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Objective To investigate the effect of 5-Aza-CdR on Notch1 pathway and neural regeneration and to explore the effects of 5-Aza-CdR on learning memory ability in mice by exploring active avoidance behavior.Methods Sixty 6～8-week-old SPF-grade ICR male mice were divided into two groups.5-Aza-CdR was administered to one group of mice via lateral ventricular injection,while the control group was injected with bovine serum albumin.Notch1 and HES1 mRNA and protein expression levels were detected by Real-time PCR and Western blot 24 hours after injection;5-bromo-2'-deoxyuridine-positive cells were observed by laser confocal microscopy,and Notch1 expression in hippocampal dentate gyrus was viewed with laser confocal microscopy.Notch1 methylation changes were detected by ethylation-specific PCR,and learning and memory behaviors of mice were assessed by passive avoidance tests and shuttle avoidance assays.Results Injection of 5-Aza-CdR increased hippocampal Notch1 pathway activity,promoted neuronal regeneration in the DG region,decreased methylation levels in the Notch1 promoter region,and enhanced the ability of mice to perform active avoidance behavior.Conclusions The effect of 5-Aza-CdR on active avoidance behavior may be related to the influence of hippocampal neural regeneration through the Notch 1 pathway.
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Objective To observe the effect of coronary reperfusion therapy on the differential ex-pression of plasma exosomal miRNAs in patients with acute myocardial infarction(AMI).Meth-ods Three elderly male AMI patients undergoing coronary reperfusion therapy in our hospital from October to November 2022 were recruited in this study.The venous blood samples were col-lected at admission and 2 and 24 h after recanalization.MiRNA-sequencing was used to screen the differentially expressed miRNAs which were commonly expressed in the plasma exosomes of the 3 patients.Bioinformatics analysis was performed on the target genes,and then the differentially expressed miR-499a-5p was verified by qPCR.Results Compared with the plasma exosomal miRNAs at admission,there were 418 up-regulated and 406 down-regulated miRNAs at 2 h after operation,and 320 up-regulated and 225 down-regulated miRNAs at 24 h after operation(P＜0.05);Compared with the miRNAs at 2 h after operation,there were 344 up-regulated and 350 down-regulated ones at 24 h after operation(P＜0.05).Kyoto Encyclopedia of Genes and Ge-nomes enrichment analysis showed that the differentially expressed miRNAs were enriched in phosphatidylinositol-3-kinase-protein kinase B,hypoxia-inducible factor 1,and vascular smooth muscle contraction pathways.Gene Ontology analysis indicated that the molecular functions of dif-ferentially expressed miRNA target genes were mainly enriched in protein binding and DNA bind-ing;cellular components were mainly enriched in cell membrane and cytoplasm;and biological processes were mainly enriched in signaling and transcription of DNA templates.The miR-499a-5p level was significantly lower at 2 h postoperatively than at admission[(0.577±0.020)vs(1.000± 0.023),P＜0.05],and at 24 h postoperatively than at 2 h postoperatively[(0.068±0.006)vs(0.577±0.020),P＜0.05].Conclusion Plasma exosomal miRNAs can be used as a biomarker for early diagnosis of elderly AMI patients and for predicting the efficacy of reperfusion therapy.
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Objective To investigate the expression of Member RAS Oncogene Family(RAB10)in pancreatic cancer(PAAD)and its effects on the proliferation,migration,invasion and apoptosis of SW1990 cells(human pancreatic cancer cells).Methods The expression of RAB1 0 mRNA in PAAD tissues wasanalyzed by the cancer gene database GEPIA(Gene Expression Profiling Interactive Analysis)and TCGA(The Cancer Genome Atlas).Cox regression analysis was used to detect relationship between RAB10 mRNA expression and the prognosis of pan-creatic cancer patients.We targeted small interfering RNA(R4B10-siRNA)targeting RAB10 as the silence group,and constructed an overexpression plasmid(RAB10-OE)for overexpression of RAB10 as the overexpression group.The effects of silencing and overexpressionweredetected by Q-PCR;protein expression levelsweredetected by West-ern blot.EdUcellproliferation test,wound healing test,Transwelltestand flow cytometry test were used to determine the effects of RAB10 on the proliferation,migration,invasion and apoptosis of SW1990 pancreatic cancer cells.Re-sults RAB10 mRNA expression in PAAD tissues was higher than that innormal pancreatic tissues(P＜0.05).The results of EdUcellproliferation testshowed that the proliferation rate of SW1990 cells in the RAB10-OE group was higher thanthat in the control group,and the proliferation rate of SW1990 cells in the RAB10-siRNA group was lower than that inthe control group(P＜0.05).The results of the Transwell test and wound healing test showed that the invasion rate and mobility rate of RAB10-OE group were higher thanthose of the control group,and the mobility and invasion rate of RAB10-siRNA group were lower than those of the control group(P＜0.05).The re-sults of flow cytometry test showed that the apoptosis rate was lower in the RAB10-OE group than the control group,and the apoptosis rate in the RAB10-siRNA group was higher than the control group(P＜0.05).The median sur-vival time of RAB10 high expression group was significantly lower than that of RAB10 low expression group(P＜0.05).Cox regression analysis showed that clinical grade,T stage,M stage and RAB10 mRNA expression were re-lated to survival and prognosis of pancreatic cancerpatients(P＜0.05).Multivariate Cox regression analysis showed that the expression level of RAB10 mRNA was the independent risk factor affecting the prognosis of pancre-atic cancer patients(P＜0.05).Conclusion RAB10 is highly expressed in PAAD tissues and RAB10 can pro-mote the proliferation of pancreatic cancer cells,accelerate the ability to invade and migrate,and inhibit the apop-tosis of pancreatic cancer cells.RAB10 is an independent risk factor for survival prognosis in patients with pancreat-ic cancer.
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Objective:To improve the understanding of cervical papillary squamous cell carcinoma (PSCC), and to provide evidence for the diagnosis and treatment of PSCC.Methods:The clinicopathological and follow-up data of 18 patients diagnosed PSCC by preoperative cervical biopsy in Tangshan Gongren hospital were collected, the correlation of preoperative biopsy, liquid-based cells, and human papilloma virus (HPV) with postoperative pathology and prognosis was analyzed.Results:The concordance rate between preoperative biopsy and postoperative pathology was 50% (9/18). 4 patients showed the characteristic features of PSCC in their liquid-based cells of the 9 patients who were diagnosed as PSCC postoperatively (4/9), the HPV infection rate was 44.4% (4/9), the International Federation of Gynecology and Obstetrics stage were IA1-IB1, no lymph node metastasis, recurrence or death occurred in all patients.Conclusions:Cervical biopsy before operation has certain limitations in the diagnosis of PSCC, which requires a clear diagnosis by postoperative pathology. The HPV infection rate is lower, the stage is earlier and the prognosis is better in PSCC. Some patients can choose a less invasive surgical method than radical surgery.
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Objective @#To investigate the expression and prognosis of protein regulator of cytokinesis 1 ( PRC1) in pancreatic carcinoma tissues．Moreover，to explore the effects of PRC1 on the biological functions of pancreatic carcinoma cell line SW1990 and its related mechanisms．@*Methods@#The GEPIA database was used to analyze the expression difference of PRC1 in pancreatic carcinoma tissues and normal pancreatic tissues．Overexpression and interference of PRC1 were achieved by Lipofectamine 3000 transfection plasmid or shRNA method．Then CCK-8 assay，Transwell assay and flow cytometry were used to detect the proliferation level，invasion ability and apoptosis of the SW1990 cells，respectively．The pancreatic carcinoma data were collected from the Cancer Genome Atlas (TCGA) database．The correlation between expression level of PRC1 and clinicopathological features of pancreatic carcinoma was analyzed．The STRING database was used to analyze the network of proteins interacting with PRC1 . Gene set enrichment analysis ( GSEA) was used to predict the possible signal pathways of PRC1 in pancreatic car- cinoma. @*Results@#GEPIA database results showed that PRC1 expression in pancreatic carcinoma tissue was higher than that in normal pancreatic tissue (P＜0．05) ．The results of CCK-8 assay，Transwell assay and flow cytometry showed that PRC1 overexpression significantly enhanced SW1990 cell proliferation，invasion and inhibited apoptosis (P＜0. 01) ．Whereas PRC1 interference significantly inhibited SW1990 cell proliferation，invasion and enhanced apoptosis (P＜0. 01) ．TCGA database data analysis identified PRC1 mRNA expression level and M stage were independent risk factors affecting the prognosis of pancreatic carcinoma (P＜0. 05) ．STRING database showed that there was an interaction between PRC1 and PLK1 and so on．GSEA research results showed that the PRC1 mRNA high expression samples were enriched into P53 signaling pathway and so on (P＜0. 05) ．@*Conclusion@# PRC1 is highly expressed in pancreatic carcinoma，and it is associated with proliferation，invasion，apoptosis and prognosis of pancreatic carcinoma．Moreover，it plays an important role in pancreatic carcinoma by regulating interacting proteins PLK1 and activating P53 signaling pathways.
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Objective:To explore the effect of moderate intensity physical exercise on depression, anxiety and cognitive function of schizophrenic patients and its possible biochemical mechanism.Methods:Totally 148 patients with schizophrenia who were hospitalized in hospital from March 2019 to March 2021 were randomly divided into control group ( n=75) and exercise group ( n=73). The patients of the two groups were given drug treatment and routine exercise according to clinical practice, and the patients in exercise group were given additional medium-intensity physical exercise.Self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to evaluate the poor mental state of the subjects.The verbal fluency task(VFT), digital span test(DST), trail making test-A(TMT-A) and the positive and negative symptom scale (PANSS) were used to evaluate cognitive function.The levels of endocannabinoids (eCBs) receptors were detected by high performance liquid chromatography, and the levels of monoamine neurotransmitters and eCBs in the patients' serum were determined by enzyme-linked immunosorbent assay (ELISA). SPSS 19.0 software was used for statistical analysis.The measurement data between the two groups were compared by t-test and the counting data between the two groups were compared by χ2 test. Results:(1) After effective intervention, the scores of SAS, SDS, TMT-A and PANSS of the two groups were significantly lower than those before intervention, and the difference before and after intervention between the two groups was statistically significant( t=6.00, 6.52, 25.79, 17.03, all P<0.01). The scores of SAS, SDS, TMT-A and PANSS after intervention in the exercise group were significantly lower than those in the control group( t=4.66, 20.88, 6.61, 8.95; all P<0.01). The number of VFT and DST in the two groups after intervention were significantly higher than those before intervention, and the differences before and after intervention between the two groups were statistically significant( t=13.78, 22.76, both P<0.01). After effective intervention, the number of VFT and DST in exercise group were significantly higher than those in the control group( t=5.02, 5.15, both P<0.01). (2) After effective intervention, the contents of monoamine neurotransmitters and eCBs in serum of the two groups were significantly higher than those before intervention, and HVA level ((63.68±6.99) pg/mL), MHPG level ((175.90±16.22) pg/mL), 5-HIAA level ((29.94±4.19) pg/mL) and CBR1 level ((6.70±1.40)μg/L), 2-AG level ((61.90±5.73)pmol/g) and AEA level ((76.48±6.59) pmol/g) in exercise group were significantly higher than those in the control group ((52.97±5.37)pg/mL, (138.50±11.52)pg/mL, (23.87±3.15)pg/mL, (5.71±1.29)μg/L, (52.13±5.14)pmol/g, (67.66±5.88)pmol/g)( t=10.43, 16.21, 10.91, 8.65, all P<0.01). Conclusion:Moderate intensity physical exercise can significantly improve their depression, anxiety and cognitive function, which may be related to regulating the levels of ECBS and their receptors in patients with chronic schizophrenia to increase monoamine neurotransmitters.
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Objective:To analyze the feasibility of developing clinical pediatrics curriculum for pediatric students at the pre-clinical stage, and to provide a basis for the subsequent curriculum construction.Methods:A total of 90 pediatric medical students were enrolled, including pre-clinical group (G1, third semester of the second year, n=47) and the clinical clerkship group (G2, seventh semester of the fourth year, n=43). A questionnaire survey was conducted to compare the two groups from three aspects: clinical interest, learning methods and learning ability. And 24 and 20 students were randomly selected from the two groups to participate a clinical course respectively. Both of the formative evaluation and in-class test were carried out to compare the learning performance and learning effect between G1 and G2. SPSS 22.0 was used for data analysis. The counting data were described by case number and rate, and the frequency between groups was compared by chi-square test. When the chi-square test condition is not met, Fisher's exact test was performed. Normal distribution test was carried out for measurement data. Two independent sample t test was conducted for the comparison between groups of normal distribution data and Mann-Whitney U test for the comparison between groups of skewed distribution respectively. Results:There was no significant difference in clinical interest and pre-clinical interest between the two groups (Fisher's exact probability method, P=0.252, 1.000). There were partial differences in learning methods: G1 spent more time learning after class ( Z=-2.36, P=0.018), learned more in spare time ( Z=2.53, P=0.011), learned more on the homework ( P=0.020), and had a higher preview rate ( Z=-5.07, P < 0.001). There were also partial differences in learning ability: G2 had better literature retrieval ability ( χ2=10.57, P=0.001); G2 had higher scores on class and extended class performance ( t=-3.18, P=0.004; t=-10.14, P<0.001). In terms of learning effect, G2 scored higher scores on only one multiple choice question ( t=-2.46, P=0.022). Conclusion:The pediatrics students at the pre-clinical stage have certain interest and ability to receive clinical pediatrics courses. Sufficient pre-class preparation and appropriate curriculum design are helpful to the early cultivation of student's clinical thinking.
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【Objective】 To investigate the effects of hsa_circ_0045943 targeting miR-106a on the biological characteristics of gastric cancer cells and its mechanism. 【Methods】 Human gastric cancer cells MKN-45， AGS and gastric mucosal epithelial cells GES-1 were cultured； circ_0045943 was detected by real-time polymerase chain reaction. The overexpression and silencing of circ_0045943 adenovirus vectors OE-circRNA and sh-circRNA together with their negative controls OE-NC and sh-NC were constructed and transfected； CCK-8 method was used to detect the proliferation activity of AGS cells after overexpression and silencing of circ_0045943； TUNEL method was used to detect the cell apoptosis； transwell assay was used to detect the cell migration and invasion； and would healing assay was used to detect the cell migration. Starbase database screened the binding site of miR-106a and circ_0045943. Real-time PCR was used to detect the expression of miR-106a， and the expression of circ_0045943 and the changes of miR-106a after the treatment of OE-circRNA and sh-circRNA. 【Results】 Real-time PCR showed that the expression of circ_0045943 decreased in gastric cancer cells MKN-45 and AGS compared to GES-1 （Pboth<0.001）. CCK-8 showed that the absorbance value of AGS cells in OE-circRNA group was lower than that in sh-circRNA group （P24 h<0.01， P48 h<0.001， and P72 h<0.001）. TUNEL showed the number of apoptotic AGS cells increased after overexpression of circ_0045943， but decreased after silencing of circ_0045943. Transwell assay showed that the migration and invasion of AGS cells were lower in OE-circRNA group than in sh-circRNA group （Pboth<0.001）. The wound healing assay showed that the migration rate of AGS cells in OE-circRNA group was the lowest， but was high in sh-circRNA group （P<0.001）. Starbase retrieved that circ_0045943 and miR-106a had complementary binding sequences. Real-time PCR showed that miR-106a was highly expressed in gastric cancer cells （P<0.001）， and the expressions of circ_0045943 and miR-106a significantly differed after treatment with OE-circRNA and sh-circRNA （Pboth<0.001）. With the increase or decrease of circ_0045943， the expression of miR-106a changed in the opposite direction. 【Conclusion】 Circ_0045943 has low expression in gastric cancer， and promoting or inhibiting circ_0045943 expression may regulate the proliferation， apoptosis， migration and invasion of gastric cancer cells by targeting miR-106a.
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Objective:To compare the effects of different anesthetic methods on the prognosis in the patients with stage Ⅲ breast cancer.Methods:Based on a multicenter randomized controlled trial (NCT00418457), 274 patients with untreated stage Ⅲ breast cancer, aged 18-85 yr, of American Society of Anesthesiologists physical statusⅠ-Ⅲ, were enrolled in the study and assigned to thoracic paravertebral block (TPVB) combined with total intravenous anesthesia group (TPVB+ TIVA group, n=141) and general anesthesia group (GA group, n=133) by computer-generated randomization stratified by study site.The primary outcome parameter of this study was postoperative recurrence rate.The secondary outcome parameters were the degree of postoperative acute pain (assessed using visual analogue scale score), the incidence of postoperative nausea and vomiting (PONV), postoperative hospital stay time, and the incidence of persistent pain after breast cancer surgery (PPBCS) at 6 and 12 months after surgery (assessed using the modified Brief Pain Inventory). Results:Compared with group GA, no significant change was found in the postoperative recurrence rate ( HR=0.711, 95% confidence interval (CI) 0.418-1.210, P=0.209), the degree of postoperative acute pain and the incidence of PONV were decreased (mean difference ( MD) of visual analogue scale score -0.890, 95% CI -1.344--0.436, P<0.001; OR=0.236, 95% CI 0.083-0.674, P=0.007), and no significant change was found in postoperative hospital stay time and the incidence of PPBCS ( HR=1.000, 95% CI 0.778-1.286, P=1.000; OR=2.100, 95% CI 0.599-7.362, P=0.246) in group TPVB+ TIVA. Conclusion:Compared with general anesthesia alone, TPVB combined with total intravenous anesthesia can provide lower degree of postoperative acute pain and lower incidence of PONV, and exert no effects on postoperative recurrence, postoperative hospital stay time and PPBCS in patients with stage Ⅲ breast cancer.
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【Objective】 To explore and evaluate infection control measures of preventing cross-contamination of novel coronavirus during gastrointestinal endoscopy treatment. 【Methods】 According to the hospital’s infection control requirements and related documents, infection control measures were formulated and implemented by combining with our actual clinical situation, including the management of the endoscope room, management and protection of patients and endoscopists. Then, we evaluated the effect of these measures. 【Results】 From January 25 to March 10, 2020, a total of 71 patients (53 males and 18 females) completed gastrointestinal endoscopy treatment, with an average age of 54 years (28-81 years). There were 36 (50.7%) cases of emergency treatment. All patients had been kept in quarantine for about 14 days (24±13), and no cross-contamination of novel coronavirus occurred. 【Conclusion】 During the novel coronavirus infection epidemic period, reasonable and effective measures should be taken to minimize the risk of infection in doctors and patients. The endoscope center should strengthen preoperative screening and management of patients, master indications of endoscopic procedures, complete endoscopists’ management and protection work, strictly follow the specifications of sterilizing gastrointestinal endoscopes, and construct the layout of "three zones and two passages".
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Objective:To investigate the clinical significance of LncRNA anti-differetiation non-coding RNA (ANCR) expression in tumor tissues of gastric cancer patients and its biological effects on cells.Methods:72 cases of gastric cancer tissues and corresponding adjacent tissues were collected from Sep. 2016 to Jun. 2018 in our Hospital. Gastric cancer cell HGC-27 was cultured, lentiviral transfected ANCR cDNA full-length vector was used as a Test group in HGC-27 cells, and transfected blank vector as a control group. Real-time quantitative PCR (qPCR) was used to detect the expression of ANCR, transcription factor Oct4 and Sox2 mRNA in tissues or cells, Western blot was used to detect the expression levels of Oct4 and Sox2 in cells, CCK-8 assay was employed for detecting cell proliferation in both groups, and Transwell invasion and migration assay was used to detect the transfer ability of cells in the two groups.Results:The expressions of ANCR in gastric cancer and corresponding adjacent tissues were respectively 0.013 (0.006, 0.025) and 0.041 (0.011, 0.136) , and the expression of ANCR in gastric cancer tissues was significantly higher than that in adjacent tissues ( P<0.01) , and patients with high expression of ANCR had higher TNM stage and lower cell differentiation ( χ2=7.414 and 8.236, P<0.05) . The expressions of ANCR mRNA in control group and test group were respectively 1.000±0.064 and 6.250±0.889, Oct4 mRNA were respectively 1.000±0.208 and 2.815±0.349, Sox2 mRNA were respectively 1.000±0.173 and 2.526±0.390, Oct4 protein were respectively 1.000±0.148 and 3.396±0.105, Sox2 protein were respectively 1.000±0.119 and 2.916±0.130, and the expressions of ANCR, Oct4 and Sox2 mRNA in the test group were significantly higher than those in the control group ( P<0.01) ; the expression levels of Oct4 and Sox2 protein in the test group were significantly higher than those in the control group. The proliferation abilities of control group and test group were 7.164±0.426 and 9.627±0.605 in 72h, and 13.750±1.089 and 19.166±1.649 in 96h. The proliferation of cells in the Test group at 72 and 96 hours was significantly higher than that in the control group ( P<0.01) . The average number of invasive cells per visual field in control group and test group were 17.26±5.48 and 39.43±5.21, and number of migration cells were 30.49±7.74 and 62.20±7.51, and the number of migration and invasion cells in the Test group was significantly larger than that in the control group ( P<0.01) . Conclusions:The expression of LncRNA ANCR in tumor tissues of gastric cancer patients is significantly increased, and it is closely related to the progression of the disease of patients and the degree of cell malignancy. It can promote the expression of gastric cancer stem cell markers in vitro and enhance the ability of cell proliferation and metastasis.
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Birth defects is one of the most important problems of human society. External birth defect is one of the major research fields of plastic surgery. This kind of disorders damages the body image of patients in mild or severe way, affects severely the social confidence of the patients themselves and their families. we summarized the research progress of the common external birth defects (the incidence top 10) from the aspects of pathogenesis, prevention, treatments and so on, in order to provide reference materials to the prevention and treatment of them.
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Objective To investigate the effect of stellate ganglion block ( SGB ) on early postoperative cognitive function in elderly patients undergoing orthopedic surgery .Methods 115 elderly patients with orthopedic surgery were selected as study objects ,and they were randomly divided into observation group (55 cases) and control group(60 cases) according to the digital table .The observation group received epidural anesthesia after SGB ,while the control group only received routine epidural anesthesia .Preoperation and postoperative 6h,3d and 7d,the mini mental state examination ( MMSE ) scores were measured and compared , the cognitive function was assessed .The MMSE score and postoperative cognitive dysfunction ( POCD) occurrence before and after surgery in the two groups were compared.Results In the observation group,the preoperative MMSE score was (29.36 ±2.54) points,the MMSE scores of 6h,3d and 7d after operation were (22.69 ±3.01) points,(25.33 ±2.69) points,(28.32 ± 3.04)points,respectively.The difference between preoperation and postoperation was statistically significant ( F =51.26,P <0.05).In the control group,the MMSE scores of before surgery and 6h,3d,7d after surgery were (29.69 ±2.17)points,(20.24 ±3.59)points,(21.87 ±2.02)points and (27.66 ±3.07)points,respectively,the difference was statistically significant (F=103.70,P<0.05).Before surgery,the MMSE score between the observa-tion group and control group had no statistically significant difference .6h and 3d after surgery,the MMSE scores of the observation group were higher than those of the control group (t=3.947,7.745,all P<0.05);7d after operation,the MMSE score between the two groups had no statistically significant difference (P>0.05).6h after surgery,the inci-dence rate of POCD of the observation group was 3.64％,which of the control group was 11.67％.3d after operation, the incidence rate of POCD was 1.82％ in the observation group and 3.33％ in the control group.There was no statistically significant difference in the incidence of POCD between the two groups at 6 and 3d after operation ( P>0.05).7d after operation,POCD was not detected in the observation group ,and the incidence rate of the control group was 3.33％.The total incidence rate of POCD was 5.45％ in the observation group and 18.33％ in the control group,and the incidence rate of the observation group was lower (χ2 =4.452,P<0.05).Conclusion SGB can improve the cognitive function of elderly patients after orthopedic surgery ,and it is worthy of clinical recommendation .
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Objective To evaluate K-wire leverage reduction and fixation via the triceps tendon for irreducible supracondylar humeral fractures of Gartland types Ⅱ& Ⅲ. Methods From June 2014 to March 2016, 31 children with irreducible supracondylar humeral fracture were treated operatively in our hospital. They were 23 boys and 8 girls, aged from 4 to 11 years ( average, 6. 3 years ) , involving 19 left and 12 right arms. Their clinical manifestations included elbow swelling at the affected arm, obvious tenderness, and limited movement of the elbow. The reduction was conducted under the guidance of C-arm roentgenography by inserting a piece of 3. 0 mm K-wire into the fracture ends via the posterior triceps tendon, inserting 2 pieces of 1. 5 or 2. 0 mm K-wire from the distal lateral humerus to the proximal through the opposite cortical bone, and inserting a piece of 1. 5 or 2. 0 mm K-wire into the opposite cortical bone through the ulnar aspect of the distal humerus. Results The operation time for the 31 patients ranged from 28 to 42 minutes ( 33 minutes on average ) . They were followed up for 6 to 18 months ( 12. 3 months on average ) . All fractures united after 4 to 6 weeks ( 4. 6 weeks on average ) . At the final follow-ups, the lengths of the affected and healthy arms were re-spectively 66. 4 ± 2. 7 cm and 66. 4 ± 2. 9 cm, showing no significant difference ( P> 0. 05 ) . The therapeutic outcomes by the Flynn criteria for the elbow function were rated at the final follow-up as excellent in 26 cases, as good in 4 and as fair in one, yielding an excellent to good rate of 96. 8％. Pin tract infection occurred in 2 patients, but no deep infection or osteomyelitis was observed during follow-ups. Conclusion K-wire leverage reduction and fixation via the triceps is an effective and simple treatment for irreducible supracondylar humeral fractures of Gartland types Ⅱ& Ⅲ.
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Objective To evaluate the effect of thoracic paravertebral block ( TPVB) combined with general anesthesia on early postoperative recovery in patients undergoing breast cancer surgery. Meth-ods A total of 201 patients with untreated primary breast cancer, aged 18-69 yr, with body mass in-dex <35 kg∕m2 , of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective surgery for treatment, were enrolled and randomly assigned to general anesthesia group (group GA, n =102) and TPVB combined with general anesthesia group (group TGA, n= 99). In group TGA, TPVB was performed under ultrasound guidance at 30 min before surgery, and 0. 75％ ropivacaine 5 ml was injected at each puncture site of T1-5 . In group GA, local infiltration anesthesia was performed with 1％ lidocaine 0. 2 ml at each puncture site. Anesthesia was induced with IV fentanyl, propofol and rocuronium in both groups. Anesthesia was maintained by inhaling sevoflurane ( group GA), target-controlled infusion of propofol (group TGA) and intermittent IV boluses of fentanyl or rocuronium. Bispectral index value was maintained at 40-60 during surgery. Verbal Rating Scale score was used to assess the severity of pain after surgery. Parecoxib sodium 40 mg, pethidine 50 mg, tramadol 50 mg or fentanyl 50 μg was selected and intrave-nously injected as rescue analgesics when Verbal Rating Scale pain score>4. The requirement for rescue analgesia and development of nausea and retching∕vomiting were recorded within 2 days after surgery. Chinese quality of recovery score was used to assess the early postoperative quality of recovery on days 1 and 2 after surgery. Results Compared with group GA, the quality of recovery score was significantly increased on days 1 and 2 after surgery, the incidence of postoperative nausea was decreased (P<0. 05), and no signifi-cant change was found in the requirement for rescue analgesia or incidence of retching∕vomiting after surgery in group TGA (P>0. 05). Conclusion TPVB combined with general anesthesia is more helpful than gen-eral anesthesia alone for early postoperative recovery in the patients undergoing breast cancer surgery.
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Objective To evaluate the effect of thoracic paravertebral block ( TPVB) combined with general anesthesia on the long-term quality of life in the patients undergoing breast cancer surgery. Methods A total of 156 patients, aged 18-64 yr, of American Society of Anesthesiologists physical statusⅠ or Ⅱ, undergoing breast cancer surgery, were randomly assigned to TPVB combined with general anes-thesia group (TPVB+GA group, n= 78) and general anesthesia group (GA group, n = 78), and the pa-tients in two groups were matched with a ratio of 1 : 1. In group TPVB+GA, propofol (target effect-site concentration 2. 5-4. 0 μg∕ml) was given by target-controlled infusion, and patients received either single or multiple injections (T1-T5 ) of TPVB under ultrasound guidance at 30 min before induction of general an-esthesia. Group GA inhaled 2. 0％-2. 5％ sevoflurane. The patients were followed up at 6 and 12 months after operation, postoperative chronic pain and chronic pain affecting daily life were assessed using the mod-ified Brief Pain Inventory, the development of neuropathic pain using neuropathic pain questionnaire-short form, and the development of long-term health-related quality of life by using the 12-item short-form scale. Results There was no significant difference in the incidence of chronic pain and chronic pain affecting dai-ly life, incidence of neuropathic pain or quality of life scale score at 6 and 12 months postoperatively be-tween the two groups (P>0. 05). Conclusion TPVB combined with general anesthesia exerts no effect on the long-term quality of life in the patients undergoing breast cancer surgery.
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Objective To investigate the diagnosis and surgical therapy of delayed diaphragmatic rupture.Methods Forty patients with traumatic diaphragmatic rupture with delayed presentation were collected in Peking Uniom Medical College Hospital from January 2000 to December 2016.In all 40 patients, 36 patients had traumatic past history, 32 patients had clini-cal manifestations when diagnosed.Left-sided diaphragmatic rupture was found in 32 patients and right in 8 patients.1 patient received emergency surgery and 39 received selective surgery.38 patients received transthoracic surgery and 2 patients received combined thoracic-abdominal surgery.36 patients received direct diaphragm suture and 4 patients received patch repair.Re-sults All patients were recovered from the hospital.The median length of postoperative hospital stay was 11 days( range, 5-26 days).1 patient was found intestinal obstruction and received enterolysis 19 days after surgery.Conclusion Delayed traumat-ic diaphragmatic rupture is a rare but serious disease.Careful past history, physical examination and CT scan with reconstruc-tion of diaphragm are helpful in diagnosis and differential diagnosis.Surgical therapy after diagnosis is the best treatment.
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Objective To establish a cranial bone defect model of goat and to study application in craniomaxillo-facial surgery.Methods Electron beam computed tomography (EBCT) scanner was used to scan goat'heads and faces in series and thin layers.Data of EBCT were input in workstation from digital inlet,and then to three-dimensional reconstruction with method of surface shadow.After final data were transformed to the files,the rapid prototyping machine was able to identify and establish the 3D model.Results The EBCT continuous thin-layer (1 mm) scanning data were passed to wave filter,falling coarse,distinguishing and collecting the outline,3D-reconstruction,curved surface reconstruction with CAD and the substance reconstruction.The final data were input into the laser rapid prototyping machine.Three-dimensional bionic cranium models were fabricated by machine in layer by layer manufacturing principle.Conclusions Establishment of the cranial bone defect model in the goat is very useful to the three-dimensional measurement,individualized reconstruction and basic and clinical research for the cranial bone defect.
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Objective To analyze the correlation between CT characteristics and epidermal growth factor receptor (EGFR)mutations in pulmonary adenocarcinoma.Methods 82 patients (87 lesions)with pulmonary adenocarcinoma were retrospectively collected.All patients were underwent CT examination before operation,and EGFR gene were determined after operation.Results EGFR mutations were found in 44 of 87 lesions (50.57%).The EGFR mutations rate was 50.00% in females and 47.50% in males,there was no statistical difference between genders (P=0.821).The EGFR mutations rate was 46.55% in the right lung and 58.62% in the left lung,while no statistically significant difference was found (P=0.289).Among all the CT characteristics,the mutations rate was 63.89% in spiculated lesions and 60.71% in lesions with pleural indentation,the differences was statistically significant (P<0.05).The mutations rate was 59.25% in lesions containing solid component and 36.36% in pure ground glass opacity lesions,the difference was statistically significant (P=0.011). There were no statistically differences in lobulation,cavitation and lymphadenectasis (P>0.05).The pleural indentation was the highest in sensitivity (77.27%)and negative predictive value (67.74%).The spiculation was the highest in specificity (69.77%)and positive predictive value (63.89%).Conclusion Among all the CT characteristics,pleural indentation,spiculation and the lesion containing solid component are prone to EGFR mutations.
摘要
Objective@#To investigate the influence of mandibular distraction osteogenesis on masticatory function by analyzing the maximal bite force before and after surgery.@*Methods@#From May 2014 to November 2015, 22 hemifacial microsomia cases, ageing from 6 to 10 years old, underwent mandibular distraction osteogenesis and their biting force data were collected. The maximal bite forces in incisor area, bilateral premolar area and molar area were measured before surgery and 1 year after surgery.@*Results@#The average maximum bite forces in the molar area of the affected side, premolar area of the affected side, incisor area, premolar area of the unaffected side, molar area of the unaffected side were (170.6±42.8)N, (141.9±34.9)N, (89.7±18.8)N, (169.3±29.0)N and (230.2± 56.4)N respectively before surgery. Statistics indicated that most patients had uneven distribution of bite force between the affected side and unaffected side before surgery. And they changed to (198.8±44.0)N, (151.8±31.1)N, (88.9±18.0) N, (167.8±26.1)N and (234.3±52.5)N respectively 1 year after surgery, showing that the bite force in the molar area of the affected side was significantly improved by the surgery(P<0.05). Regression analysis showed that the postoperative bite force distribution had a tendency to become more symmetrical in hemifacial microsomia patients.@*Conclusions@#Mandibular distraction osteogenesis can improve the bite force of the affected side in hemifacial microsomia patients and enhance the balance of masticatory in the long-term postoperatively.