目的 观察针刀镜下松解术联医用几丁糖注射治疗冻结肩的临床疗效.方法 回顾性分析45例采用针刀镜下松解术联合医用几丁糖注射治疗的冻结肩患者临床资料.比较术前、术后1周、术后1个月、术后3个月的肩关节疼痛视觉模拟量表(VAS)评分、Constant-Murley肩关节功能评分.评价临床疗效,记录切口愈合情况及不良反应发生情况.结果 与术前相比,术后1周、术后1个月、术后3个月患者VAS评分均明显降低,Constant-Murley肩关节功能评分明显升高,差异均具有统计学意义(P＜0.01).随着时间的变化,VAS评分逐渐降低,Constant-Murley肩关节功能评分逐渐升高,差异均有统计学意义(P＜0.01).治疗有效率为91.11%,手术过程中无不良反应发生,术后切口Ⅰ期愈合.结论 针刀镜下松解术联合医用几丁糖注射治疗冻结肩,可明显缓解肩关节疼痛症状,改善肩关节功能,且损伤小,操作简便,安全性高.
目的 探究长链非编码RNA(lncRNA)NNT-AS1对膀胱癌细胞增殖、转移及肿瘤干细胞干性的影响和机制.方法 qRT-PCR检测lncRNA NNT-AS1在膀胱癌细胞T24、5637、UM-UC-3、TCC-SUP和膀胱上皮细胞SV-HUC-1中的表达,将T24细胞和膀胱癌干细胞分为sh-NC组(转染sh-NC)、sh-NNT-AS1组(转染sh-NNT-AS1)、Control组(共转染sh-NC、inh-NC和si-NC)、sh-NNT-AS1+inh-NC+si-NC组(共转染sh-NNT-AS1、inh-NC和si-NC)、sh-NNT-AS1+inh-582-5p+si-NC组(共转染sh-NNT-AS1、miR-582-5p抑制物和si-NC)、sh-NNT-AS1+inh-582-5p+si-NCKAP1组(共转染sh-NNT-AS1、miR-582-5p抑制物和NCKAP1小干扰RNA).CCK8检测各组细胞增殖能力;Transwell法检测细胞迁移和侵袭能力;细胞成球实验检测各组干细胞干性;流式细胞术检测CD133和CD44表达;双荧光素酶报告基因实验检测lncRNA NNT-AS1与miR-582-5p及miR-582-5p与NCKAP1的靶向关系;体内成瘤实验检测lncRNA NNT-AS1对体内成瘤的影响;Western blot检测NCKAP1、YAP、TAZ、CD44、ALDH1A1、Oct4、Nanog蛋白表达.结果 lncRNA NNT-AS1高表达于T24、5637、UM-UC-3、TCC-SUP细胞.与sh-NC组比较,sh-NNT-AS1组T24细胞增殖、迁移和侵袭能力显著下降(P<0.05),膀胱癌干细胞成球数、CD44、ALDH1A1、Oct4、Nanog蛋白表达及CD133+CD44+细胞比例显著减少(P<0.05).lncRNA NNT-AS1调控miR-582-5p/NCKAP1分子轴.与Control组比较,sh-NNT-AS1+inh-NC+si-NC组细胞光密度(OD)值显著降低(P<0.05),细胞迁移和侵袭数显著减少(P<0.05),膀胱癌干细胞干性显著降低(P<0.05),肿瘤体积显著减小(P<0.05),YAP和TAZ表达显著下调(P<0.05).与sh-NNT-AS1+inh-NC+si-NC组比较,sh-NNT-AS1+inh-582-5p+si-NC组细胞OD值、细胞迁移数和侵袭数均显著升高/增加(P<0.05),膀胱癌干细胞干性、肿瘤体积显著增加(P<0.05),YAP和TAZ表达均显著升高(P<0.05).与sh-NNT-AS1+inh-582-5p+si-NC组比较,sh-NNT-AS1+inh-582-5p+si-NCKAP1组细胞OD值、细胞迁移数和侵袭数均显著降低/减少(P<0.05),膀胱癌干细胞干性、肿瘤体积显著减小(P<0.05),YAP和TAZ表达均显著降低(P<0.05).结论 lncRNA NNT-AS1通过调控miR-582-5p/NCKAP1分子轴影响膀胱癌细胞的增殖、转移及肿瘤干细胞干性,并激活Hippo-YAP/TAZ信号通路.
Polycystic ovary syndrome(PCOS)is a common endocrine disease that often leads to infertility.Its pathogenesis is relatively complex,involving multiple organs(hypothalamus and ovary,etc.),as well as genetic factors.Therefore,there are significant individual differences in clinical manifestations and treatment effects.Precise diagnostic and classification of PCOS is beneficial for personalized treatment and long-term management of PCOS.This paper discusses the relationship between diverse clinical features,biochemical characteristics,metabolic complications and gene polymorphisms in PCOS patients,and reviews the research progress on genes associated with PCOS,in order to provide a new interpretation for the pathophysiology mechanism of PCOS and a new idea for the diagnosis and treatment of PCOS gene.
Objective To explore the molecular mechanism of pituitary growth hormone adenoma cell proliferation.Methods Functional growth hormone-secreting pituitary adenoma(fGH-PA)tissue samples were collected from 12 patients with acromegaly.The exchange protein 1 directly activated by cAMP(Epac1)mRNA expression levels in fGH-PA tissues and rat RGC-5,MMQ and GH3 cells were determined by qPCR.The expression levels of Epac1 in fGH-PA tissues were determined by immunohistochemistry.Western blot was used to determine the expression levels of Epac1 in MMQ and GH3 cells.Overexpression or knockdown of Epac1,or knockdown of cAMP response element-binding protein(CREB)in GH3 cells,cell cycle changes were determined by flow cytometry,cell proliferation ability was determined by CCK-8 assay,and the expression levels of p-CREB,CREB,Cyclin D1,CDK2 and p21 in cells were determined by Western blot.Results qPCR and immunohistochemistry results showed that the expression levels of Epac1 mRNA and protein in fGH-PA tissues were significantly higher than those in adjacent normal tissues(P<0.05).qPCR and Western blot results showed that compared with RGC-5 cells,the expression levels of Epac1 mRNA and protein in MMQ and GH3 cells were significantly increased(P<0.05).After overexpres-sion of Epac1 in GH3 cells,compared with the Control group,the proportion of cells in G0/G1 phase and S phase in the Epac1-OE group were significantly reduced(P<0.05),and the proportion of cells in G2/M phase were significantly increased(P<0.05);the cell prolifera-tion ability were significantly enhanced(P<0.05);the expression levels of p-CREB and Cyclin D1 in cells were significantly increased(P<0.05),the expression levels of CDK2 and p21 were significantly decreased(P<0.05),while there was no significant change in the expression level of CREB between the two groups(P>0.05).After knockdown of Epac1 or knockdown of CREB in GH3 cells,all of the above results were reversed(P<0.05).Conclusion The overexpression of Epac1 in pituitary growth hormone adenoma cells can up-regulate the levels of p-CREB in cells,and promote adenoma cells to pass through G1/S phase checkpoint,resulting in cell cycle checkpoint disorder and massive proliferation,but it does not affect the expression levels of CREB.
Objective To explore the effect and safety of target controlled infusion mode based on precision anesthesia concept in cardiac surgery anesthesia.Methods A total of 100 patients underwent cardiac surgery in our hospital were selected as the research subjects,and they were randomly divided into the control group and the observation group,with 50 cases in each group.The surgical types,surgical related indicators,dosage of anesthetic drugs,and complications of the two groups were compared.Results There was no statistically significant difference in the proportions of patients who underwent coronary artery bypass surgery,valve surgery,macrovascular surgery,artial septal defect repair surgery,or other types of surgery between the two groups(P>0.05).There were statistically significant differences in the surgical time,bleeding volume,infusion volume,proportion of cardiopulmonary bypass,times of postoperative analgesic drug use and mechanical ventilation duration between the two groups(P<0.05).The usage of various anesthetic drugs in the observation group was lower than that in the control group,with statistically significant difference(P<0.05).The incidence of complication in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The target controlled infusion mode based on precision anesthesia concept can be used for cardiac surgery anesthesia to reduce the dosage of anesthetic drugs and postoperative complications,and improve the anesthesia effect and surgical safety.
Objective To explore the effect and influencing factors of prosthesis placement angle on hip replacement for bone fusion of hip joint.Methods A total of 100 patients with bone fusion of hip joint who were admitted to our hospital from May 2019 to January 2022 were selected as the research objects and randomly divided into the observation group(n=50)and the control group(n=50).The prosthesis placement angle was 30° to 40° in the observation group and 41° to 50° in the control group.The clinical data,VAS score and Harris score before and after operation,and postoperative complications of the two groups were compared.The improvement of hip joint function of the two groups was compared by random walking model.According to the prognosis of patients,patients were divided into the poor prognosis group(n=32)and the good prognosis group(n=68).Univariate and multivariate Logistic regression analysis were used to analyze the independent influencing factors of the prognosis of hip replacement for bone fusion of hip joint,and a prediction model was constructed and verified.Results The Harris score 6 months after operation in the observation group was significantly higher than that in the control group(P<0.05),and there was no significant difference in VAS score before and after operation and incidence of complications after operation between the two groups(P>0.05).The results of random walking model showed that the improvement of hip joint function in the observation group was better than that in the control group.There were significant differences in age,hyperlipidemia,osteoporosis,prosthesis placement angle,intraoperative blood loss,emotional disorder,postoperative complications,rehabilitation training and postoperative outdoor activity time of patients between the good prognosis group and the poor prognosis group(P<0.05).Multivariate Logistic regression analysis showed that osteoporosis and prosthesis placement angle of 41° to 50° were the independent risk factors of the prognosis of hip replacement for bone fusion of hip joint(P<0.05),and rehabilitation training was the protective factor(P<0.05).A prediction model of the prognosis of hip replacement for bone fusion of hip joint was constructed.The calibration curve of the model fit well with the ideal curve,and the area under the receiver operating characteristic curve(AUC)was 0.854(95%CI:0.830 to 0.871),which indicates that the prediction model had good accuracy.The concordance index(C-index)of the model was 0.849(95%CI:0.817 to 0.868),which indicates that the model had high discrimination.Conclusion The prosthesis placement angle of 30° to 40° can significantly improve the postoperative hip joint function of patients,and the therapeutic effect is significant.Osteoporosis,prosthesis placement angle,and rehabilitation training are the independent influencing factors of the prognosis of hip replacement for bone fusion of hip joint.
Objective To observe the effect of cervical degenerative change on the expression of vascular endothelial growth factor(VEGF)and vascular endothelial growth factor receptor-2(VEGFR-2).Methods The C3 to C7 segments of bilateral healthy cervical vertebrae of adult cadavers were taken as the control group,and the C3 to C7 segments of bilateral degenerative cervical vertebrae of adult cadavers were taken as the experimental group.The expression changes of VEGF and VEGFR-2 of the two groups were observed and analyzed by immunohistochemistry,immunofluorescence staining and real-time quantitative PCR.Results The protein and mRNA expressions of VEGF and VEGFR-2 in the experimental group were higher than those in the control group,with statistically significant differences(P<0.05).Conclusion Cervical Luschka joint degenerative change significantly up-regulates the expression of VEGF and VEGFR-2,which is closely related to the microenvironmental changes around the Luschka joint caused by degeneration of joint-like structure.
Objective To study the clinical application value of the upright seated + head down(30° to 45°)+ tongue protrusion technique for the completely exposure of the epiglottic surface under electronic laryngoscopy.Methods Based on the clinical examination process of electronic laryngoscopy in the laryngoscopy room,two methods were applied for the patients with difficulty in exposing the epiglottic surface:① upright seated + tongue protrusion;② upright seated + head down(30° to 45°)+ tongue protrusion.The proportions of patients exposed to the epiglottic surface by these two methods were compared.Results The electronic laryngoscopy examination used the upright seated + tongue protrusion technique allowed for the clear exposure of the epiglottic surface in approximately 73.91%of patients with exposure difficulty.By using the upright seated + head down(30° to 45°)+ tongue protrusion technique,combined with the operator's control over the free movement of the laryngoscope's front end lens into the epiglottic vallecula space for close-range exploration,a 100%clear exploration of the epiglottic surface was achieved.Conclusion The upright seated + head down(30° to 45°)+ tongue protrusion technique for electronic laryngoscopy examination in patients with difficulty in exposing the epiglottic surface can completely expose the epiglottic surface,with significantly clinical effect.It can be used as a supplementary examination method for patients with difficulty in exposing the epiglottic surface in the ordinary upright seated or upright seated + tongue protrusion technique,and has certain clinical application value.
Objective To explore the protective mechanism of RNA binding protein LIN28 on diabetic nephropathy(DN).Methods LIN28 was overexpressed or knocked down by adenovirus in HEK 293T cells.The gene and functional signaling pathway significantly changed after overexpression of LIN28 were obtained through RNA Seq transcriptome sequencing and bioinformatics analysis.HEK 293T cells were divided into the Control group,the Treatment group,the Adv-LIN28-OE+D-ribose group and the Adv-LIN28-NC+D-ribose group in in vitro LIN28 overexpression studies.And HEK 293T cells were divided into the Control group,the Treatment group,the Adv-shRNA LIN28+D-ribose group and the Adv-shRNA NT+D-ribose group in in vitro LIN28 knockdown studies.ELISA was used to detect the levels of human advanced glycation end products(AGEs)of cells supernatants in the above groups.Western blot was used to detect the expression levels of RAGE,NF-κB and MMP-2 of cells in the above groups.Results The results of RNA-Seq transcriptome sequencing,GO analysis and KEGG analysis showed that overexpression of LIN28 resulted in a significant down-regulation of AGE-RAGE signaling pathway in HEK 293T cells(P<0.05).The results of ELISA showed that compared with the Control group,the cell in the Treatment group produced a large amount of AGEs(P<0.05);compared with the Treatment group,the AGEs level of cells in the Adv-LIN28-OE+D-ribose group was significantly decreased(P<0.05),while the AGEs level of cells in the Adv-shRNA LIN28+D-ribose group was increased(P>0.05).The results of Western blot showed that compared with the Control group,the expression levels of RAGE,NF-κB and MMP-2 of cells in the Treatment group were significantly increased(P<0.05);compared with the Treatment group,the expression levels of RAGE,NF-κB and MMP-2 of cells in the Adv-LIN28-OE+D-ribose group were significantly decreased(P<0.05),while the expression levels of RAGE,NF-κB and MMP-2 of cells in the Adv-shRNA LIN28+D-ribose group were significantly increased(P>0.05).Conclusion Overexpression of LIN28 by adenovirus at the cellular level in vitro can lead to significant differential expression of thousands of genes.In particular,it can inhibit the diabetes and complications-related AGE-RAGE signaling pathway,which is critical in the progression of DN disease,and play a role in protecting DN.
Objective To detect the expression of DCST1-AS1 in non-small cell lung cancer and explore its effect on malignant biological behavior of cancer cells.Methods The tissues and corresponding adjacent tissues from 65 patients with non-small cell lung cancer were collected,and the normal human bronchial epithelial cells 16HBE and the non-small cell lung cancer cell lines(A549,H1299,H1650 and HCC827)were cultured in vitro.The expression levels of DCST1-AS1 and miR-29b in tissues and cells were detected by RT-qPCR assay,and the correlation between the DCST1-AS1 expression and the clinical characteristics of patients with non-small cell lung cancer were analyzed.A549 cells were divided into the control group,the si-NC group,the si-DCST1-AS1 group,the si-DCST1-AS1+ anti-NC group and the si-DCST1-AS1+anti-miR-29b group.The cell proliferation was detected by CCK-8 assay and clone formation assay,the invasion and migration of cells were detected by Transwell;the expression of E-cadherin,Vimentin and N-cadherin was detected by Western blot.Results The expression of DCST1-AS1 increased and the expression of miR-29b decreased in non-small cell lung cancer tissues and cells(P<0.05).The expression of DCST1-AS1 was correlated with TNM stage,differentiated degree of tissue,lymph node metastasis and pathological types in non-small cell lung cancer patients(P<0.05).Compared with the control group or the si-NC group,the expression of DCST1-AS1,OD value,number of colony-forming cells,migration cells and invasion cells and the expression of Vimentin and N-cadherin in A549 cells of the si-DCST1-AS1 group decreased(P<0.05),while the expression of miR-29b and E-cadherin increased(P<0.05).Knocking down miR-29b could significantly reduce the effect of down-regulation of DCST1-AS1 expression on the malignant biological behavior of A549 cells.Conclusion DCST1-AS1 is highly expressed in non-small cell lung cancer,knocking down DCST1-AS1 may inhibit the malignant biological behavior of non-small cell lung cancer cells by up-regulating the expression of miR-29b.
Parkinson's disease(PD)is the most common neurodegenerative disease,and Lewy bodies(LBs)is the most typical pathological change.α-synuclein(α-syn),as the main component of LBs,is considered as the pathogenic factor of PD.According to the transmission hypothesis,pathological α-syn can be transported from damaged neurons to normal neurons,leading to pathological misfolding and aggregation of α-syn in recipient neurons,resulting in cascading neuronal damage.According to the hypothesis of gut-brain axis,pathological α-syn can be produced in the intestine,and uploaded to the central nervous system via the vagus nerve.In this paper,the role of α-syn in the pathogenesis of PD is summarized,in order to provide reference for the study of intervention targets of PD.
Objective To explore the clinical effect of amniotic membrane transplantation combined with entropion correction for ocular surface and eyelid burns.Methods A total of 80 patients with ocular surface injury and lower eyelid entropion caused by chemical or thermal burns who received surgical treatment in our hospital were selected as the research objects.All patients received amniotic membrane transplantation combined with entropion correction.All patients were examined by slit-lamp microscope and photographed before and 8 weeks after surgery.The visual acuity changes,tear film rupture time and serum levels of vascular endothelial growth factor(VEGF),trans-forming growth factor β1(TGF-β1)and insulin growth factor 1(IGF-1)were compared before and 8 weeks after surgery.Eight weeks after surgery,exfoliated epithelial cells of the central cornea and limbus were collected and analyzed by PAS staining and immunofluorescence staining.Results At 8 weeks after surgery,the patient's ocular surface condition recovered well,eyelid entropion was successfully corrected,postoperative visual acuity was significantly better than that before surgery(P<0.05).Compared with before surgery,the tear film rupture time 8 weeks after surgery was significantly prolonged(P<0.05),and the serum VEGF,TGF-β1 and IGF-1 levels 8 weeks after surgery were significantly increased(P<0.05).PAS staining showed that there was no goblet cell in the central cornea and limbus.Immunofluorescence staining showed that cytokeratin 12(CK12)was highly expressed in the corneal epithelial cells,and low expressed in corneal limbal epithelial cells near the cornea.Conclusion Amniotic membrane transplantation combined with entropion correction has a significant therapeutic effect on patients with ocular burn,which can promote ocular surface repair,correct entropion,improve postoperative visual acuity,and achieve self-amplification of cornea stem cells.It is a safe and effective treatment method.
Myocardial infarction is a serious cardiovascular disease that can disrupt the myocardial energy metabolism.Sirt3,as an important mitochondrial deacetylase,plays a crucial role in the regulation of energy metabolism after myocardial infarction.This review aims to analyze and summarize the research progress of Sirt3 in the regulation of energy metabolism after myocardial infarction,so as to provide new theoretical and practical basis for the treatment of cardiovascular diseases.
Objective To explore the mechanism of hepatocyte injury and inflammatory reaction induced by sepsis based on miR-129-5p/TLR4 signaling axis regulated by lncRNA NEAT1.Methods Peripheral blood from 15 sepsis patients(the sepsis group)and 15 healthy individuals(the healthy group)were collected for gene expression detection.The mouse normal liver cell line NCTC1469 was used in in vitro experiments,and an in vitro sepsis model(the LPS group)was established by lipopolysaccharide(LPS).The cells stimulated with LPS and transfected with mimic NC,mimic,siNC or siNEAT1 plasmid vectors were named as the LPS+mimic NC group,the LPS+mimic group,the LPS+siNC group or the LPS+siNEAT1 group,respectively.The cells treated with a combination of LPS,siNEAT1,and TLR4 recombinant protein or LPS,mimic,TLR4 recombinant protein were named as the LPS+siNEAT1+TLR4 group or the LPS+mimic+TLR4 group,while the control group was not treated.The mRNA and protein expression levels of TNF-α,IL-6,and IL-1β were detected by qPCR and ELISA,respectively.The cell apoptosis rate was detected by TUNEL assay.The binding of lncRNA NEAT1/miR-129-5p and miR-129-5p/TLR4 was detected by dual-luciferase reporter gene analysis.The TLR4 expression in cells was detected by Western blot.Results In the in vivo experi-ment,compared with the healthy group,the expression of TNF-α,IL-6,IL-1β,lncRNA NEAT1,and TLR4 of peripheral blood in the sepsis group was significantly increased(P<0.05),while the expression of miR-129-5p was decreased(P<0.05).In the in vitro experiment,compared with the control group,the expression of lncRNA NEAT1 in the LPS group was increased(P<0.05).Compared with the LPS group and the LPS+siNC group,the expression of lncRNA NEAT1 in the LPS+siNEAT1 group was decreased(P<0.05),and the expression of miR-129-5p was increased(P<0.05).Compared with the control group,the cell apoptosis rate and the expression of TLR4,TNF-α,IL-6,and IL-1β in the LPS+siNC group were up-regulated(P<0.05).Compared with the LPS+siNC group,the cell apoptosis rate and the expression of TLR4,TNF-α,IL-6,and IL-1β in the LPS+siNEAT1 group were down-regulated(P<0.05).Compared with the LPS+siNEAT1 group,the cell apoptosis rate and the expression of TLR4,TNF-α,IL-6,and IL-1β in the LPS+siNEAT1+TLR4 group were up-regulated(P<0.05).Dual-luciferase reporter gene assay revealed an interaction between lncRNA NEAT1 and miR-129-5p,and TLR4 was the target gene of miR-129-5p.Compared with the control group,the expression of TNF-α,IL-6,and IL-1β as well as cell apoptosis rate in the LPS+ mimic NC group were increased(P<0.05).Compared with the LPS+mimic NC group,the expression of TNF-α,IL-6,and IL-1β as well as cell apoptosis rate in the LPS+mimic group were down-regulated(P<0.05).Compared with the LPS+mimic group,the expression of TNF-α,IL-6,and IL-1β as well as cell apoptosis rate in the LPS+mimic+TLR4 group were up-regulated(P<0.05).Conclusion lncRNA NEAT1 interacts with miR-129-5p and directly targets TLR4 to promote LPS-induced hepatocyte injury and inflammatory reaction.This study can provide a new therapeutic target for hepatocyte injury caused by sepsis.
Benign ureteral strictures refers to obstructive lesions caused by the narrowing of ureteral lumen,which may lead to severe renal function damage and even failure.It is related to the incarcerated stones,the ureteral lithotripsy,and the pelvic and abdominal surgery.The primary treatment of benign ureteral strictures is surgery,but the cure rate is closely related to the characteristics of the stricture.In the past,repair and reconstruction surgery has been used for treatment,although the cure rate is high,it is traumatic,risky and slow in postoperative recovery.At present,endovascular surgery treatment is widely used in the treatment of benign ureteral strictures with short stricture length,short disease course,good renal function,and non-ischemic stricture due to the characteristics of small trauma,low risk,and fast recovery.Meanwhile,long-term maintenance treatment of indwelling ureteral stents can also effectively protect renal function.Therefore,in the treatment of benign ureteral strictures,the most appropriate individualized treatment plan should be provided for the patients based on the patient's physical conditions and stricture characteristics.
Objective To observe the effects of thoracic paravertebral nerve block(TPVB)combined with preserved spontaneous respiratory anesthesia on intraoperative local cerebral oxygen saturation(SrcO2)and postoperative delirium(POD)in elderly patients undergoing thoracoscopic surgery.Methods A total of 80 elderly patients who planned to undergo thoracoscopic wedge resection of lung were randomly divided into the control group and the observation group,and finally 76 patients completed the study,with 39 cases in the control group and 37 cases in the observation group.The control group was given general anesthesia under single lung ventilation,while the observation group was given TPVB combined with preserved spontaneous respiratory anesthesia.Patients'SrcO2 was monitored by a near infrared spectrometer,and the decrease of SrcO2 from baseline by≥10%was considered as cerebral oxygen desaturation(COD).The preoperative baseline value of SrcO2,intraoperative lowest value of SrcO2,the incidence and duration of COD of the two groups were compared.The operation situation,the incidence of hypotension,hypoxemia,delayed awakening and analgesic recovery rate were counted.The incidence of POD and pain visual analogue scale(VAS)score 2 hours,24 hours and 72 hours after surgery were evaluated.The hospitalization time was recorded,and the quality of recovery-40(QoR-40)scores at admission and discharge were evaluated.Results There was no significant difference in operative time,intraoperative blood loss,preoperative baseline value of SrcO2,VAS score 2 hours after surgery and QoR-40 score at admission between the two groups(P>0.05).Compared with the control group,the observation group had higher intraoperative lowest value of SrcO2(P<0.05),lower incidence and shorter duration of COD(P<0.05),lower incidence of POD 2 hours,24 hours and 72 hours after surgery(P<0.05),lower VAS scores 24 hours and 72 hours after surgery and analgesic recovery rate(P<0.05),lower/shorter incidence of intraoperative hypotension,delayed awakening and hospitalization time(P<0.05),and higher QoR-40 scores at discharge(P<0.05).Conclusion TPVB combined with preserved spontaneous respiratory anesthesia can improve the level of cerebral oxygenation and reduce the occurrence of POD in elderly patients undergoing thoracoscopic surgery.
Objective To investigate the expression levels of microRNA-384(miR-384)and LIN28B in serum of patients with diabetic retinopathy(DR)and their diagnostic value.Methods A total of 100 patients with type 2 diabetes diagnosed in our hospital from January 2020 to November 2021 were selected as the research subjects.According to the occurrence of retinopathy,the patients were divided into the non-DR group(40 cases)and the DR group(60 cases).In addition,40 healthy person who underwent physical examination in our hospital during the same period were regarded as the control group.The relative expression levels of serum miR-384 and LIN28B were detected by qRT-PCR,and the relationship between the two indexes and the general clinical data of DR patients was analyzed.Pearson method was applied to analyze the correlation between the expression of miR-384 and LIN28B in serum of DR patients.Logistic regression was applied to analyze the influencing factors of DR.The diagnostic value of serum miR-384 and LIN28B levels for DR patients was analyzed by receiver operating characteristic(ROC)curve.Results The level of serum miR-384 in the DR group was obviously lower than that in the non-DR group and the control group(P<0.05),and the non-DR group was lower than the control group(P<0.05).The level of serum LIN28B in the DR group was obviously higher than that in the non-DR group and the control group(P<0.05),and the non-DR group was higher than the control group(P<0.05).The expression levels of miR-384 and LIN28B were related to the course of diabetes and blood glucose(P<0.05).Pearson's correlation analysis showed that the expression of miR-384 was negatively correlated with LIN28B in serum of DR patients(r=-0.296,P<0.05).Logistic regression analysis showed that miR-384 and LIN28B were the independent influencing factors for DR(P<0.05).The results of ROC curve analysis showed that the area under the curve(AUC)of miR-384,LIN28B and the combination of two in DR patients was 0.625,0.646,and 0.682,respectively,and the specificity was 67.50%,85.00%,and 97.50%,respectively.Conclusion The serum expression of miR-384 is low and LIN28B is high in DR patients.Both miR-384 and LIN28B are the influencing factors for the occurrence of DR and are expected to be potential serological markers for the diagnosis of DR.
The distal tibial epiphyseal fractures is a common type of fracture in adolescents.The distal tibia is adjacent to the ankle joint,where the epiphysis is fragile and easily damaged when the fracture occurs,resulting in ischemic necrosis of the epiphysis and impaired bone growth,and the degree of damage and treatment effect directly influence the shape and function of the ankle joint,seriously affect the prognosis and quality of life of adolescents.Therefore,anatomical reduction should be achieved after injury as much as possible to achieve stable fixation.For stable fractures of the distal tibial epiphysis(such as Salter-Harris type Ⅰ or Ⅱ fractures),the conservative treatment can be used;whereas for unstable fractures,especially Salter-Harris type Ⅲ and Ⅳ fractures with a high risk of displacement,surgical treatment is preferred.However,due to the physiological characteristics of the epiphysis of adolescents,the distal tibia grow and develop differently,the individualized treatment plans should be developed according to the situation of adolescents.3D printing technology combined with imaging technologies including CT and MRI can print complex shapes of geometric structures to meet individual needs,and play an important role in the surgical treatment of distal tibial epiphyseal fractures,especially Salter-Harris type Ⅲ and Ⅳ fractures,which can contribute to formulating individualized surgical plans,improving the success rate of surgery,reducing the incidence of long-term complications,and greatly improving the prognosis of adolescents.Based on the literature reports in the past decade,this paper reviews the research progress of the application of 3D printing technology in the diagnosis and treatment of distal tibial epiphyseal fractures in adolescents.
Objective To evaluate the relationship between preoperative prognostic nutritional index(PNI),controlling nutritional status(CONUT)and Naples prognostic score(NPS)and the clinicopathological characteristics and prognosis of patients with radical resection of hepatocellular carcinoma.Methods The clinicopathological data of 122 patients with hepatocellular carcinoma who underwent radical resection in the first affiliated hospital of university of science and technology of China from January 2016 to December 2019 were retrospec-tively analyzed,and the relationship between preoperative PNI,CONUT and NPS and the clinicopathological characteristics and prognosis was analyzed.The survival curve was drawn by Kaplan-Meier method.Cox proportional-hazards regression model was used to analyze the influencing factors of the overall survival of hepatocellular carcinoma patients.The area under the receiver operating characteristic(ROC)curve(AUC)was used to compare the predictive value of each scoring system.Results Preoperative PNI was related to the tumor differentiation,microvascular invasion(MVI),cirrhosis and preoperative hemoglobin level(P<0.05).The preoperative CONUT was related to the tumor differentiation,cirrhosis and preoperative hemoglobin level(P<0.05).The preoperative NPS was related to the cirrhosis and preoperative hemoglobin level(P<0.05).The low PNI group,high CONUT group and high NPS group had longer postoperative hospital stay and higher postoperative complications rate compared with the high PNI group,low CONUT group and low NPS group,respectively,and the differences were statistically significant(P<0.05).Cox proportional-hazards regression model showed that preoperative PNI,CONUT and NPS were associated with the prognosis of patients with hepatocellular carcinoma(P<0.05);However,only preoperative NPS was the independent risk factor for prognosis of patients with hepatocellular carcinoma(P<0.05).The ROC curve results showed that the AUC of NPS was higher than those of PNI and CONUT.Conclusion preoperative PNI,CONUT and NPS are all related to the prognosis of hepatocellular carcinoma patients undergoing radical resection,and the predictive value of preoperative NPS is higher than preoperative PNI and CONUT.
目的 分析使用覆膜支架对腘动脉瘤患者行腔内治疗的效果.方法 纳入联勤保障部队第九二〇医院行腔内修复的12例腘动脉瘤患者.观察动脉瘤变化,置入支架通畅情况,支架有无移位、断裂、内漏,肢体有无缺血及其他并发症.结果 12例患者腔内修复术均获得成功.3例出现围术期并发症,其中切口血肿1例,蓝趾综合征1例,消化道出血1例.患者术后无夹层、血栓及假性动脉瘤形成,Viabahn支架无内漏、移位及断裂.随访期间1例出现股浅-腘动脉段动脉瘤形成,予以腔内覆膜支架修复;1例出现支架远心端局限性狭窄,狭窄约60%,予以球囊扩张后狭窄明显好转.随访1年,覆膜支架修复腘动脉瘤的通畅率为100%.1例患者术后16个月因心肌梗死死亡.结论 使用覆膜支架腔内修复腘动脉瘤的短中期疗效较好,安全有效.
