal strength values of the DWI、FLAIR and ADC in ipsi?lateral and contralateral sides were measured. Result There was a significant difference in the FLAIR signal strength among these three groups.The FLAIR signal strength was significantly lower in 0~180 min and 180~360 min groups than in 360-720 min. FLAIR positive rate was 16.7%, 62.5%, and 70.6% in 0~180 min, 180~360 min and 360~729 min groups, respectively. Conclusion FLAIR positive rate gradually increases as the onset prolongs. Thus, lower FLAIR posi?tive rate indicates shorter onset time of AIS, which can be used to assist acute intravenous thrombolytic therapy.
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Objective Discuss clinical type and treatment of postoperative digestive tract fistula and associate complications of esophageal or cardiac cancer.Methods Analized clinical manifestations and treatment retrospectively of 53 cases of digestive tract fistula after operation of esophageal or cardiac cancer from January,2010 to December,2012.Results All the 10 undergoing surgery are cured by reoperation.2 died of mediastinal infection and sepsis.4 died of respiratory failier,malnutrition,left and right bronchal fistula,respectively.Conclusion There are 4 types of fistula:Ⅰ type of sepsis,Ⅱ type of respiratory failure,Ⅲ type of thoracic infection,Ⅳ type of neck inection.Reoperation within 24 hours is the key of suscessful repairment of intrathoracic anastmotic leakage.Bronchal fistula or respiratory failure caused by multiple thoracic encapsulated effusion is also the indication of surgery.Complete lung reexpansion and complete drainage is the key.Mini-invasive VATS is the method of exact drainage.
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Objective To observe the dynamic expression of Nogo receptor (NgR) in spinal cord of rats after spinal cord injury. Meth-ods 108 Sprague-Dawley rats were randomly assigned into normal group, sham operated group and model group, with 36 rats in each group. The model of spinal cord injury was established with the modified Allen's method. The rats were killed 24 h, 3 days, 7 days and 14 days re-spectively after intervention (9 rats from each group), and expression of NgR in the spinal cord tissue of the rats was detected with immuno-histochemistry and Western blotting, and expression of NgR mRNA was detected with fluorescence quantitative PCR. Results There was no significant change in the expression of NgR in the normal group and the sham operated group (P>0.05). The expression of protein and mRNA of NgR was less in the model group 24 h after modeling, dropped to the lowest on the 3rd day, then rapidly peaked on the 7th day, and gradually declined on the 14th day after spinal cord injury. Compared with the normal group, there were significant differences in ex-pression of NgR in immunohistochemistry and Western blotting in the model group at each time point after spinal cord injury (P<0.05). Compared with the sham operated group, there were significant differences in expression of NgR mRNA in the model group at each time point after spinal cord injury (P<0.01). Conclusion The expression of NgR and mRNA peaks on the 7th day after spinal cord injury in the rats, and maintains at high level for a long time, which may associated with the difficulty of axonal regeneration after spinal cord injury.