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Objective @#To study the effect of sex-determining region Y-frame protein 3 (SOX3) on proliferation and estradiol secretion in human ovarian granulosa cells (KGN cell line) . @*Methods@#The gene sequence of human SOX3 (NM_005634. 3) was searched in Gene-Bank , an NCBI database , and the target gene SOX3 was amplified by PCR , which was cloned into lentiviral vector pLV-EF1a-GFP-2A-Puro to obtain the overexpression lentiviral re- combinant plasmid pLV-EF1a-GFP-2A-Puro- SOX3 ; the correctly sequenced overexpressed lentiviral recombinant plasmid as well as packaging plasmids ( pGag/Pol , pRev , pVSV-G) were co-transfected into human embryonic kidney cell line ( HEK 293T) cells ( pLV-SOX3 group) , and pLV-EF1a-GFP-2A-Puro and packaging plasmids (pGag/Pol , pRev , pVSV- G) were co-transfected into HEK 293T cells (pLV-NC group) , the lentiviral particles of both groups were collected and the titers of the viruses were measured after 48 h of transfection , the lentiviruses of the two groups were infected into KGN cells , and the stably expressed cell lines were obtained after puromycin screening for 2 weeks; real-time fluorescence quantitative PCR (RT-qPCR) and Western blot were used to detect the SOX3 mRNA and protein levels in the two groups; CCK-8 assay was used to detect the proliferative ability of the cells in the two groups; ELISA was used to determine the concentration of estradiol in the two groups .@*Results@#The identification of PCR products and sequencing results showed that the SOX3 gene fragment was amplified successfully , and the enzyme digestion and sequencing results indicated that the construction of overexpression lentiviral recombinant plasmid was completed; green fluorescence could be detected after lentiviral infection of HEK 293T cells , which indicated that lentiviral packaging was successful; the lentivirus was screened by puromycin after lentiviral infection of KGN cells , and the cells were observed to express green fluorescence under the fluorescence microscope; RT- qPCR and Western blot assays both showed that the expression level of SOX3 in the pLV-SOX3 group was significantly higher than that in the pLV-NC group ( P < 0. 05) . CCK-8 assay results showed that the proliferation ability of the cells in the pLV-SOX3 group significantly increased compared with that in the pLV-NC group (P < 0. 01) . ELISA results showed that estradiol concentration was elevated in the pLV-SOX3 group com- pared with the pLV-NC group (P < 0. 05) . @*Conclusion@#Overexpression of the transcription factor SOX3 can pro- mote the proliferation and estradiol secretion of human ovarian granulosa cells KGN .
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Portal vein thrombosis (PVT) refers to thromboembolism that occurs in the extrahepatic main portal vein and/or intrahepatic portal vein branches. PVT is the result of the combined effect of multiple factors, but its pathogenesis remains unclear. Animal models are an important method for exploring the pathophysiological mechanism of PVT. Based on the different species of animals, this article reviews the existing animal models of PVT in terms of modeling methods, principles, advantages and disadvantages, and application.
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Objective:To evaluate the value of a three-dimensional inversion-recovery with real reconstruction (3D-real IR) sequence with an ultralong repetition time (TR) for the endolymphatic hydrops (EH) of Meniere disease (MD) after intravenous gadolinium administration, and compare it with a heavily T 2-weighted three-dimensional fluid-attenuated inversion recovery (hT 2-3D-FLAIR) sequence. Methods:From July 2021 to July 2022, 52 definite MD patients (58 ears) were retrospectively enrolled at Zhongshan Hospital, Fudan University. The 3D-real IR with an ultralong TR (16 000 ms) and hT 2-3D-FLAIR sequences were performed four hours after intravenous single-dose gadolinium administration. The image quality of the two sequences was rated. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were measured in the two sequence. The EH of cochlear and vestibular was graded, and EH detection rates were calculated. Scores of the two sequences were compared using the paired Wilcoxon signed rank test. Paired t test was used to compare the differences of the SNR and CNR. McNemar test was performed to compare the EH detection rate between the two sequences. Results:The score of the 3D-real IR [3 (3, 4)] was significantly higher than that of the hT 2-3D-FLAIR [2.5 (2, 3), Z=-6.06, P<0.001]. No significant difference was found in SNR of 3D-real IR and hT 2-3D-FLAIR (11.4±6.5 and 12.3±3.7, t=-1.38, P=0.175). CNR of the 3D-real IR (21.7±9.3) was significantly higher than that of the hT 2-3D-FLAIR (9.7±3.8, t=10.67, P<0.001). Using 3D-real IR sequence, the EH detection rate of cochlear (89.7%, 52/58) was higher than using hT 2-3D-FLAIR (67.2%, 39/58, χ 2=11.10, P<0.001). No significant difference was found in the EH detection rate of vestibular between 3D-real IR (77.6%, 45/58) and hT 2-3D-FLAIR (74.1%, 43/58, χ 2=0.50, P=0.500). Conclusion:Compared with hT 2-3D-FLAIR sequence, the 3D-real IR with an ultralong TR can improve the depiction of EH in MD patients after intravenous single-dose gadolinium administration. It can provide higher image quality and detection rate of EH.
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Oxidative stress, due to the disruption of the balance between reactive oxygen species (ROS) generation and the antioxidant defense system, plays an important role in the pathogenesis of rheumatoid arthritis (RA). Excessive ROS leads to the loss of biological molecules and cellular functions, release of many inflammatory mediators, stimulate the polarization of macrophages, and aggravate the inflammatory response, thus promoting osteoclasts and bone damage. Therefore, foreign antioxidants would effectively treat RA. Herein, ultrasmall iron-quercetin natural coordination nanoparticles (Fe-Qur NCNs) with excellent anti-inflammatory and antioxidant properties were constructed to effectively treat RA. Fe-Qur NCNs obtained by simple mixing retain the inherent ability to remove ROS of quercetin and have a better water-solubility and biocompatibility. In vitro experiments showed that Fe-Qur NCNs could effectively remove excess ROS, avoid cell apoptosis, and inhibit the polarization of inflammatory macrophages by reducing the activation of the nuclear factor-κ-gene binding (NF-κB) pathways. In vivo experiments showed that the swollen joints of mice with rheumatoid arthritis treated with Fe-Qur NCNs significantly improved, with Fe-Qur NCNs largely reducing inflammatory cell infiltration, increasing anti-inflammatory macrophage phenotypes, and thus inhibiting osteoclasts, which led to bone erosion. This study demonstrated that the new metal-natural coordination nanoparticles could be an effective therapeutic agent for the prevention of RA and other diseases associated with oxidative stress.
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The application of intraocular drug delivery is usually limited due to special anatomical and physiological barriers, and the elimination mechanisms in the eye. Organic nano-drug delivery carriers exhibit excellent adhesion, permeability, targeted modification and controlled release abilities to overcome the obstacles and improve the efficiency of drug delivery and bioavailability. Solid lipid nanoparticles can entrap the active components in the lipid structure to improve the stability of drugs and reduce the production cost. Liposomes can transport hydrophobic or hydrophilic molecules, including small molecules, proteins and nucleic acids. Compared with linear macromolecules, dendrimers have a regular structure and well-defined molecular mass and size, which can precisely control the molecular shape and functional groups. Degradable polymer materials endow nano-delivery systems a variety of size, potential, morphology and other characteristics, which enable controlled release of drugs and are easy to modify with a variety of ligands and functional molecules. Organic biomimetic nanocarriers are highly optimized through evolution of natural particles, showing better biocompatibility and lower toxicity. In this article, we summarize the advantages of organic nanocarriers in overcoming multiple barriers and improving the bioavailability of drugs, and highlight the latest research progresses on the application of organic nanocarriers for treatment of ocular diseases.
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Portadores de Fármacos , Preparaciones de Acción Retardada , Sistemas de Liberación de Medicamentos , Nanopartículas/químicaRESUMEN
Hepatobiliary tumor is a type of malignant tumor including primary liver cancer, cholangiocarcinoma, and gallbladder carcinoma. At present, hepatobiliary tumors have become the second leading cause of cancer-related death worldwide, while the treatment methods for such tumors cannot effectively meet clinical needs. Therefore, it is a key scientific problem in this field to explore and develop the experimental technology of accurate drug screening for hepatobiliary tumors, find new strategies and methods for clinical treatment, and provide new ideas for early diagnosis and comprehensive treatment of hepatobiliary tumors. This article introduces the latest research advances in the novel technologies for accurate drug screening for hepatobiliary tumor and their application potential by focusing on the construction of individualized pathological models of hepatobiliary tumor, drug screening technologies, the design and screening strategy of specific target drugs, and drug screening strategy based on artificial intelligence and big data analysis, as well as the directions for future development.
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OBJECTIVE@#To observe the clinical effect of transforaminal endoscopy combined with interspinous fusion in the treatment of lumbar spinal stenosis with instability in the elderly.@*METHODS@#From February 2018 to February 2019, 82 elderly patients with lumbar spinal stenosis and instability were divided into control group and observation group. In the control group, there were 23 males and 18 females;the age was (68.9±4.1) years;the course of disease was (14.1±5.7) months;there were 5 cases of single segment lesions and 36 cases of multi segment lesions;simple bacfuse interspinous fusion was used. In the observation group, there were 22 males and 19 females;the age was (69.1±4.0) years;the course of diseasewas (14.4±5.5) months;there were 6 cases of single segment lesions and 35 cases of multi segment lesions;they were treated with transforaminal endoscopic surgery combined with Bacfuse interspinous fusion. The clinical efficacy, visual analogue scale (VAS), Japanese Orthopaedic Association scores (JOA), Oswestry disability index (ODI), Lehmann lumbar function score, posterior disc height and intervertebral foramen height, complication rate and recurrence rate of the two groups were compared.@*RESULTS@#The clinical efficacy of the observation group was better than that of the control group;the VAS score of the observation group was lower than that of the control group, the JOA score was higher than that of the control group, and the ODI index at 3 months after operation and at the last follow-up was lower than that of the control group, the Lehmann lumbar function score was higher than that of the control group;the posterior edge height of intervertebral disc and intervertebral foramen height were higher than those of the controlgroup;the incidence of complications and recurrence rate (4.9% and 0.0%) of the observation group were lower than those of the control group (19.5%, 9.8%), the difference was statistically significant (@*CONCLUSION@#The clinical effect of transforaminal endoscopy combined with interspinous process fusion in the treatment of lumbar spinal stenosis with instability in the elderly is ideal. It can reduce postoperative pain, improve lumbar function, improve the height of posterior edge of intervertebral disc and intervertebral foramen, and reduce the incidence and recurrence rate. It is worthy of clinical promotion.
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Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Endoscopía , Degeneración del Disco Intervertebral , Vértebras Lumbares/cirugía , Estudios Retrospectivos , Fusión Vertebral , Estenosis Espinal/cirugía , Resultado del TratamientoRESUMEN
@#Objective To compare the short-term outcomes of surgical repair for atrial septal defect (ASD) with a robotic (da Vinci Si) approach versus a conventional open procedure. Methods Clinical data of 140 patients undergoing ASD closure in the First Affiliated Hospital of Anhui Medical University from January 2016 to May 2020 were retrospectively analyzed. The patients were divided into a robotic group and a sternotomy group according to different surgical methods. In the robotic group, there were 67 patients including 20 males and 47 females at a median age of 40.0 (25.0) years, and in the sternotomy group there were 73 patients including 23 males and 50 females at a median age of 41.0 (29.0) years. Multivariate linear regressions were used to produce risk-adjusted analysis of pertinent clinical characteristics. Kaplan-Meier analysis was performed to compare the speed of sternotomy versus robotic group returning to exercise or daily life. Results Robotic-assisted surgery was associated with significantly shorter 24 h postoperative drainage volume [220.0 (210.0) mL vs. 345.0 (265.0) mL, P<0.001], mechanical ventilation [6.0 (11.0) h vs. 8.0 (11.0) h, P=0.024], intensive care unit length of stay (LOS) [19.0 (19.0) h vs. 22.0 (25.0) h, P=0.005], postoperative hospital LOS [9.0 (5.0) d vs. 10.0(6.0) d, P=0.003], and a lower rate of perioperative blood transfusion (28.36% vs. 84.93%, P<0.001). After controlling for patient comorbidity in the multiple regression model, there remained a trend toward decreased 24 h postoperative drainage volume (β=–115.30, 95%CI–170.78 to –59.82, P<0.001), mechanical ventilation (β=–4.96, 95%CI –8.33 to –1.59, P=0.004) and postoperative hospital LOS (β=–2.31, 95%CI –3.98 to –0.63, P=0.007) in the robotic group. Kaplan-Meier analysis revealed that patients returned to exercise or daily life earlier in the robotic group [35.0 (32.0) d vs. 90.0 (75.0) d, P<0.001]. Conclusion Closure of ASD can be performed safely and effectively via robotic approach. And the minimally invasive technique is beneficial to postoperative recovery.
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Radiation therapy is an extensively applied cancer treatment methods in clinic. Radiation therapy can be conducted by either administrating/implanting radioactive isotope agents into the patients to irradiate tumors from inside, or using external beams (e.g. X-ray beams) to irradiate the tumor from the outside. It is well known that oxygen molecules play an important role in enhancing radiation-induced cancer cell killing. However, as most of solid tumors possess hypoxic tumor microenvironment, the tumor hypoxia is well recognized as one of important reasons that lead to the resistance of tumors to radiation therapies. In recent years, owing to the rapid development of biomaterials and nanotechnology, many different strategies have been reported to effectively modulate and reverse the hypoxic tumor microenvironment. In this article, we will summarize various types of nano-biomaterials for tumor hypoxia relief and their application in radiotherapy sensibilization, as well as the future clinical translation.
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The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly become a global public health threat due to the lack of effective drugs or vaccines against SARS-CoV-2. The efficacy of several repurposed drugs has been evaluated in clinical trials. Among these drugs, a relatively new antiandrogen agent, enzalutamide, was proposed because it reduces the expression of transmembrane serine protease 2 (TMPRSS2), a key component mediating SARS-CoV-2-driven entry into host cells, in prostate cancer cells. However, definitive evidence for the therapeutic efficacy of enzalutamide in COVID-19 is lacking. Here, we evaluated the antiviral efficacy of enzalutamide in prostate cancer cells, lung cancer cells, human lung organoids and SARS-CoV-2-infected Ad-ACE2-transduced Tmprss2 knockout (Tmprss2-KO) and wild-type (WT) mice. TMPRSS2 knockout significantly inhibited SARS-CoV-2 infection in vivo. Enzalutamide effectively inhibited SARS-CoV-2 infection in human prostate cancer cells (LNCaP) but not in human lung cancer cells or patient-derived lung organoids. Although Tmprss2 knockout effectively blocked SARS-CoV-2 infection in ACE2-transduced mice, enzalutamide showed no antiviral activity due to the AR independence of TMPRSS2 expression in mouse and human lung epithelial cells. Moreover, we observed distinct AR binding patterns between prostate cells and lung cells and a lack of direct binding of AR to TMPRSS2 in human lung cells. Thus, our findings do not support the postulated protective role of enzalutamide in treating COVID-19.
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Objective To evaluate the efficacy and safety of stereotactic body radiation therapy (SBRT) using Cyberknife in the treatment of patients with recurrent cholangiocellular carcinoma (RCC) after surgery.Methods Clinical data of 26 patients with recurrent RCC after surgery undergoing Cyberknife SBRT from 2010 to 2015 were retrospectively analyzed.The median recurrence time was 10 months (range 2.0-63.0 months) and the median tumor diameter was 2.8 cm (range 1.2-4.8 cm).The median prescription dose/fraction was 45 Gy/5f (range 40-50 Gy/3-8 f).The tumor progression was evaluated based on enhanced CT or MRI.Overall survival (OS),progression-free survival (PFS) and local control rate (LC) were analyzed by Kaplan-Meier method.Toxicity was assessed using the common terminology criteria for adverse events version 4.0.Results For the entire cohort,the median OS and PFS were 13.5 months and 6.5 months at a median follow-up of 29.3 months (range 2.1-62.0 months).The 1-and 2-year OS and PFS rates were 52% and 21% as well as 28% and 15%,respectively.Among them,4 patients (4/26,15%) were recurrent in situ after SBRT.Three patients experienced grade Ⅲ adverse reactions including 1 case of gastrointestinal reaction,1 case of liver dysfunction and 1 case of biliary tract infection.Only 1 patient suffered from ≥ grade Ⅳ gastrointestinal bleeding during the advanced stage.Conclusions SBRT using Cyberknife is a safe and effective treatment for patients with recurrent RCC after surgery.The adverse reactions can be tolerated by patients.
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Objective To investigate the effect of maximal sterile barrier precaution during deep venous/arterial catheterization on preventing catheter-related bloodstream infection (CRBSI)in patients in the department of critical care medicine.Methods 996 patients who were hospitalized in Beijing Friendship Hospital and underwent deep ve-nous/arterial catheterization from September 2011 to April 2014 were analyzed retrospectively,patients were divided into standard sterile barrier precaution group (SSB group,September 2011-December 2012,n=560)and maximal sterile barrier precaution group (MSB group,January 2013-April 2014,n=436)based on whether they received maximal sterile barrier precaution,incidence of CRBSI and mortality were compared between two groups.Results There was no statistical difference in constitute of intubation sites between patients in SSB group and MSB group(χ2=6.750,P=0.08).The incidence of CRBSI per 1000 catheter days in SSB group and MSB group were 2.41‰(1.64‰-4.02‰)and 1.91‰(0‰-4.56‰)respectively,rank test revealed no significant difference(Z=-0.057, P>0.05);24 (4.29%)patients in SSB group and 26(5.96%)patients in MSB group developed CRBSI,difference between two groups was not statistically significant(χ2=1.447,P>0.05).The mortality in SSB group and MSB group were (18.43±5.53)% and (11.68±4.14)% respectively,independent sample t-test revealed that difference was significant(t=3.907,P<0.05).Conclusion Maximal sterile barrier precaution did not reduce the incidence of CRBSI.
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Objective: To explore application value of brachial-ankle pulse wave velocity (baPWV) in physical examination in Shenyang district and its risk factors.Methods: A total of 1610 cases, who received regular physical examination in health management center of General Hospital of Shenyang Military Command and met enrollment standards, were selected.Bilateral baPWV and other indexes were measured in all subjects.Logistic regression analysis was used to assess relationship among age, body mass index (BMI), arterial blood pressure, blood biochemical indexes and baPWV.Results: Compared with women, there was significant rise in baPWV[(1361.03±244.72) cm/s vs.(1397.93±239.08) cm/s, P=0.003]in men.baPWV rose along with age increased despite male or female.Compared with normal baPWV group (<1400 cm/s), there were significant rise in age[(45.57±8.95) years vs.(57.07±10.50) years], BMI[(25.25±6.82) kg/m2 vs.(26.14±3.44) kg/m2], fasting blood glucose[FBG, (4.88±1.73) mmol/L vs.(5.43±2.02) mmol/L], low density lipoprotein cholesterol[LDL-C, (2.67±0.82) mmol/L vs.(2.84±0.77) mmol/L], total cholesterol[TC, (4.88±0.99) mmol/L vs.(5.13±0.98) mmol/L], triglyceride[TG, (1.73±1.65) mmol/L vs.(2.15±1.91) mmol/L], systolic blood pressure[SBP, (116.72±12.04) mmHg vs.(136.87±16.21) mmHg], diastolic blood pressure[DBP, (76.99±9.01) mmHg vs.(86.34±10.84) mmHg]and pulse pressure[PP, (39.72±8.32) mmHg vs.(50.53±14.17) mmHg]in elevated baPWV group (≥1400cm/s), P<0.01 all.Multivariable Logistic regression analysis indicated that age, FBG,TG, SBP, DBP and PP levels were independent risk factors for elevated baPWV (OR=1.549~5.943, P<0.05 or <0.01).Conclusion: In Shenyang district, baPWV is closely correlated with cardiovascular risk factors, and it possesses good application value in physical examination and early risk screening of cardiovascular diseases.
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BACKGROUND: Tendon injury is common in clinic, which is mainly treated by surgical anastomosis. Postoperative tendon healing is usually assessed through surgeons' experience due to high cost and application restrictions of MRI examination. Thus there is still a lack of a convenient and objective imaging support. With the advancement and widespread application of high-frequency ultrasound, the diagnosis rate of tendon injury has been improved remarkably; thereafter, high-frequency ultrasound used for assessing tendon injury and repair has become an issuehas become an issue of concern.OBJECTIVE: To clarify the ultrasonic imaging features of tendon repair through high-frequency ultrasound scancombined with histological examination.METHODS: This was a single-central, preoperative and self-controlled animal experiment and finished in the Central People'sHospital of Siping, China. 130 adult male Highbrow chickens were selected and were then randomized into 13 groups (n=10per group). One side of each chicken hind foot was randomly selected as experimental limb to undergo achillotomy followedby repair using the modified Kessler method (groups 2-13) or no treatment (group 1); the contralateral limb served as control.Moreover, passive flexion-extension functional training targeting the experimental limbs was performed in the groups 8-13beginning at the 1st day after surgical anastomosis, several times a day. The high-frequency ultrasound and hematoxylineosinstaining were conducted before and after chillotomy (group 1), and at 3 (groups 2 and 8), 7 (groups 3 and 9), 14 (groups4 and 10), 21 (groups 5 and 11), 35 (groups 6 and 12) and 42 (groups 7 and 13) days after surgical anastomosis, respectively.RESULTS AND CONCLUSION: The primary measurement outcomes were the repair and healing of the injured tendonas assessed by high-frequency ultrasound; the secondary outcomes were the pathological manifestations of the injuredtendon detected by hematoxylin-eosin staining. Our findings will provide preclinical proof for high-frequency ultrasounduse in the assessment of tendon injury, repair and healing as well as for the rehabilitation therapy that promotes functionrecovery in the future.
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AIM:To explore the cataract suspensory ligament rupture and artificial lens implantation suture fixation into capsular bag without capsular tension ring(CTR).METHODS:We reviewed 20 cases of 20 cataract suspensory ligament rupture without CTR intraocular lens (IOL) implantation fixation in our department from Jan.2012 to Dec.2016.The needle crossed into ocular ciliary sulcus, in the equator of the eye ball which suspensory ligament rupture from, then the needle crossed out 1.5mm away from the angle of sclera.Sutures fixed on the IOL, then the artificial lens implantation in the pouch, carried out in accordance with the Z type suture, or to the beforehand prepared triangle scleral flap.The visual acuity, intraocular pressure, the anterior chamber and the IOL position were measured after operations.RESULTS:All of the postoperative visual acuity improved different level.The postoperative best corrected visual acuity(BCVA) was ≥0.8 in 4 eyes(20%), 0.5-0.6 in 7 eyes(35%), 0.3-0.4 in 8 eyes(40%), 0.1 in 1 eye(5%) because of the glaucoma optic atrophy.There were 12 cases with mild corneal endothelium edema, 4 cases exudation membrane in the pupil area, 2 cases hyphema, all of which recovered after treatment.There were 2 eyes with vitreous prolapse in the pupil, 1 case appeared mild IOL center deviation and no special treatment for the vision did not be involved.Followed up for 6mo, displaced stitches or artificial lens shift did not occur.CONCLUSION:Without CTR, the IOL implantation and suture fixation in capsular bag during cataract surgery is a surgical method for basic-level hospitals.
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Objective To explore the changes of bulbocavemosus sphincter reflex (BCR) in male rabbit models of spinal cord ischemia injury of different levels at acute stage and their values in predicting spinal cord functions,and provide theoretical basis for protecting the spinal cord function by neurophysiology examination in clinical microsurgical operation.Methods Thirty-six adult New Zealand rabbits were randomly divided into 6 groups:a control group (n=6) was used to eliminate the effects of anesthesia and surgery on BCR;rabbits in the experimental group (n=30) were randomly divided into 5 groups (n=6) according to different levels of lumbar arteries being ligatured between the left renal artery and arterial bifurcate (subgroups of one,two,three,4 and 5 lumbar arteries being ligatured).BCR was recorded continuously within two h of ligation;rabbits in each group were subjected to double-blind Tarlov lower limb motor function scale before and 2 d after surgery;and ischemic spinal cord specimens were performed hematoxylin and eosin (HE) staining to observe pathological changes in sacral spinal cord ischemic areas after 2 days.Results There was no significant difference in BCR amplitude and latency between different time points after anesthesia (P>0.05);there was no significant difference in BCR amplitude and latency between different time points before and after operation (P>0.05).There was no significant change in the amplitude of BCR before and after one lumbar artery ligation;however,the BCR amplitude immediately changed after ligaturing two,three,4 or 5 lumbar arteries:the latency of BCR immediately began to extend and amplitude immediately began to reduce;amplitude was stable respectively after (0.7±0.4),(0.7±0.3),(0.7±0.3) and (0.6±0.3) min of ligation.The amplitude variation of BCR was positively correlated with Tarlov lower limb motor function scale scores 2 days after ligation (r=0.791,P=0.0001).HE staining showed that the normal sacral spinal cord structure was observed in the control group,subgroups of one and two lumbar arteries being ligatured;the basically normal sacral spinal cord structure was observed in the subgroup of three lumbar arteries being ligatured;the normal sacral spinal cord structure basically disappeared in the subgroup of 5 lumbar arteries being ligatured;the spinal cord injury of subgroup of 4 lumbar arteries being ligatured was between that of subgroup of three lumbar arteries being ligatured and subgroup of 5 lumbar arteries being ligatured.Conclusion The amplitude and latency of BCR in male rabbits are sensitive to sacral cord ischemic injury,which can help find ischemic injury in the reversible phase of the sacral cord ischemia and provide theoretical basis for the prevention of occurrence of male irreversible sacral spinal cord injury during microsurgery.
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BACKGROUND AND OBJECTIVES: To explore the lung-protective effect of levosimendan (LS) during cardiopulmonary bypass in a canine model by determining the wet/dry weight (W/D) ratio of lung tissue, malonaldehyde (MDA) and superoxide dismutase (SOD) concentrations, and performing a histological evaluation. MATERIALS AND METHODS: Thirty-two canines were divided randomly into four groups and underwent a routine aortic cross-clamping cardiopulmonary bypass procedure for 1 h, followed by recovery for 2 h. Animals were handled as follows: group C (means control group), no special treatment after aortic cross clamping; group P (means pulmonary artery perfusion group), pulmonary artery perfusion with cold oxygenated blood after aortic cross clamping; group LSIV (means intravenous injection of LS group), intravenous injection of LS (65 µg/kg) before thoracotomy, and the rest of the procedure was identical to the control group; group LPS (means pulmonary perfusion with LS group), pulmonary perfusion with cold oxygenated blood combined with LS (65 µg/kg) after aortic cross clamping. Lung tissues were removed and subjected to evaluation of pathological alterations, W/D ratio and MDA and SOD concentrations. RESULTS: In group C, the W/D ratio and MDA concentration were higher, while the SOD concentrations were lower (p<0.05). Compared with groups P and LSIV, the MDA concentration was lower in group LPS, while that of SOD was higher (p<0.05); Light and electron microscopy indicated that LS intervention reduced impairment of lung tissues. CONCLUSION: Our findings suggest that LS plays an important role in protecting lung tissues.
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Animales , Puente Cardiopulmonar , Constricción , Inyecciones Intravenosas , Lesión Pulmonar , Pulmón , Malondialdehído , Microscopía Electrónica , Oxígeno , Perfusión , Arteria Pulmonar , Superóxido Dismutasa , ToracotomíaRESUMEN
OBJECTIVE To retrospectively analyze the clinical characteristics of the benign paroxysmal positional vertigo (BPPV) secondary to the sudden deafness (SD) and to explore the possible pathogenetic mechanism, diagnosis and treatment. METHODS 218 cases of the SD in our department were retrospectively analyzed, and 37 patients with primary BPPV during the same period were used as control group. All patients were confirmed by the examination of Dix-Hallpike and the roll check,the primary disease (sudden deafness) of secondary BPPV patients were in line with the Chinese Medical Association diagnostic criteria. RESULTS In all these patients with SD,there were 91 cases with BPPV secondary to the SD. There were 67 cases of BPPV of posterior semicircular canal and 21 cases of BPPV of lateral BPPV semicircular canal. Besides, 3 cases were of multi-semicircular canal affected. All patients with BPPV were diagnosed as the same ears as the SD. The symptoms were alleviated and initial success rate was 68.1%. During 6-22 month follow-ups, total success rate was 100%, and recurrence rate was7.7% (7/91). The hearing recovery of high frequency is worse than that of the low frequency. There were 2 cases of recurrence in lateral BPPV group, 5 cases in posterior BPPV group. All were cured by reposositioning maneuver. All patients with primary and secondary BPPV were cured with Epley maneuver or Barbecue roll maneuver, and the curative effect of them is similar. CONCLUSION The occurrence of BPPV may follow SD,and the majority of BPPV secondary to the SD occurs in the posterior semicircular canal. The canalith repositioning is an effective therapy for secondary BPPV.
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Objective To explore lung protection effect of levosimendan(LS) during cardiopulmonary bypass in canine model by ratio between dry and wet (W/D) lung tissue,concentrations of malonaldehyde (MDA) and superoxide dismutase (SOD) and alterations of histology.Methods A total of 32 canines were divided into 4 groups at random with the procedure of myocardial blocking for 1 hour and then recovering for 2 hours.Animals in 4 groups were handled as following:No any special treatment after myocardial blocking in control group(group C).Lung perfusion was performaned with cold oxygenated blood after myocardial blocking in experiment 1 group(group P).LS(65 μg/kg) was injected intravenously before thoracotomy in experiment 2 group(group LSIV) and remaining procedure was same to the control one.Combined with LS (65 μg/kg),lungperfusion was performaned with cold oxygenated blood after myocardial blocking in experiment 3 group(group LSP).Right lung tissue of canines was taken immediately after the study for observing pathological alterations and measuring the concentrations of MDA and SOD through corresponding procedure.Results Compared with group C,the ratios of W/D and the concentrations of MDA were lower significantly,while those of SOD were higher significantly(P < 0.05).Compared with group P and LSIV,the concentration of MDA was lower significantly,while that of SOD was higher significantly(P < 0.05).There was no significant difference between group P and LSIV(P >0.05).Less impairment of lung tissue was found after LS intervention by light and electric microscope.Conclusion LS plays an important role in protecting lung tissue,based on founding in canine model,with decreasing ration of W/D and concentration of MDA and increasing that of SOD by both intravenous injection and lung perfusion.
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Objective To explore the risk factors of the occurence and 28-day death of acute respiratory distress syndrome (ARDS) in intensive care unit (ICU). Methods A prospective multicentral cohort study was conducted. The patients from five ICUs of grade A tertiary hospitals in Beijing from July 2009 to March 2014, including sepsis,septic shock,trauma,pneumonia,aspiration,massive blood transfusion,bacteremia and pulmonary contusion,were enrolled. Researchers in each center reported the records with uniform tables,which included demographic,systemic conditions,the primary disease,and the severity within 24 hours,past history and so on. According to the admission diagnosis in ICU,these patients were divided into ARDS group and other severe disease control group. The risk factors of occurence and prognosis of ARDS were analyzed by univariate analysis,multivariate logistic regression and multivariate COX regression analysis. Kaplan-Meier method was applied to draw the 28-day survival curves of the two groups. Results There were 343 critical patients included in this prospective multicenter cohort study,of which 163 patients who developed ARDS were considered as ARDS group(2 case lost to follow-up, and 49 died)and 180 patients who did not developed ARDS regarded as severe control group(1 case lost to follow-up, and 34 died). The 28-day mortality of ARDS group was significantly higher than that of severe control group〔30.43%(49/161)vs. 18.99%(34/179),χ2=6.013,P=0.014〕. Multivariate logistic analysis showed that aspiration〔odds ratio(OR)=6.390,95% confidence interval(95%CI)=2.046-19.953,P=0.001〕,history of alcohol (OR=4.854,95%CI=1.730-13.617,P=0.003),sepsis(OR=2.859,95%CI=1.507-5.425,P=0.001), pneumonia(OR=2.822,95%CI=1.640-4.855,P30 beats/min(OR=3.305,95%CI=1.910-5.721,P100 beats/min(OR=2.101,95%CI=1.048-4.213,P=0.037)happened in critically ill patients, it highly suggested ARDS would happen. The proportion of the patients whose serum creatinine>176.8 μmol/L in ARDS group was lower than that in control group(OR=0.387,95%CI=0.205-0.733,P=0.004). Multivariate COX regression analysis showed that old age and septic shock were significantly associated with the increased risk of in 28-day death of ARDS〔advanced age:hazard ratio(HR)=1.040,95%CI=1.018-1.064,P30 beats/min and heart rate>100 beats/min could predict the occurrence of ARDS in critical patients. Old age and septic shock were the risk factors of 28-day death of ARDS.