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Objective:To explore the application value of Oxford nanopore technologies (ONT) in the diagnosis and treatment of periprosthetic joint infection (PJI).Methods:A prospective analysis was conducted on 32 patients with PJI admitted to the joint department of Xi'an Honghui Hospital from October 2021 to March 2023, who met the 2018 PJI diagnostic criteria of the American Skeletal Infection Society (MSIS), including 15 males and 17 females with an average age of 63.93±8.93 years. 32 revision patients who did not meet the 2018 MSIS PJI criteria during the same period were collected as controls (non PJI group), including 13 males and 19 females with an average age of 65.53±8.54 years. All patients underwent joint fluid puncture before or during surgery, and the specimens were tested by ONT, metagenomic next generation sequencing (mNGS), and general microbial culture. The receiver operating characteristic (ROC) curves were drawn for both groups, and the sensitivity, specificity, positive predictive value, negative predictive value, and Youden index of the three detection techniques were calculated and compared to evaluate the detection efficiency of different detection methods in PJI.Results:Among the 32 patients with PJI, 30 were positive for ONT, with a total of 30 pathogenic bacteria detected, and the detection time was 22.37±8.36 h. 31 were positive for mNGS, with a total of 33 bacterial species detected, and the detection time was 46.25±9.36 h. 17 were positive for microbial culture, with a total of 8 bacterial species detected, and the detection time was 96.23±15.62 h. Among the 32 patients with non PJI group, 1 was positive for ONT and 5 were positive for mNGS, with a total of 1 and 3 bacterial species detected, respectively. The results of microbial culture were all negative. The detection time and area under the curve (AUC) of ONT and mNGS were 22.37±8.36 h and 0.953[95% CI (0.901, 1.006)], 46.25±9.36 h and 0.906[95% CI (0.835, 0.977)], respectively, which were better than those of microbial culture 96.23±15.62 h and 0.766[95% CI (0.678, 0.853)], and the difference was statistically significant ( P<0.05). The sensitivity of ONT, mNGS, and microbial culture were 0.938, 0.969, and 0.531, respectively, and the specificity was 0.969, 0.844, and 1.000, respectively. The Jordan index was 0.906, 0.813, and 0.531, respectively. Conclusion:ONT testing has higher diagnostic efficacy than mNGS and microbial culture in the diagnosis of PJI, and also has advantages in detection time. It also suggests that some PJI are not caused by a single microbial infection.
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Postoperative complications of colorectal cancer (CRC) are the main cause of postoperative death and seriously affect the quality of life and survival time of patients. The application of a clinical prediction model for postoperative complications of CRC can help promptly identify high-risk patients. Accordingly, reasonable intervention measures can be actively taken to reduce the incidence of postoperative complications of CRC. A scientific basis can also be provided to improve the prognosis of patients. In this work, literature on the risk-factor analysis and prediction-model construction of postoperative complications of CRC at home and abroad in recent years was collected and reviewed. The evaluation content and efficiency of the clinical prediction models in postoperative complications of CRC were summarized. Their advantages and disadvantages were also analyzed. The purpose of this study was to provide a reference for the subsequent optimization of such models and the development of a strong, clinically practical, and universal risk-screening tool for postoperative complications of CRC.
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Objective To evaluate the effect of high mobility group box 1 (HMGB1)/ cysteinyl aspartate specific proteinase (Caspase)-1/Gasdermin D (GSDMD) signaling axis-mediated hepatocyte pyroptosis on liver ischemia-reperfusion injury (IRI). Methods C57BL/6 mice were randomly divided into the sham operation group (Sham group), IRI 2 h group, IRI 6 h group, IRI 12 h group, glycyrrhizic acid (GA)+Sham group and GA+IRI 12 h group (n=8 in each group). AML12 cells were evenly divided into the Sham group, IRI 12 h group, GA+Sham group and GA+IRI 12 h group. The serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), interleukin (IL)-1β and IL-6 in each group were detected by enzyme-linked immune absorbent assay(ELISA). The messenger ribonucleic acid (mRNA) levels of IL-1β and IL-6 were detected by reverse transcription polymerase chain reaction(RT-PCR). The pathological score of liver ischemia and cell apoptosis were compared among all groups. The expression level of HMGB1 in the liver tissues of each group was determined by immunohistochemistry. The expression levels of HMGB1, Caspase-1 and GSDMD proteins in the mouse liver tissues and AML12 cells were measured by Western blot. Results Compared with the Sham group, the serum levels of ALT, AST, IL-1β and IL-6 and the relative expression levels of IL-1β and IL-6 mRNA in the liver tissues were all significantly up-regulated after IRI in each group (all P < 0.05), and showed significant time-dependent pattern along with the prolongation of reperfusion time. Compared with the Sham group, the pathological score of hepatic ischemia and the apoptosis rate of hepatocytes were significantly increased after IRI in each group (all P < 0.05). Immunohistochemical results showed that the expression level of HMGB1 in the liver tissues was significantly up-regulated after IRI, which showed an increasing trend along with the prolongation within the period of 2-12 h. Western blot showed that compared with the Sham group, the relative expression levels of HMGB1, Caspase-1 and GSDMD proteins in vivo and in vitro were up-regulated in the IRI 12 h group. The relative expression level of HMGB1 protein was significantly up-regulated, whereas those of Caspase-1 and GSDMD proteins were significantly down-regulated in the GA+IRI 12 h group compared with those in the IRI 12 h group (all P < 0.05). Conclusions Hepatocytes probably activate the Caspase-1/GSDMD signaling pathway by releasing HMGB1, thereby triggering hepatocyte pyroptosis and leading to liver IRI. Inhibition of extracellular release of HMGB1 by GA may mitigate liver IRI.
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Objective:To evaluate whether underdilated stent could reduce the occurrence of hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunt (TIPS) creation.Methods:A total of 197 patients with decompensated liver cirrhosis, who had underwent TIPS creation at Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, were analyzed retrospectively, including 110 males and 87 females with age 25-79 (54±11) years old. Uncovered and covered stents with 8 mm diameter were implanted in all subjects, and then dilated by balloon catheters with 6 mm or 8 mm diameter. The patients were divided into two groups, including underdilated group (6 mm, n=105) and control group (8 mm, n=92).Kaplan-Meier curves were used to illustrate cumulative rate of HE, and the differences were assessed with the log-rank test. Multivariate analyses with a Cox regression model were conducted to explore the risk factors for HE. Results:During a median follow-up period of 29 (12-54) months, 16 (15.2%) patients developed HE in the underdilated group and 27 (29.3%) patients in the control group. There was a significant difference in the cumulative rate of HE ( P=0.014), but no statistical differences were found in terms of variceal rebleeding, shunt dysfunction and survival between the two groups ( P=0.608, P=0.659, P=0.968). In multivariated analysis, group assignment (underdilated vs. control, HR=0.291, 95% CI 0.125-0.674, P=0.004) was identified as an independent risk factor for HE after TIPS creation. Conclusion:Underdilated TIPS could reduced the risk of HE compared with completely dilated TIPS, with comparable risk of variceal rebleeding, shunt dysfunction and mortality. And it is worthy of applying this technique to a large sample of patients in clinical practice.
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Gastric cancer is a common cancer in digestive system in China. It′s in the forefront of cancer in terms of morbidity and case fatality, posing a great threat to people′s health. With the advent of the era of precision medicine, the treatment of each patient with gastric cancer must follow the principle of individualization. However, individualized treatment is based on the development of biomarkers. Liquid biopsy has been reported to be a biomarker capable of detecting information about tumorigenesis and progression, and has been suggested as a useful tool for personalized treatment. Compared with traditional "tissue biopsy" , liquid biopsy has significant advantages because it is noninvasive and painless, reduces cost and time for diagnosis, and could be used for diagnosis, prognosis, prediction of disease progression, or as a surrogate marker of response to treatment.For this purpose, the author will review the related detection techniques of liquid biopsy and its role in early screening, efficacy evaluation and recurrence monitoring of gastric cancer.
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OBJECTIVES@#To coat a zirconia surface with silica-zirconia using a dip-coating technique and evaluate its effect on resin-zirconia shear bond strength (SBS).@*METHODS@#A silica-zirconia suspension was prepared and used to coat a zirconia surface using a dip-coating technique. One hundred and eighty-nine zirconia disks were divided into three groups according to their different surface treatments (polishing, sandblasting, and silica-zirconia coating). Scanning electron microscopy (SEM), energy dispersive X-ray (EDX), and X-ray diffraction (XRD) were used to analyze the differently treated zirconia surfaces. Different primer treatments (Monobond N, Z-PRIME Plus, and no primer) were also applied to the zirconia surfaces. Subsequently, 180 composite resin cylinders (Filtek Z350) were cemented onto the zirconia disks with resin cement (RelyX Ultimate). The SBS was measured after water storage for 24 h or 6 months. The data were analyzed by two-way analysis of variance (ANOVA).@*RESULTS@#SEM and EDX showed that the silica-zirconia coating produced a porous layer with additional Si, and XRD showed that only tetragonal zirconia was on the silica-zirconia-coating surface. Compared with the control group, the resin-zirconia SBSs of the sandblasting group and silica-zirconia-coating group were significantly increased (@*CONCLUSIONS@#Dip-coating with silica-zirconia might be a feasible way to improve resin-zirconia bonding.
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A prospective randomized controlled study was conducted in 120 patients with hydronephrosis-free lower calyceal calculi in Jiangshan People′s Hospital from June 2020 to August 2021. Patients were divided into drug group, vibration group and combination group by random number table method with 40 cases in each group. The drug group was treated with potassium hydrogen citrate sodium, the vibration group was treated with external physical vibration lithotripsy (EPVL), and the combination group was treated with EPVL combined with potassium hydrogen citrate sodium. The renal stone discharge rate and complications were observed and compared among three groups 1, 2 and 4 weeks after treatment. The overall discharge rate in 120 patients was 39.2%(47/120). The discharge rate of vibration group and combination group were higher than that of drug group ( P<0.05). There were no significant differences in stone discharge rate at 1 and 2 weeks after treatment between vibration and combination group ( P=0.63 and 0.14), while the calculi discharge rate at 4 weeks after treatment in combination group was higher than that in vibration group ( P=0.03).The overall incidence of complications in 120 patients was 12.5% (15/120), that of drug group, vibration group and combination group was 7.5%(3/40), 15.0%(6/40), and 15.0% (6/40), respectively ( P<0.05). No serious complication occurred, and all patients recovered well after treatment. The results suggest that EPVL can promote the discharge of small calyceal calculi in hydronephrosis-free patients, and potassium hydrogen citrate sodium can further facilities the discharge of renal stone.
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Objective:To investigate the effect of pulmonary vascular dysfunction in the prognosis of patients with acute lung injury (ALI).Methods:Patients with ALI who underwent pulmonary artery catheterization in the department of critical care medicine of Wuhan NO.1 Hospital from June 2017 to June 2019 were enrolled. The general information, clinical and hemodynamic indexes [central venous pressure (CVP), pulmonary artery wedge pressure (PAWP), pulmonary artery systolic pressure (sPAP), pulmonary artery diastolic pressure (dPAP), mean pulmonary artery pressure (mPAP), cardiac index (CI)], acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, arterial blood gas parameters [pH, partial pressure of oxygen (PO 2), partial pressure of carbon dioxide (PCO 2), oxygenation index (PaO 2/FiO 2)], whether there was shock or not; ventilator parameters [platform pressure (Plat), positive end-expiratory pressure (PEEP)], etc. were recorded. Pulmonary artery oxygen saturation, pulmonary vascular function indexes [transpulmonary potential gradient (TPG) and pulmonary vascular resistance index (PVRi)] were calculated. The relationship between TPG, PVRi and mechanical ventilation time, the length of intensive care unit (ICU) stay, cardiovascular days and 60-day mortality were analyzed in patients with different prognosis of 60-day and whether the TPG increased (≥12 mmHg was defined as elevated TPG, 1 mmHg = 0.133 kPa). Results:A total of 65 patients were included in the study, including 30 males and 35 females; aged (48.9±15.2) years old. Forty-eight cases survived in 60-days, 17 died, and the 60-day mortality was 26.2%. At the baseline, there were no significant differences in cardiopulmonary function measurements, such as CVP, sPAP, dPAP, PAWP, CI, etc. between the two groups of patients with different prognosis. The APACHEⅡ score, shock ratio, TPG and PVRi of the death group were significant higher than those of the survival group [APACHEⅡ: 34±9 vs. 28±11, shock: 52.9% vs. 25.0%, TPG (mmHg): 16.2±1.9 vs. 14.6±2.1, PVRi (kPa·s·L -1): 31.8±4.2 vs. 29.7±3.5, all P < 0.05]. The 60-day mortality of 47 patients with TPG ≥ 12 mmHg was significantly higher than that of 18 patients with TPG < 12 mmHg (34.0% vs. 5.6%), and the mechanical ventilation time and the length of ICU stay were also significantly longer (days: 17±9 vs. 11±8, 16±5 vs. 12±5), and the cardiovascular days also increased significantly (days: 23±7 vs. 18±6), and the differences were statistically significant (all P < 0.05). Pearson correlation analysis showed that PVRi was significantly correlated with mechanical ventilation time, the length of ICU stay and cardiovascular days ( r1 = 0.317, P1 = 0.030; r2 = 0.277, P2 = 0.005; r3 = 0.285, P3 = 0.002). In the individual multivariate Logistic regression model, the highest PVRi was an independent risk factor for the 60-day mortality [odds ratio ( OR) = 30.5, 95% confidence interval was 20.4-43.1, P = 0.023]. Conclusion:Pulmonary vascular dysfunction is common in ALI patients and is independently associated with adverse outcomes.
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Objective To study the clinical efficacy of transjugular intrahepatic portosystemic shunt (TIPS) combined with agitation thrombolysis in treatment of acute portal vein thrombosis (PVT) in patients with liver cirrhosis.Methods The clinical data of 37 cirrhotic patients with acute PVT treated from January 2014 to December 2017 at the First Affiliated Hospital of Henan University of Science and Technology was analyzed.There were 20 males and 17 females with age ranging from 29 to 71 years.The patients were divided into the combined group (n =15) and the anticoagulation group (n =22).The combined group was treated with TIPS combined with agitation thrombolysis anticoagulation.The anticoagulation group was treated with anticoagulation.The changes in liver function and hemodynamics of portal vein of the two group were compared.Follow-up studies included postoperative portal vein patency,bleeding and survival rates of patients.Results The postoperative portal vein pressure and maximum burden of PVT in the combined group were significantly lower than those before operation,and the portal vein maximum blood volume and flow velocity of portal vein were significantly higher than those before operation (all P < 0.05).At 2 weeks,6 months and 12 months after operation,the maximum burden of PVT of the combined group was (13.9 ±5.4)%,(16.1 ±5.5)% and (13.8 ±6.2)%,respectively,which was significantly lower than that of the anticoagulant group (84.1±31.3)%,(85.9±27.6)% and (88.2±39.5)% (all P<0.05).At 2 weeks,6 months and 12 months after operation,the flow velocity of portal vein of the combined group was (21.6 ± 5.7) cm/s,(16.1 ± 6.3) crn/s and (17.6 ± 4.9) cm/s,respectively,which was significantly higher than that of the anticoagulation group (9.7 ± 4.6) cm/s,(8.1 ± 4.3) cm/s and (8.2 ± 3.5) cm/s (all P < 0.05).After operation,3 patients in the combined group developed recurrence of portal vein thrombosis,while the remaining patients had smooth blood flow in the portal vein and shunt.In the anticoagulation group,only 3 patients had unobstructed portal vein blood flow.The cumulative rate of no gastrointes tinal bleeding in the combined group was significantly better than the anticoagulant group.The cumulative survival rate of the combined group was also significantly better than the anticoagulation group (P < 0.05).Conclusion TIPS combined with agitation thrombolysis was more effective than the traditional anticoagulant therapy in treatment of acute portal vein thrombosis in cirrhotic patients.
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Objective: To summarize the guiding role of imaging evaluation of oblique lumbar interbody fusion (OLIF) in recent years. Methods: The reports of OLIF surgical imaging research at home and abroad in recent years were extensively reviewed and analyzed. Results: Preoperative imaging evaluation plays an important role in guiding the operation of OLIF, the placement of fusion Cage, the selection of indications, and the reduction of complications. Conclusion: Detailed preoperative imaging evaluation can correctly estimate the indications of OLIF, and avoid the nerve, blood vessel, and muscle injuries.
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OBJECTIVE: To explore the effect of occupational high temperature exposure on type 2 diabetes( T2 DM) in male steel workers. METHODS: A cluster random sampling method was used to select 684 male steel workers,who exposed to occupational high temperature in a steel enterprise in Tangshan City,as the high temperature group,and 1 153 male steel workers without occupational high temperature exposure as the control group. The high temperature level of workers in these two groups was measured. The cumulative exposure( CE) of high temperature was calculated,and occupational health exam was performed. The multivariate logistic regression analysis and restricted cubic splines were used to analyze the relationship between high temperature CE and T2 DM. RESULTS: The prevalence of T2 DM in high-temperature group was higher than that in the control group( 13. 0% vs 7. 9%,P < 0. 05). The multivariate logistic regression analysis results showed that the risk of T2 DM in the high temperature group was higher than that in the control group after adjusting for age,body mass index,smoking,drinking,physical exercise and parents with diabetes( P < 0. 05). The 95% confidence interval was 1. 65( 1. 17-2. 33). Restricted cubic spline analysis showed that the high temperature CE was correlated with the prevalence of T2 DM in workers( P < 0. 01) and showed a linear correlation( nonlinearity test,P > 0. 05). CONCLUSION: Occupational high temperature exposure is associated with the occurrence of T2 DM in male steel workers. The male steel workers with high temperature CE show high prevalence of T2 DM risk.
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Objective@#To discuss the surgical method and clinical effect of applying the facial artery perforator-based nasolabial para-nasal advanced flap to repair the medial canthus and inner lower eyelid skin defects.@*Methods@#The advance nasolabial para-nasal perforator flap supplied by facial artery, was used to repair the medial canthus and inner lower eyelid skin defects, caused by dermatoma excision.@*Results@#All 18 flaps completely survived. The detects in the medial canthus andinner lower eyelid, and the donor sites in the nasolabial fold were primary healed.The medial canthus and inner lower eyelid were recovery satisfactorily.The flaps were not bloated, and the contour and texture of flaps were similar to adjacent tissue, with no need of secondary repair.The donor site was successfully hidden in the nasolabial dermatoglyph.@*Conclusions@#Nasolabial para-nasal perforator flap is easily obtained, reliable in blood supply, and flexible in transfer. It has a wide range of movement and is easy to advance, so as to repair medial canthus andinner lower eyelid defect. With above advantages, this flap is worthy towidely popularize.
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There is growing evidence shown that microRNAs (miRNAs) are associated with cancer and can play a role in human cancers as oncogenes or tumor suppressor genes. MicroRNA-214 (miR-214) shows carcinogenesis in various tumor types, but little is known about biological functions of miR-214 in esophageal squamous cell carcinoma (ESCC). In this study, we observe that the expression of miR-214 is not only increased in human ESCC tissues, but also remarkably increased in cell lines correlates with LZTS1. In addition, the expression of miR-214 inhibited proliferation of ESCC cells in vitro and inhibit the growth of xenograft tumor in vivo. The results show miR-214 serve as a tumor promoter regulating cells migration, invasion and apoptosis in ESCC. Ferthermore, LZTS1 has been proved to as a functional target for miR-214 to regulate cells poliferation and apoptosis. In summary, these results suggest that miR-214 serves as tumor promoter to promote proliferation, migration, invasion and inhibit apoptosis of ESCC cells by targeting LZTS1 via PI3K/AKT/mTOR signaling pathway. The miR-214/LZTS1 pathway provides a new insight into the molecular mechanisms that the occurrence and development of ESCC and it provides a novel therapeutic target for ESCC.
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Apoptosis/genética , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/patología , Neoplasias Esofágicas/genética , Neoplasias Esofágicas/patología , MicroARNs/metabolismo , Fosfatidilinositol 3-Quinasas/metabolismo , Proteínas Proto-Oncogénicas c-akt/metabolismo , Animales , Secuencia de Bases , Línea Celular Tumoral , Proliferación Celular/genética , Proteínas de Unión al ADN/genética , Proteínas de Unión al ADN/metabolismo , Regulación hacia Abajo/genética , Carcinoma de Células Escamosas de Esófago , Regulación Neoplásica de la Expresión Génica , Humanos , Masculino , Ratones Endogámicos BALB C , Ratones Desnudos , MicroARNs/genética , Metástasis de la Neoplasia , Serina-Treonina Quinasas TOR/metabolismo , Proteínas Supresoras de Tumor/genética , Proteínas Supresoras de Tumor/metabolismo , Ensayos Antitumor por Modelo de XenoinjertoRESUMEN
OBJECTIVE: To analyze the effect of occupational stress on abnormity of serum total cholesterol and triglyceride in male steel workers. METHODS: A total of 3 957 male steel workers from an iron and steel group company were selected as study objects by judgment sampling method. Occupational stress was measured by the Chinese version of Job Content Questionnaire. The serum total cholesterol and triglyceride levels were measured using fasting venous blood. RESULTS: Among the 3 957 workers,the detection rate of occupational stress was 56. 8%,and 55. 0% of them showed high social support. The abnormal rates of total cholesterol and triglyceride were 21. 8% and 40. 9%,respectively. The multivariate logistic regression analysis showed that workers with high social support had high risk of abnormal total cholesterol and abnormal triglyceride than workers with low social support( P < 0. 05) after adjusting for confounding factors such as age,education level,marital status,body mass index,smoking and drinking alcohol,tea. The odds ratio of abnormal total cholesterol in occupational stress workers was 1. 17 times of that of non-occupational stress workers. No association was found between occupational stress and abnormal triglyceride( P > 0. 05). CONCLUSION: Occupational stress may be associated with abnormity of total cholesterol in male steel workers. Social support is an important influences factor to the abnormity of total cholesterol and triglyceride in male steel workers.
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Objective To investigate the relationship of NT-ProBNP,IVRT and Ea/Aa in patients with acute cerebral infarction.Methods From February 2015 to May 2016,67 patients with acute cerebral infarction and 60 healthy subjects were selected as observation group and control group.Sserum NT-proBNP levels and cardiac ultrasound parameters of the two groups were measured.The correlation between NT-ProBNP and left ventricular diastolic function was analyzed,and the ability of NT-ProBNP to detect left ventricular diastolic function was assessed with the ROC curve analysis.Results Compared with those in control group,IVRT and NT-ProBNP of observation group were significantly increased (t =5.844,7.947,P =0.005,0.000),while Ea/Aa was significantly lower (t =4.639,P =0.012).Correlation analysis showed that there was a significant positive correlation between NT-ProBNP and IVRT (r =0.507,P =0.001),and a remarkably negative correlation between NT-ProBNP and Ea/Aa (r =-0.592,P <0.001) Multiple linear regression analysis showed that NT-ProBNP was independently correlated with IVRT and Ea/Aa (3 =541.90,26.38).ROC predictive results showed that NT-proBNP had the most optimal sensitivity (100%) and specificity (100%) for detecting Ea/Aa < 1.0 in patients with acute cerebral infarction.Conclusion Serum NT-ProBNP levels can indirectly reflect the severity of left ventricular diastolic dysfunction in patients with acute cerebral infarction.
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Objective To explore the expression changes and possible molecular mechanisms of Neuritin and HSP60 during the repair of liver injury,and to provide an experimental basis for the study of the repair of liver injury. Methods Forty-eight Sprague-Dawley(SD)rats were randomly divided into control group without any treatment(n=6)and experimental group(n=42)underwent 70% hepatectomy to induce acute liver injury,and 6 h,12 h,24 h,48 h,3 d,7 d and 14 d after the operation,the left lobe resection of the residual liver was per-formed. Immunoblotting technique (Western blot) was used to detect the expression difference of Neuritin and HSP60 in liver tissue of the corresponding time points. Hematoxylin eosin staining(hematoxylin-eosin staining, HE)was used to observe the expression changes at each time point in liver pathology,and tail vein blood to detect ATL and AST changes. Results (1)Compared with those in the control group,the serum ALT and AST levels in the experimental group were increased at 6 h,12 h,24 h and 48 h after the operation,and reached the peak at 48 h postoperatively but those began to decrease 3 d postoperatively and was almost normal 7 d postoperatively. The difference was statistically significant(P < 0.05). Pathological findings:compared with that in the control group, the hepatic lobule structure in the experimental group was disorderly. The obvious balloon like change reached the peak 48 h postoperatively.(2)In the whole process of repair of liver injury,the expression of Neuritin and HSP60 showed differences in the opposite. There was a significantly negative correlation between Neuritin expression and the repair or the aggravation of the injury(P<0.001)and the lowest expression was observed 48 h postoperatively. There was a significantly positive correlation between HSP60 expression and the repair or the aggravation of the injury(P < 0.001)and the highest expression was observed 48 h postoperatively. Conclusions (1)With simple 70% left hepatic lobectomy,the repair of liver injury model of SD rats is successfully established and the heaviest injury is observed 48h postoperatively. With a high success rate(100%,42/42),simple and practical,the method provides a reliable and convenient animal model for the study of liver regeneration,liver injury and liver transplan-tation.(2)The expression of Neuritin decreases gradually after liver injury and reaches the lowest 48 h postopera-tively,while the expression of HSP60 increases gradually and reaches the highest 48 h postoperatively.(3)The change of expression of Neuritin and HSP60 is closely related to the process of liver injury repair(P < 0.001), showing a certain change rule. They may have some biological effects through interactions,and participate in and promote the regeneration and repair of liver injury.
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Objective To evaluate the clinical efficacy of combination of transjugular intrahepatic portosystemic shunt (TIPS) and catheter-directed thrombolysis (CDT) in the treatment of acute portal vein thrombosis (PVT) accompanied by Budd-Chiari syndrome (BCS) with extensive occlusion of the hepatic veins.Methods From March 2013 to December 2015,nine patients of acute PVT accompanied by BCS with extensive occlusion of the hepatic veins were collected,and the patients were treated by the combination of TIPS and CDT.The clinical symptoms,liver function and portal vein hemodynamics of patients were observed.After operation,portal vein and shunt patency was followed up by Doppler ultrasound.The patients were followed up seven days,one,three,six months,and every six months after the operation.Paired sample t test was performed for statistically analysis.Results The study enrolled nine patients,six male and three female,with an average age of (41.6 ± 10.9) years old.Operation was successfully performed in eight patients,and of whom three were completed under the assist of perctaneous transhepatic approach.After operation,the blood flow of portal vein was unobstructed and clinical symptoms of portal vein hypertension were obviously improved.There was no significant difference in portal vein diameter between pre-operation ((13.6 ± 2.1) cm) and seven days ((12.5±1.7) cm),one month ((12.1±2.9) cm),three months ((12.9±3.2) cm),six months ((11.6± 1.8) cm) after operation (all P>0.05).And the portal vein velocity after operation were (79.3± 14.6),(84.4±17.3),(87.3±21.4) and (80.1±12.6) cm/s,respectively,which were higher than that before operation ((9.8 ± 3.1) cm/s),and the differences were statistically significant (t=28.169,34.713,36.519,30.314,all P<0.01).The maximum cross sectional area ratios of the thrombus to the lumen after operation were (17.1±6.9)%,(19.1±6.2)%,(16.2±±5.5)% and (16.7±5.1)%,respectively,which were lower than that before operation ((78.2 ±14.5)%),and the differences were statistically significant (t=26.182,23.931,29.371,27.471,all P<0.01).At the seventh day after operation,the pressure of portal vein decreased from (42.2±8.9) cmH2O (1 cmH2O=0.098 kPa) to (19.6±4.2) cmH2O (t=17.410,P<0.01).At seven days,one month,three months and six months after operation,albumin levels ((30.7±3.9),(30.9±4.2),(29.9±3.1) and (33.1±4.7) g/L) were all higher than that before operation ((26.5 ± 4.8) g/L),and the differences were statistically significant (t =4.785,4.874,2.874,5.402,all P<0.05).The levels of transaminase after operation (32.9±21.6),(39.5±22.4),(24.8± 19.8),(37.1±26.9) U/L) were all lower than that before operation ((99.6±31.7) U/L),and the differences were statistically significant (t=27.624,24.913,33.671 and 25.019,all P<0.01).During eight to 17 months follow-up,TIPS stent shunt stenosis was found in one case at three months after operation and the blood flow recovered after treatment of balloon dilation.The shunt and blood flow of portal vein of the other seven cases were clear.None of the eight patients had the symptoms of hepatic encephalopathy and pulmonary embolism.Operation was not successfully performed in one case,and 29 days later the patient died of hepatic and renal failure.Conclusion The combination of TIPS and CDT is safe and effective in the treatment of acute PVT accompanied by BCS with extensive occlusion of the hepatic veins,which maintain the blood flow of portal vein clear during short-and medium-term follow-up.
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AIM: To study the suppressive effect of glycogen synthase kinase-3β( GSK-3β) knockdown by RNA interference on the formation of keloid .METHODS:Human keloid fibroblasts ( KFB) in vitro were transfected with 3 pairs of specific GSK-3βsmall interfering RNA (siRNA).The best siRNA to inhibit the GSK-3βexpression in human KFB was screen by RT-PCR and Western blot .The expression of GSK-3βand related proteins at mRNA and protein levels in the KFB was determined by RT-PCR and Western blot .RESULTS: The GSK-3βsiRNA1434 remarkably inhibited the expression of GSK-3βat mRNA and proteins levels in the human KFB .After transfection with GSK-3βsiRNA, the protein levels of β-catenin, p-GSK-3β, Wnt2 and cyclin D1 were all decreased.KFB growth became slow.With the extension of time, the inhibition of cell growth increased , and the cell doubling time was significantly delayed .CONCLUSION:siRNA targeting GSK-3βefficiently knocks down the expression of GSK-3βin the human KFB, and inhibits the activation of Wnt signaling pathway , thus inhibiting the growth of keloid .GSK-3βmay be a potential therapeutic target for keloid .
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Objective To evaluate the clinical effect of endovascular interventional therapy in treating Cockett syndrome associated with deep vein thrombosis (DVT) of left lower extremity.Methods The clinical data of a total of 256 patients with Cockett syndrome complicated by DVT of left lower extremity,who were admitted to authors' hospital during the period from January 2011 to January 2015,were retrospectively analyzed.The patients were treated with catheter-directed thrombolysis,balloon dilatation of the occluded or narrowed venous segment,and/or stent implantation.The circumference differences of the affected limbs before and after treatment and the long-term patency rates were compared.Results Of the 256 patients with Cockett syndrome complicated by DVT of left lower extremity,complete dissolution of thrombus was achieved in 232 (90.6%) and partial dissolution of thrombus in 24 (9.4%).The circumference difference of thigh and calf was (7.12±2.15) and (4.57±2.81) cm respectively before and after treatment.Iliac vein reconstruction was carried out in 206 patients,among them simple balloon dilatation was employed in 46 and balloon dilatation together with stent implantation was adopted in 160.The patients were followed up for 9-24 months with a mean of 15 months.In simple balloon dilatation group,3 patients lost touch with the authors during the following-up period,26 patients (60.5%) developed iliac vein occlusion and post-embolization syndrome occurred in 21 patients (48.8%).In balloon dilatation plus stent implantation group,11 patients lost touch with the authors during the following-up period,stenosis or occlusion of the stent was seen in 13 patients (8.7%),post-embolization syndrome was observed in 15 patients (10.1%).The differences in vascular stenosis or occlusion and in the occurrence of post-embolization syndrome between the two groups were statistically significant (P<0.001).Conclusion For the treatment of Cockett syndrome complicated by DVT of left lower extremity,catheter-directed thrombolysis and balloon dilatation combined with stent implantation carry definite clinical curative effect.
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To explore the application of gene chip technology in the acupuncture research so as to provide evidences for the mechanism of acupuncture for regulating bodies. The literature on the application of gene chip technology in the acupuncture field from 2001 to 2016 was collected in PubMed, Springer, CNKI and WANFANG databases, which was analyzed and summarized. There were some achievements of the technology for acupuncture research, focusing on the five aspects, including the study of the relationship between meridian-point and viscera, the influencing factors of acupuncture effect, the effect and mechanism of acupuncture analgesia, the mechanism of acupuncture anti-aging, the effect and mechanism of acupuncture for diseases of each system. Gene chip technology plays an important role in researching acupuncture mechanism. It is an important technology for genomics study of acupuncture. However, there are also some disadvantages such as high cost, deficient data mining, non-uniform observation objects, deficient professionals, etc. All those need further resolution so as to promote the application of this technology in the acupuncture researching field.