[Clinical analysis of laparoscopic treatment of chronic traumatic diaphragmatic hernia in 29 cases].

Objective: To examine the safety and effectiveness of laparoscopic individualized surgical treatment for chronic traumatic diaphragmatic hernia (CTDH). Methods: The clinical data and follow-up data of 29 CTDH cases admitted to the Qilu Hospital of Shandong University or the First Affiliated Hospital of Shandong First Medical University from June 2015 to January 2023 were retrospectively analyzed. There were 21 males and 8 females, aged (49.4±17.8) years (range: 19 to 79 years). The main clinical manifestations were symptoms of the digestive system and respiratory system, and only 4 cases were asymptomatic. All patients received laparoscopic treatment (conversion to open surgery was not excluded). Intraoperative exploration (location of the hernia, contents of the hernia, diameter of the hernia ring), surgical conditions (surgical repair plan, operation time, blood loss, postoperative complications) and postoperative follow-up were analyzed and discussed. Results: Laparoscopic repair was successfully completed in 27 cases, including simple suture in 6 cases, suture and patch repair in 17 cases, the anterior abdominal wall muscle flap reversal suture and patch repair of in 3 cases, and patch bridge repair in 1 case. The operation time was (112.8±44.7) minutes (range: 60 to 200 minutes). The amount of bleeding (M(IQR)) was 35 (58) ml (range: 10 to 300 ml). The other 2 patients were converted to laparotomy. Except for one patient with transverse colon strangulation necrosis who died of aggravated pulmonary infection after surgery, the remaining 28 patients were discharged successfully. The follow-up time was 36 (24) months (range: 1 to 60 months). During the follow-up period, only two patients had occasional left upper abdominal discomfort. Twenty-seven patients with left diaphragmatic hernia had no recurrence, and the symptoms of 1 patient with right diaphragmatic hernia were relieved. Conclusion: Customized laparoscopic surgical repair for CTDH according to the location and size of the diaphragmatic defect can achieve good surgical results.

[Study on the effect of slightly acid hypochlorous water on dental unit waterlines biofilm model].

Pseudomonas aeruginosa biofilm was established on PU and PVC's surface by Center of Disease Control (CDC) Biofilm Reactor, to evaluate the effectiveness of Slightly Acidic Hypochlorous water (SAHW) for removing Pseudomonas aeruginosa biofilm on Polyurethane (PU) or Polyvinyl Chloride (PVC), which are commonly used in dental unit waterlines (DUWL). The biofilms were treated with 10 mg/L SAHW, 40 mg/L SAHW and sterile distilled water (control group) by the continuous immersion method for 3, 7, and 10 days. The total viable count (TVC) and Confocal laser scanning microscopy (CLSM) were selected to evaluate the biofilm removal effect and calculate the biofilm reduction rate. The results of TVC showed that 99%-100% biofilm reduction could be achieved in 10 mg/L SAHW group and 40 mg/L SAHW group. The results of CLSM showed that 10 mg/L SAHW group and 40 mg/L SAHW group could reach 89%-100% biofilm reduction after 10 days of treatment.

[Clinical outcome of totally thoracoscopic cardiac surgery for mitral valve replacement: a series of 634 cases].

OBJECTIVE: To summarize the clinical outcome of totally thoracoscopic cardiac surgery for mitral valve replacement. METHODS: Clinical data of 634 cases undergoing totally thoracoscopic cardiac surgery for mitral valve replacement from May 2004 to February 2016 in Department of Thoracoscopic Cardiacsurgery, Shanghai Yodak Cardiothoracic Hospital was analyzed retrospectively. There were 292 male and 342 female patients, aged from 17 to 68 years with a mean of (45±13) years. All the 634 patients had moderate-severe mitral valve stenosis and (or) incompetence, 263 patients had moderate-severe tricuspid valve incompetence, 356 patients had atrial fibrillation, 46 patients had left atrium thrombosis. Cardiopulmonary bypass was established with right femoral artery and a single 2 stage venus cannula in the right atrium. The ascending aorta was cross-clamped and the myocardium was protected by coronary perfusion with cold crystalloid cardioplegia. Totally thoracoscopic mitral valve replacement were performed. RESULTS: Thirteen cases had incision expanded and 8 cases had conversions to sternotomy. Cardiopulmonary bypass and aortic cross-clamp time were (89±18) minutes and (51±12) minutes, respectively. Operation time was (3.1±1.2) hours. Mechanical ventilation time and intensive care unit stay were (17±6) hours and (27±8) hours, respectively. Postoperation drainage quantity was (390±70) ml. The hospital days was (9.2±2.1) days. There were 5 cases in-hospital deaths. Postoperative complications occurred in 42 cases (6.6%), including 18 cases of right hemoneumothorax, 12 cases of reoperation for bleeding, 3 cases of perivalvular leakage (reoperation was done in 1 patient), 3 cases of low cardiac output syndrome, 2 cases of acute renal failure, 2 cases of inferior vena cava injury, 1 case of right femoral artery thrombosis and liver injury, respectively. The mean duration of follow-up was (58±9) months in 608 cases, with a follow-up rate of 96.7% (608/629). Three patients had died during the period of follow-up caused by congestive heart failure (2 patients) and stroke (1 patient). Late complication among 605 survivors were 37 cases, including 32 cases of moderate tricuspid valve insufficiency, 3 cases of stroke, 1 case of perivalvular leakage and infective endocarditis, respectively.There was no reoperation during the period of follow-up. CONCLUSION: Totally thoracoscopic cardiac surgery for mitral valve replacement is safe and effective, with unique superiority and clinical feasible.

In situ investigation of the surface morphology evolution of the bulk ceramic Y2Mo3O12 during crystal water release.

The surface morphology evolution of the bulk ceramic Y2Mo3O12 during the release of crystal water is followed in situ for the first time using atomic force microscopy. It is found that both the shape and size of individual grains and the integration morphology of the sample exhibit dynamic changes with increasing temperature. We believe that the surface morphology evolution of the sample with increasing temperature is closely correlated with the forces induced by the contraction and expansion of the lattice during crystal water release in two different stages.

Lead inhibition of DNA-binding mechanism of Cys(2)His(2) zinc finger proteins.

The association of lead with chromatin in cells suggests that deleterious metal effects may in part be mediated through alterations in gene function. To elucidate if and how lead may alter DNA binding of cysteine-rich zinc finger proteins, lead ions were analyzed for their ability to alter the DNA binding mechanism of the Cys(2)His(2) zinc finger protein transcription factor IIIA (TFIIIA). As assayed by DNase I protection, the interaction of TFIIIA with the 50-bp internal control region of the 5S ribosomal gene was partially inhibited by 5 microM lead ions and completely inhibited by 10 to 20 microM lead ions. Preincubation of free TFIIIA with lead resulted in DNA-binding inhibition, whereas preincubation of a TFIIIA/5S RNA complex with lead did not result in DNA-binding inhibition. Because 5S RNA binds TFIIIA zinc fingers, this result is consistent with an inhibition mechanism via lead binding to zinc fingers. The complete loss of DNase I protection on the 5S gene indicates the mechanism of inhibition minimally involves the N-terminal fingers of TFIIIA. Inhibition was not readily reversible and occurred in the presence of an excess of beta-mercaptoethanol. Inhibition kinetics were fast, progressing to completion in approximately 5 min. Millimolar concentrations of sulfhydryl-specific arsenic ions were not inhibitory for TFIIIA binding. Micromolar concentrations of lead inhibited DNA binding by Sp1, another Cys(2)His(2) finger protein, but not by the nonfinger protein AP2. Inhibition of Cys(2)His(2) zinc finger transcription factors by lead ions at concentrations near those known to have deleterious physiological effects points to new molecular mechanisms for lead toxicity in promoting disease.

Reproducibility of studies of peritoneal dialysis adequacy.

To assess the variability and reproducibility of dialysis adequacy clearance measurements (weekly Kt/V and weekly creatinine clearance/1.73 m2 BSA) in a given patient, 42 patients underwent three clearance studies in a one week period. The dialysis prescription was kept constant. There were 21 males with a group mean age of 49 +/- 15 years; 37 patients performed CAPD and 5 DAPD; the dialysis prescription was 6 to 12 liters/day; and 17 patients were anuric. To assess test variability within each patient, the coefficient of variation (CV) and the range were determined for each patient's three clearance values, and for the factors that determine those values. These were averaged to determine the mean patient variability (CV and range) of those measurements. The mean patient CV of the weekly Kt/V was 8.1%. The mean patient range of the weekly Kt/V was 0.30. Of the determinants of total Kt/V, the greatest variability (GV) existed in residual renal urea clearance at 35.4%, with moderate variability seen for peritoneal dialysis urea clearance at 7.0%, which was more a function of variability in D/P urea (CV = 6.3%) than variability in drain volume (CV = 4.1%). There was little variability in V (CV = 0.6%). Similar results were seen for the variability in weekly creatinine clearance measurements. We found that the day-to-day reproducibility of Kt/V measurements is limited, especially in patients with residual renal function, although day-to-day variability in D/P urea also affects Kt/V reproducibility in all patients. Values that fall into the borderline "adequate" range may need to be repeated when considering a patient's dialysis prescription. In addition, research that involves the measurement of Kt/V should utilize more than one collection to increase the reliability of those measurements.

A neuromagnetic study of acupuncturing LI-4 (Hegu).

The brain magnetic fields evoked by acupuncturing LI-4(Hegu) were measured by using SQUID (superconductive Quantum Interference Device) Biomagnetometer, and the morphological characters of these biomagnetic fields were examined in 12 subjects. The observed phenomenon of the LI-4(Hegu)'s projection area overlapping on the jaw's and face's projection area suggests that excitation of LI-4 (Hegu)'s projection area activated by acupuncturing LI-4(Hegu) could inhibit action of the jaw's and face's projection through the overlapping area, and this is the reason why the acupuncturing LI-4(Hegu) could effectively case pains in the treatment of dental pain.

Role of phosphate in initial iron deposition in apoferritin.

Ferritins from microorganisms to man are known to contain varying amounts of phosphate which has a pronounced effect on the structural and magnetic properties of their iron mineral cores. The present study was undertaken to gain insight into the role of phosphate in the early stages of iron accumulation by ferritin. The influence of phosphate on the initial deposition of iron in apoferritin (12 Fe/protein) was investigated by EPR, 57Fe Mössbauer spectroscopy, and equilibrium dialysis. The results indicate that phosphate has a significant influence on iron deposition. The presence of 1 mM phosphate during reconstitution of ferritin from apoferritin, Fe(II), and O2 accelerates the rate of oxidation of the iron 2-fold at pH 7.5. In the presence or absence of phosphate, the rate of oxidation at 0 degrees C follows simple first-order kinetics with respect to Fe(II) with half-lives of 1.5 +/- 0.3 or 2.8 +/- 0.2 min, respectively, consistent with a single pathway for iron oxidation when low levels of iron are added to the apoprotein. This pathway may involve a protein ferroxidase site where phosphate may bind iron(II), shifting its redox potential to a more negative value and thus facilitating its oxidation. Following oxidation, an intermediate mononuclear Fe(III)-protein complex is formed which exhibits a transient EPR signal at g' = 4.3. Phosphate accelerates the rate of decay of the signal by a factor of 3-4, producing EPR-silent oligonuclear or polynuclear Fe(III) clusters. In 0.5 mM Pi, the signal decays according to a single phase first-order process with a half-life near 1 min.(ABSTRACT TRUNCATED AT 250 WORDS)