最新刊期

    49 2 2024

      Guideline and Consensus

    • Expert Consensus Group on Electroencephalogram Examination and Qualification Criteria for Chinese Military Aircrew
      Vol. 49, Issue 2, Pages: 123-130(2024) DOI: 10.11855/j.issn.0577-7402.1121.2023.1219
      摘要:The electroencephalography (EEG) is an important method to evaluate epileptic seizure and brain functions, and it is of great significance for screening aircrew with potential risks of seizure and thus reducing the incidence of airborne incapacitation events. There are cases of epileptic seizure and seizure attack during flight among military aircrew both at home and abroad. However, currently there is no detailed EEG standards for the selection of aircrew applicants and physical examination of military aircrew. This consensus of Chinese experts on electroencephalographic examination and identification criteria for military aircrew was compiled jointly by experts in the fields of aeromedicine, neurology, epilepsy, and neuro-electrophysiology, from Xijing Hospital of Air Force Military Medical University and PLA General Hospital. This consensus was formulated based on 287 relevant literatures from PubMed, CNKI, Wanfang Data and VIP, combined with guidelines in the fields of epilepsy and EEG and the clinical experiences of Chinese experts. The objectives of the consensus are to further clarify the definition of "normal EEG", "borderline EEG" and "abnormal EEG" for military aircrew, unify the criteria of EEG identification for military aircrew with high risk of incapacitation, and standardize the criteria of EEG examination for aeromedical identification for military aircrew. This consensus includes four sections: applicable population and quality requirements for EEG monitoring, standards for EEG interpretation, standards for medical decision based on EEG, and the treatment of "temporarily unqualified" aircrew, which aim to literature supports and practical expert opinions for the standardization and accuracy of aeromedical qualification of EEG in military aircrew.  
      关键词:military aircrew;epilepsy;electroencephalography   
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      发布时间:2024-03-21

      Clinical Research

    • Tang Lu-Lu,Chen Huai-Zhen,Zhang Jing,Dong Ting,Li Jun,Jiang Hai-Lin,Yang Wen-Ming
      Vol. 49, Issue 2, Pages: 131-136(2024) DOI: 10.11855/j.issn.0577-7402.1940.2023.0316
      Prognostic factor and its predictive value of patients with Wilson's disease-related acute-on-chronic liver failure
      摘要:ObjectiveTo explore the prognostic factor and its predictive value of patients with Wilson disease-related acute-on-chronic liver failure (WD-ACLF).MethodsThe clinical data of 70 patients diagnosed as WD-ACLF admitted to the Department of Encephalopathy of the First Affiliated Hospital of Anhui University of Chinese Medicine from January 1, 2017 to January 1, 2022 were retrospectively collected. According to the 12-week prognosis, patients were divided into survival group (n=36) and death group (n=34). The data of the two groups were analyzed by univariate and multivariate logistic analysis to screen the prognostic risk factors and evaluate their predictive value. The model coefficient is omnibus tested, and the model-fitting degree is evaluated by the Hosmer-Lemeshow test. ROC curve was used to analyze the prognostic value for WD-ACLF between the new model and chronic liver failure-sequential organ failure assessment (CLIF-SOFA) score, model for end-stage liver disease (MELD) score and Child-Turcotte-Pugh (CTP) score.ResultsA total of 70 WD-ACLF patients were enrolled in present study, including 36 cases in survival group [22 males and 14 females with median age of 30.0 (17.3, 40.0)] and 34 cases in death group [25 males and 9 females with median age of 34.0 (28.8, 41.0)]. Univariate analysis showed that the course of disease, prothrombin time (PT), activated partial thromboplastin time (APTT) were shorter in survival group than that in death group, the white blood cells (WBC), international normalized ratio (INR), aspartate transaminase (AST), total bilirubin (TBIL), blood urea nitrogen (BUN), creatinine (Cre) and ceruloplasmin (CER) levels and the proportion of infection, ascites, and upper gastrointestinal bleeding were lower in survival group than those in death group, however, the proportion of infection, ascites and upper digestive bleeding in the survival group were lower than those in the death group. Meanwhile, the red blood cells (RBC), hemoglobin (Hb), Na+ and total cholesterol (TC) level in the survival group were higher than those in the death group (P<0.05 or P<0.01). The results of multivariate logistic regression analysis showed that disease course (OR=1.176, 95%CI 1.043-1.325), INR (OR=7.635, 95%CI 1.767-32.980), TBIL (OR=1.012, 95%CI 1.003-1.021), and upper gastrointestinal bleeding (OR=11.654, 95%CI 1.029-131.980) were independent risk factors affecting the prognosis of WD-ACLF (P<0.05). Based on the results of logistic regression analysis, a joint model for predicting the prognosis of WD-ACLF was established. The AUC of the model for evaluating the prognosis of WD-ACLF was 0.941, which was greater than the CLIF-SOFA score (AUC=0.802), MELD score (AUC=0.897), and CTP score (AUC=0.722).ConclusionsThe course of disease, TBIL, INR, and upper gastrointestinal bleeding are risk factors that affect the prognosis of WD-ACLF. The prognosis model established based on this can more accurately predict the prognosis of WD-ACLF patients, and its predictive value is superior to CLIF-SOFA score, MELD score, and CTP score.  
      关键词:Wilson disease;acute-on-chronic liver failure;prognosis;chronic liver failure-sequential organ failure assessment;model for end-stage liver disease;Child-Turcotte-Pugh   
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      发布时间:2024-03-21
    • Chen Yan-Yan,Li Meng-Ying,Zhou Jie,Fu Jian-Fang,Zhang Ying,Wang Yi,Wang Cheng,Liu Xiang-Yang,Ta Sheng-Jun,Liu Li-Wen,Li Ze-Ping,Li Xiao-Miao
      Vol. 49, Issue 2, Pages: 137-143(2024) DOI: 10.11855/j.issn.0577-7402.2265.2023.0915
      Comparison of the predictive value of new simplified insulin resistance assessment indexes in identifying left ventricular subclinical dysfunction in T2DM patients
      摘要:ObjectiveTo investigate the predictive value of new simplified insulin resistance (IR) assessment indexes in identifying subclinical left ventricular systolic function impairment in patients with type 2 diabetes mellitus (T2DM).MethodsA total of 150 T2DM patients with preserved left ventricular ejection fraction (LVEF≥50%) who were admitted to Department of Endocrinology of the First Affiliated Hospital of Air Force Medical University from June 2021 to December 2021 were retrospectively analyzed. All patients underwent two-dimensional speckle tracking echocardiography to measure left ventricular global longitudinal strain (GLS). According to GLS value, the subjects were divided into the normal group (GLS≥18% group, n=80) and the impaired group (GLS<18% group, n=70). Some new simplified IR assessment indicators were calculated and compared between the two groups, including body mass index (BMI), TG/HDL‑C ratio, triglyceride-glucose (TyG) index, TyG‑BMI index, TyG‑WHR and metabolic score for IR (METS‑IR). Correlation between the GLS and the new simplified IR assessment indexes was analyzed. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficacy of different simplified IR assessment indexes, with the area under the curve (AUC) calculated. Furthermore, according to whether the subjects were complicated with hypertension, binary logistics regression analysis was performed to explore the independent correlation between the simplified IR assessment index and GLS <18%.ResultsTotal 150 were included with aged (54.5±13.7) years with 96 (64.0%) men and 54 (36.0%) women. Compared with the GLS≥18% group, the TG/HDL‑C ratio, TyG index, TyG‑BMI, and METS‑IR of subjects in the GLS<18% group were significantly increased (P<0.05). Pearson correlation analysis showed that TG/HDL‑C ratio, TyG index, TyG‑BMI, TyG‑WHR, and METS‑IR were negatively correlated with GLS (P<0.05). ROC analysis showed that TyG index had a certain predictive value for the evaluation of GLS<18% (AUC=0.678, 95%CI 0.591-0.765, P<0.001). Stratification based on hypertension and further adjusting for confounding factors, TyG index remains significantly associated with GLS<18% (OR=3.249, 95%CI 1.045-10.103, P=0.042).ConclusionsThe novel simplified insulin resistance evaluation indexes are closely associated with left ventricular subclinical systolic dysfunction in T2DM patients with preserved ejection fraction. TyG index is an effective index to identify left ventricular subclinical dysfunction in these populations.  
      关键词:diabetes mellitus, type 2;insulin resistance;triglyceride glucose index;left ventricular global longitudinal strain   
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      发布时间:2024-03-21
    • Wei Kai,Wang Xi,He Bai,Zhao Zi-Qiang,Zhang Wei,Jing Jing,Shan Dong-Kai
      Vol. 49, Issue 2, Pages: 144-151(2024) DOI: 10.11855/j.issn.0577-7402.1849.2023.0818
      CCTA based clinical value analysis of ΔCT-FFR in evaluating coronary artery function in patients with severe calcification
      摘要:ObjectiveTo investigate the clinical value of coronary computed tomography angiography (CCTA) based CT derived fractional flow reserve (CT-FFR) and ΔCT-FFR in improving the diagnostic efficiency for coronary abnormal hemodynamics in patients with severe calcification.MethodsWe retrospectively analyzed the clinical data of coronary artery disease (CAD) patients who underwent CCTA, CT-FFR, invasive coronary angiography (ICA) and FFR during hospitalization from January 2018 to June 2019 in Chinese PLA General Hospital. Severe calcification was defined as coronary artery calcium score (CACS) ≥100 on single vessel level. A total of 107 CAD patients with 149 coronary arteries were included in the present study. The enrolled coronary arteries were assigned to CACS≥100 group (n=56) and CACS<100 group (n=93). CT-FFR was performed on the deep FFR platform based on machine learning (ML) algorithms and ΔCT-FFR was defined as CT-FFR difference between proximal and distal to the coronary lesion. The correlation and consistency between CT-FFR and FFR values were analyzed by Pearson and Bland-Altman methods. We attempted to analyze the incremental value of ΔCT-FFR for coronary functional evaluation, especial for coronary arteries with severe calcification, regarding FFR≤0.8 as the diagnostic gold standard. Comparison of receiver operating characteristic curves (ROC) between different diagnostic methods was presented by Delong test.ResultsPearson and Bland-Altman analyses showed appreciable correlation (CACS≥100 group, r=0.71, P<0.01; CACS<100 group, r=0.73, P<0.01) and consistency (CACS≥100 group, Mean=-0.01, P=0.25; CACS<100 group, Mean=0, P=0.96) between CT-FFR and FFR values in both groups. FFR (0.80±0.08 vs. 0.84±0.09, P=0.004) and CT-FFR (0.81±0.06 vs. 0.85±0.06, P<0.001) levels were significant lower in CACS≥100 group than those in CACS<100 group, while ΔCT-FFR (0.14±0.06 vs. 0.09±0.06, P<0.001) levels were significant higher in CACS≥100 group. Moreover, the diagnostic efficiency of CT-FFR in CACS≥100 group was inferior to that in CACS<100 group [AUC=0.792(95%CI 0.663-0.889) vs. AUC=0.929(95%CI 0.856-0.972), P=0.04], while it achieved significant improvement after ΔCT-FFR adjustment [AUC=0.876(95%CI 0.760-0.949) vs. AUC=0.792(95%CI 0.663-0.889), P=0.02] and was similar to that in CACS<100 group (P=0.37).ConclusionFor coronary arteries with severe calcification, CT-FFR demonstrated significant incremental value in improving the diagnostic efficiency of coronary abnormal hemodynamics after ΔCT-FFR adjustment.  
      关键词:coronary artery disease;coronary computed tomography angiography;fractional flow reserve;severe calcification   
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      发布时间:2024-03-21
    • Wang Wei-Jiao,Chen Hui-Sheng
      Vol. 49, Issue 2, Pages: 152-158(2024) DOI: 10.11855/j.issn.0577-7402.2544.2023.0825
      Effects of different doses of statins on clinical outcomes in patients with acute ischemic stroke who received intravenous urokinase thrombolysis
      摘要:ObjectiveTo investigate the effect of different doses of statins on the clinical efficacy and safety outcome of intravenous thrombolytic therapy of urokinase in patients with acute ischemic stroke (AIS).MethodsBased on a large prospective, multicenter study, the Chinese Intravenous Thrombolysis Registry for AIS within 4.5 h of onset (INTRECIS) database, clinical data of 898 patients with urokinase intravenous thrombolysis for AIS were retrospectively analyzed. According to the amount of statin used during hospitalization, the patients were divided into 132 patients in no-statin group, 591 patients in conventional statin group and 175 patients in intensive statin group. Clinical outcome measures included 14-day improvement in the National Institutes of Health Stroke Scale (NIHSS) and 90-day excellent prognosis (improved Rankin score ≤1 point). Safety measures included recurrent stroke, bleeding events, and 90-day all-cause mortality.ResultsAfter adjusting for differences in baseline characteristics (age, coronary heart disease, diabetes, atrial fibrillation, systolic blood pressure, OTT, DNT, previous anti-plate use, blood glucose, and treatment in Class A hospitals), NIHSS scores improved at 14 days after admission and excellent prognosis at 90 days after admission in convention-dose and intensive statin groups were superior to those in no-statin group (P<0.05); Univariate and multivariate analysis of safety outcome indicators showed no statistically significant differences in stroke recurrence and bleeding events among the three groups (P>0.05); The 90-day all-cause mortality was significantly higher in no-statin group (10.6%) than in convention-dose statin group (2.0%) and intensive dose statin group (2.9%) (P<0.01).ConclusionsIn patients with AIS who were treated with intravenous urokinase thrombolytic therapy, intensive statin use was associated with improved 14-day NIHSS score and near-term prognosis without increasing the risk of stroke recurrence and bleeding events. Statin use is beneficial to reduce mortality.  
      关键词:statin;acute ischemic stroke;urokinase;intravenous thrombolysis;prognosis   
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      发布时间:2024-03-21
    • Wang Guang-Xiang,Dong Chang-Hao,Li Chao,Xian Rui,Cui Li-Hong
      Vol. 49, Issue 2, Pages: 159-164(2024) DOI: 10.11855/j.issn.0577-7402.0669.2023.1011
      摘要:ObjectiveTo analyze the correlation between irritable bowel syndrome (IBS) as well as its subtypes and gallbladder stone.MethodsCollected the clinical data of 556 patients who were treated in Department of Gastroenterology of the Sixth Medical Center of Chinese PLA General Hospital from January 2019 to March 2023. The patients were divided into IBS group (n=161) and non-IBS group (n=395). The subjects were investigated by questionnaire, physical examination and blood examination, and the data of gender, age, height, weight, blood pressure and blood biochemical indexes were obtained and compared between two groups. The relation between gallbladder stone and IBS were evaluated by logistic regression analysis.ResultsThere were 90 cases of gallbladder stone in the total population, accounting for 16.2%, including 37 cases of gallbladder stone in IBS group (23.0%) and 53 cases in non-IBS group (13.4%). The prevalence rate of gallbladder stone in IBS group was significantly higher than that in non-IBS group (P<0.05). There were 6 cases of gallbladder muddy stones (3.7%) in IBS group and 3 cases (0.8%) in non-IBS group. And the prevalence rate of gallbladder muddy stones in IBS group was also significantly higher than that in non-IBS group (P<0.05). Logistic regression analysis showed that the age, BMI, total bile acids (TBA), total cholesterol (TC) and combined IBS were independently related to the occurrence of gallbladder stone (P<0.05). In the 161 IBS patients, there were 114 cases of diarrhea-predominant IBS (IBS-D group), including 26 cases (22.8%) of gallbladder stone in IBS-diarrhea (IBS-D, n=114) group and 47 cases of constipation-predominant IBS (IBS-C group), including 11 cases (23.4%) of gallbladder stone. And there were 53 cases (13.4%) of gallbladder stone in the non-IBS group (n=395). Further analysis showed that the prevalence rate of gallbladder stone in IBS-D group was significantly higher than that in non-IBS group (P<0.05). There was no significant difference in gallbladder stone prevalence rate between IBS-C group and non-IBS group (P>0.05).ConclusionsThere is a correlation between IBS and gallbladder stones. In addition, among the two subtypes of IBS, IBS-D patients may have an increased risk of gallbladder stone compared with non-IBS patients.  
      关键词:irritable bowel syndrome;diarrhea predominant irritable bowel syndrome;predominant constipation predominant irritable bowel syndrome;gallbladder stones   
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      发布时间:2024-03-21
    • Wang Jing,Li Ya-Qun,Wang Hai-Yan,Song Yao-Ru,Li Jing,Wang Wen-Xin,Wan Lin-Yu,Zhou Chun-Bao,Fan Xing,Wang Fu-Sheng
      Vol. 49, Issue 2, Pages: 165-170(2024) DOI: 10.11855/j.issn.0577-7402.0075.2023.0427
      Characteristics of T cell immune responses in adults inoculated with 2 doses of SARS-CoV-2 inactivated vaccine for 12 months
      摘要:ObjectiveTo evaluate the characteristics of different antigen-specific T cell immune responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) after inoculation with 2 doses of SARS-CoV-2 inactivated vaccine for 12 months.MethodsFifteen healthy adults were enrolled in this study and blood samples collected at 12 months after receiving two doses of SARS-CoV-2 inactivated vaccine. The level and phenotypic characteristics of SARS-CoV-2 antigen-specific T lymphocytes were detected by activation-induced markers (AIM) based on polychromatic flow cytometry.ResultsAfter 12 months of inoculation with 2 doses of SARS-CoV-2 inactivated vaccine, more than 90% of adults had detectable Spike and Non-spike antigen-specific CD4+ T cells immune responses (Spike: 14/15, P=0.0001; Non-spike: 15/15, P<0.0001). 80% of adults had detectable Spike and Non-spike antigen-specific CD8+ T cells immune responses (Spike: 12/15, P=0.0463; Non-spike: 12/15, P=0.0806). Antigen-specific CD4+ T cells induced by SARS-CoV-2 inactivated vaccination after 12 months were composed of predominantly central memory (CM) and effector memory 1 (EM1) cells. On the other hand, in terms of helper subsets, antigen-specific CD4+ T cells mainly showed T helper 1/17 (Th1/17) and T helper 2 (Th2) phenotypes.ConclusionsSARS-CoV-2 inactivated vaccination generates durable and extensive antigen-specific CD4+ T cell memory responses, which may be the key factor for the low proportion of severe coronavirus disease 2019 (COVID-19) infection in China.  
      关键词:severe acute respiratory syndrome coronavirus 2;Inactivated vaccine;T cell immune response   
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    • Yang Si-Yao,Wang Yuan-Yuan,Liu Jian-Bing,Liu Zhi-Rong
      Vol. 49, Issue 2, Pages: 171-176(2024) DOI: 10.11855/j.issn.0577-7402.2092.2023.0717
      Association between<italic style="font-style: italic"> ELL2 </italic>polymorphism and susceptibility to pleomorphic adenoma of salivary gland
      摘要:ObjectiveTo analyze the correlation between the ELL2 gene 1119 T>C polymorphism and the susceptibility to pleomorphic adenoma of the salivary gland.MethodsThe pedigree of the pleomorphic adenoma family of salivary gland was drawn. The exons of ELL2 gene in 5 members of salivary pleomorphic adenoma family were sequenced. A case-control study was conducted. One hundred and twelve patients with pleomorphic adenoma of the salivary gland who visited the Department of Oral and Maxillofacial Surgery of Shanxi Bethune Hospital from January 2016 to July 2020 were taken as case group, and 176 healthy examinees from January 2019 to January 2020 were taken as control group with age and sex as matching conditions. The 1119 T>C polymorphism of ELL2 genes in the two groups were detected with high resolution melting (HRM) curve. Chi-square test was adopted to analyze the correlation between gene polymorphism and the occurrence of pleomorphic adenoma of the salivary gland, stratified analysis was performed to evaluate the synergistic effect of smoking and genotype, and real time quantitative reverse transcription polymerase chain reaction (RT-PCR) was used to detect the expression level of ELL2 in individuals with different genotypes.ResultsThe 1119 T>C polymorphism site existed in the exon 8 of ELL2 gene in a family with pleomorphic adenoma of salivary gland. The results of case-control study showed that the genotype frequency of homozygous CC was significantly higher in patients with pleomorphic adenoma of salivary gland than that in the controls (24.1% vs. 11.9%, P=0.002). Homozygous CC was associated with increased risk for developing pleomorphic adenoma of salivary gland (OR=3.059, 95%CI 1.494-6.263) in this cohort. Stratification analysis showed that smoking and 1119C allele cooperated to increase the risk of pleomorphic adenoma of salivary gland (OR=3.200, 95%CI 1.460-7.014). The expression level of ELL2 mRNA in CC genotype was significantly higher than that in individuals with CT or TT genotype (P<0.05).ConclusionThe genetic variation of ELL2 may play an important role in the occurrence of pleomorphic adenoma of salivary gland, and smoking combined with the 1119C allele increased the risk of this disease.  
      关键词:salivary gland pleomorphic adenoma;gene, ELL2;single nucleotide polymorphism;genetic variation   
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      发布时间:2024-03-21
    • Li Xin-Yu,Yang Xi-Tao,Guo Zhi-Lin
      Vol. 49, Issue 2, Pages: 177-181(2024) DOI: 10.11855/j.issn.0577-7402.1705.2023.0619
      摘要:ObjectiveTo evaluate the clinical effect of total optic nerve canal decompression in the treatment of traumatic optic neuropathy (TON) without photoreceptor.MethodsThe clinical data of 67 patients with no photoreceptor TON admitted to Department of Neurosurgery of the Shanghai Ninth People's Hospital of Shanghai Jiao Tong University School of Medicine from January 2015 to December 2021 were selected for retrospective analysis, in which 37 cases in observation group received total optic nerve canal decompression surgery and 30 cases in control group received non-total optic nerve canal decompression surgery. Both groups received high-dose glucocorticoid therapy and oral administration of methylcobalamin before surgery. The visual acuity changes and complications after admission and treatment were examined and recorded in both groups. The effective rate, unblinding rate and complications after treatment were compared between the two groups.ResultsThere were no statistically significant differences between observation group and control group in terms of age, gender, time from injury to surgery, preoperative GCS score, operative time, and intraoperative bleeding volume (P>0.05). After treatment, the effective rate of observation group was 54.1% and the unblinding rate was 35.1%, while the effective rate of control group was 46.7% and the unblinding rate was 33.3%; there was no statistically significant difference between the effective rate and unblinding rate of the two groups (P>0.05). No serious complications such as cerebrospinal fluid leakage, epilepsy, and intracranial infection occurred in both groups after surgery. In observation group, the effective rate after treatment was significantly lower in those with optic nerve canal fractures than that in those without optic nerve canal fractures (P<0.05); the effective rate was significantly higher in patients with injury-to-operation time ≤7 d than that in patients with injury-to-operation time >7 d (P<0.05).ConclusionTotal optic nerve canal decompression can improve the visual acuity of patients without photoreceptor TON and reduce the blinding rate, which is an effective surgical treatment method.  
      关键词:traumatic optic nerve injury;decompression of optic nerve canal;treatment;prognosis   
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    • Tian He-Ping,Zhong Qi,Wang Geng-Huan,Zhou Hai-Hang
      Vol. 49, Issue 2, Pages: 182-187(2024) DOI: 10.11855/j.issn.0577-7402.1897.2023.0720
      Advantages of intraventrilular intracranial pressure monitoring with modified paine point puncture in decompression of severe traumatic brain injury
      摘要:ObjectiveTo explore the advantages of modified Paine point puncture for intraventricular intracranial pressure (ICP) monitoring probe implantation during decompressive craniectomy (DC) for severe traumatic brain injury.MethodsThe clinical data of 48 patients with severe traumatic brain injury admitted from April 2020 to April 2022 in Jiaxing Second Hospital were retrospectively collected. All patients underwent DC combined with ICP monitoring probe implantation. According to different ICP monitoring methods, they were divided into observation group (23 cases) and control group (25 cases). The observation group underwent the implantation of the intracerebroventricular ICP monitoring probe by puncture at the modified Paine point in the DC incision, while the control group underwent implantation of intracerebroventricular ICP monitoring probe by drilling of the skull through contralateral incision of DC at the Kocher point. The preoperative general data, operation time, postoperative mannitol dose and duration, ICP monitoring duration, postoperative rebleeding rate, intracranial infection rate and Glasgow outcome score (GOS) at 3 months after the operation were compared between the two groups.ResultsThere was no statistical difference between the two groups in general data, mannitol dosage, mannitol duration and ICP monitoring duration (P>0.05). The operation time, postoperative rebleeding rate and intracranial infection rate in observation group were lower than those in control group (P<0.05). In the GOS score at 3 months after the operation, there was no statistical difference between the two groups (P>0.05).ConclusionsCompared with the traditional implantation of intraventricular ICP monitoring probe through Kocher point through skull drilling with contralateral incision of DC, the implantation of intraventricular ICP monitoring probe through modified Paine point in the DC incision for severe traumatic brain injury can shorten the operation time and lower the postoperative rebleeding rate and intracranial infection rate.  
      关键词:severe traumatic brain injury;decompressive craniectomy;implantation of ventricular intracranial pressure monitoring probe;modified Paine point ventricular puncture   
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    • Wang Xiao-Lei,Zhou Qing,Li Yan,Li Jia-Xin,Guo Shuai-Kang,Xu Shu-Fei
      Vol. 49, Issue 2, Pages: 188-193(2024) DOI: 10.11855/j.issn.0577-7402.1978.2023.0410
      Synovial sarcoma of the liver: a case report and literature review
      摘要:ObjectiveTo report a case of synovial sarcoma of the liver and review the literature for improving the understanding of the disease.MethodsThe clinical data of a patient with liver synovial sarcoma admitted to the First Affiliated Hospital of Henan University were analyzed retrospectively. The imaging, pathological features, treatment and prognosis of this disease were summarized by searching the database (CNKI, Wanfang Data, PubMed, untill July 2022) and the literature results analyzed comprehensively.ResultsThe patient was a 71-year-old female who was admitted to the hospital due to abdominal pain. Computed tomography (CT) scan showed a mass with mixed density in the right lobe and caudate lobe of the liver. The large cross section size was about 115 mm×87 mm and the mass showed continuous heterogeneous enhancement, being considered as malignant hepatic tumors with multiple metastasis of the liver and lung. Ultrasound-guided needle biopsy was performed, and microscopy showed the tumor cells were obvious atypical, and some were spindle-shaped. Immunohistochemistry showed that the patient was positive for vimentin (VIM), epithelial membrane antigen (EMA), methylation of histone at lysine 27 (H3K27Me3), and negative for pan cytokeratin (CK-pan) and S-100, and pathological diagnosis of synovial sarcoma was made. The patient did not undergo subsequent treatment and was lost to follow-up after discharge. A total of 12 cases of hepatic synovial sarcoma were reported after searching the database. The clinical manifestations were abdominal pain or distention. The lesions were mostly located in the right lobe of the liver, usually large, heterogeneous density, and heterogeneous enhancement on enhanced CT or magnetic resonance imaging (MRI). Spindle-shaped cells were found at histopathologic examination. Immunohistochemistry showed the patient was positive for VIM, EMA, H3K27Me, B-cell leukemia/lymphoma-2 (BCL-2) and transducer-like enhancer of split 1 (TLE1). SS18-SSX fusion gene or SS18 gene isolation were detected. Eleven patients received surgical treatment, 5 received adjuvant chemotherapy, and 4 had recurrence or metastasis during the follow-up period.ConclusionsSynovial sarcoma of the liver is a rare malignant tumor of the liver. The clinical and imaging features are not specific. The diagnosis depends on pathology. At present, the main treatment is surgery, and comprehensive treatment such as adjuvant chemotherapy can be performed. The prognosis of the patient is poor.  
      关键词:liver;synovial sarcoma;diagnosis;treatment   
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      发布时间:2024-03-21

      Basic Research

    • Lin Mei-Jia,Lei Yu-Qing,Ye Zhou-Jie,Zhu Li-Ping,Wang Xin-Rui,Huang Xiong-Fei
      Vol. 49, Issue 2, Pages: 194-203(2024) DOI: 10.11855/j.issn.0577-7402.2561.2023.0731
      The biological function and mechanism of <italic style="font-style: italic">IDH1</italic> gene in intrahepatic cholangiocarcinoma cell HuCCT1
      摘要:ObjectiveTo explore the role and possible molecular mechanism of Isocitrate dehydrogenase 1(IDH1) gene in proliferation and migration of intrahepatic cholangiocarcinoma (iCCA) cell HuCCT1.MethodsHuCCT1 cells with IDH1 gene knockout (HuCCT1IDH1-/-) were constructed by CRISPR/Cas9 gene editing technology. To investigate the capacities of proliferation, migration and invasion of HuCCT1WT (HuCCT1 cells with wild-type IDH1 gene) and HuCCT1IDH1-/- cells, assays of CCK-8, clone formation, scratch and transwell were performed. Western blotting was used to detect the expression levels of epithelial-mesenchymal transition(EMT) associated proteins E-cadherin, N-cadherin, Vimentin, MMP-9, Wnt3a and β-catenin in two groups of cells. The transcriptome sequencing data of HuCCT1WT and HuCCT1IDH1-/-cells were analyzed by bioinformatics methods, Western blotting was used to verify the expression of signaling pathway-related proteins.ResultsCompared with HuCCT1WT cells, HuCCT1IDH1-/- cells showed the number of proliferation and clone formation significantly reduced (P<0.05), the proportion of cells blocked in G2/M phase was significantly increased (P<0.01), the rate of scratch healing was significantly decreased (P<0.01), and the number of migrated cells (P<0.001) and invaded cells (P<0.05) was significantly reduced. qRT- PCR assay showed that the expression levels of IDH1, Vimentin, MMP-9 and genes related to the regulation of G2/M cycle proliferation, Cyclin A2, Cyclin B1 and CDK1 mRNA were down-regulated in HuCCT1IDH1-/- cells (P<0.05), and the expression of CDH1 mRNA encoding E-cadherin was up-regulated (P<0.01); Western blotting assay showed that the expression level of E-cadherin in HuCCT1IDH1-/- cells was significantly increased (P<0.05), and the expression level of N-cadherin, Vimentin and MMP-9 protein was significantly decreased (P<0.05) than that in HuCCT1WT cells. Data of transcriptome sequencing revealed 1476 differentially expressed genes (DEGs) between two groups of HuCCT1 cells. Go enrichment analysis showed the DEGs were significantly enriched in cell biological processes associated with inflammatory response, cell signaling and cell metabolism. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis suggested that the DEGs may be involved in some signaling pathways such as Wnt,MAPK, Rap1, Hippo and TNF, which are closely related to the regulation of proliferation and invasion of tumor cells. Western blotting verification results showed that compared with HuCCT1WT cells, the relative expression of Wnt3a and β‑catenin proteins of HuCCT1IDH1-/- cells was significantly decreased (P<0.05).ConclusionsIDH1 gene may participate in the control of biological functions of HuCCT1 cells, including cell proliferation, migration, invasion and epithelial mesenchymal transition.The mechanism may be related to the activation of the Wnt/β-catenin signaling pathway.  
      关键词:intrahepatic cholangiocarcinoma;isocitrate dehydrogenase 1;cell migration;cell invasion;transcriptome sequencing   
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    • Fu Yu-Xuan,Chen Jun,Zhao Fu-Sheng,Li Yuan-Yuan,Zhang Ke-Xin,Wu Geng
      Vol. 49, Issue 2, Pages: 204-213(2024) DOI: 10.11855/j.issn.0577-7402.0055.2023.0328
      Effect and mechanism of transplantation bone marrow stromal stem cells transfected <italic style="font-style: italic">NRG1</italic> gene on repair of hemi-transected spinal cord injury in rats
      摘要:ObjectiveTo investigate the effect and mechanism of transplantation of neuregulin1 (NRG1) gene-modified bone marrow mesenchymal stem cells (BMSCs) on the repair of hemi-transected spinal cord injury (SCI) in rats.MethodsIsolated and cultured rat BMSCs, followed by transfection with the NRG1 gene. The levels of NRG1 in BMSCs lysate and culture supernatant was deected by ELISA method, and the proliferation activity of the BMSCs was detected by cell counting method. Forty-three healthy 8-week-old SD rats were randomly divided into control group (n=10), SCI model group (n=10), BMSCs group (n=10), and NRG1-BMSCs group (n=13). After establishing the spinal cord hemisection model, animals received in-situ transplantation of BMSCs or NRG1-BMSCs. On the 1, 7, 14, 21, and 28 days after transplantation, the hind limb motor function was evaluated using BBB score and inclined plate test; on the 7th day after transplantation, the migration and distribution of transplanted cells was monitored using a fluorescence microscope; on the 28th day after transplantation, the pathological changes of rat spinal cord tissues was examined using HE staining and Nissl staining; cell apoptosis using TUNEL staining, and levels of endoplasmic reticulum stress-related proteinsX-box binding protein 1 (XBP1), C/EBP homologous protein (CHOP), activating transcription factor 4 (ATF4), ATF6, glucose-regulated protein 78 (GRP78)] and apoptosis-related proteins [B-cell lymphoma-2 (Bcl-2) and Bcl-2-associated protein X (Bax)] in rat spinal cord tissues using Western blotting.ResultsBMSCs were successfully isolated, cultured, and transfected with the NRG1 gene. ELISA method results showed that the NRG1 contents in the NRG1-BMSCs lysate and culture supernatant were significantly higher than that of BMSCs in a time-dependent manner (P<0.05). The proliferation activity of NRG1-BMSCs was significantly higher than that of BMSCs (P<0.05). On the 21 and 28 days after transplantation, the BBB score and the slope angle of the inclined plate in NRG1-BMSCs group were higher than those in SCI model group or BMSCs group (P<0.05). However, it did not reverse to the level in control group (P<0.05). On the 28th day after transplantation, compared with the SCI model group and BMSCs group, neuronal pyknosis reduced, the Nissl body density increased, the expression levels of XBP1, CHOP, ATF4, ATF6, GRP78, and Bax, and the rate of TUNEL-positive cells significantly reduced in NRG1-BMSCs group (P<0.05), and the expression level of Bcl-2 significantly increased (P<0.05).ConclusionTransplantation of NRG1 gene-modified BMSCs can alleviate SCI and improve the recovery of motor function in rats. The mechanism may be related to promoting the proliferation activity of BMSCs, inhibiting cell apoptosis, and mitigating endoplasmic reticulum stress.  
      关键词:spinal cord hemi-transverse injury;neureglin1;bone marrow mesenchymal stem cells;endoplasmic reticulum stress;apoptosis   
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    • Li Yuan,Wang Zhen,Cao Xue,Hou Shao-Zhang
      Vol. 49, Issue 2, Pages: 214-219(2024) DOI: 10.11855/j.issn.0577-7402.1838.2023.0824
      Effect of glycyrrhizin on inflammatory factors and fibrotic factors in high glucose-induced glomerular mesangial cells
      摘要:ObjectiveTo investigate the effect of glycyrrhizic acid (GA) on the inflammatory and fibrotic factors in high glucose-induced glomerular mesangial cells (SV40 MES13).MethodsCultured mouse SV40 MES13 were divided into normal group (NG, 5.6 mmol/L glucose), high glucose group (30 mmol/L glucose) and HG+GA group (30 mmol/L glucose+200 μmol/L GA). The expression levels of inflammatory cytokines interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), IL-6, IL-8 andα-smooth muscle actin (α-SMA) in different groups were detected by Western blotting. The fluorescence intensity of IL-1β, TNF-α and α-SMA in different groups were detected by immunofluorescence. The levels of IL-1β, TNF-α, IL-6 and IL-8 in the culture supernatant of different populations were detected by enzyme-linked immunosorbent assay (ELISA).ResultsThe protein expressions of IL-1β, TNF-α, IL-6, IL-8 and α-SMA in HG group were significantly higher than those in NG group (P<0.01); Compared with HG group, the protein expression levels of IL-1β, TNF-α, IL-6, IL-8 and α-SMA decreased significantly in HG+GA group (P<0.05). The fluorescence intensity of inflammatory cytokines IL-1β, TNF-α and α-SMA increased in HG group than those in NG group (P<0.05); While compared with the HG group, the fluorescence intensity of IL-1β, TNF-α and α-SMA in HG+GA group decreased markedly (P<0.05). The experimental results of ELISA showed that compared with NG group, the levels of IL-1β, IL-6, TNF-α and IL-8 in cell supernatent increased in HG group (P<0.01); while the levels of IL-1β, TNF-α, IL-6, IL-8 in HG+GA group significantly lower than those in HG group (P<0.05).ConclusionGlycyrrhizic acid has certain inhibitory effect on high glucose-induced inflammatory factors and fibrotic factors in glomerular mesangial cells, which may play an important role in prevention of diabetic nephropathy.  
      关键词:diabetic nephropathy;high glucose;glycyrrhizic acid;glomerular mesangial cells;inflammatory factor;fibrosis   
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      Review

    • Wang Tong-Xin,Zhang Fan,Yan Xin,Zhang Ya-Ting,Li Yu-Min
      Vol. 49, Issue 2, Pages: 220-228(2024) DOI: 10.11855/j.issn.0577-7402.1986.2023.0524
      Advances in the study of neoantigen pulsed dendritic cell vaccines in tumor immunotherapy
      摘要:Neoantigen pulsed dendritic cell vaccine (Neo-DCVac) is a new type of tumor immunotherapy. Neoantigen is strong immunologic and tumor-specific mutated peptides expressed in a tumor. Neo-DCVac is a therapeutic modality based on the uptake and processing of neoantigens by dendritic cells and their delivery and activation of T cells to trigger the body's immune response for anti-tumor effects. The development of individualized Neo-DCVac based on high-throughput sequencing is expected to be a new direction for precision immunotherapy of tumors. In this review, we discuss construction of individualized Neo-DCVac, clinical application of combination therapy in solid tumors, suitable population for vaccination and the current limitations of Neo-DCVac, aiming to provide a theoretical reference for research on tumor immunotherapy.  
      关键词:neoantigen;dendritic cell vaccine;tumor;immunotherapy   
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    • Li Tong,Wang Ning,Wang Xin
      Vol. 49, Issue 2, Pages: 229-235(2024) DOI: 10.11855/j.issn.0577-7402.0151.2023.0531
      摘要:When refractory diarrhea comes on, it greatly affects the life and daily work of patients, and there is no unified treatment. Patients with refractory diarrhea have varying degrees of intestinal flora disorder, so rebuilding the intestinal micro ecosystem may be an effective way to treat refractory diarrhea. Fecal microbiota transplantation (FMT) has the potential to be an effective treatment for refractory diarrhea as a therapy that reconstructs normal intestinal flora. In recent years, FMT has been applied to the treatment of some refractory diarrhea related to intestinal flora imbalance, such as recurrent clostridium difficile infection, inflammatory bowel disease, irritable bowel syndrome, and has achieved good results, but some problems have not been properly solved so far. This article reviews the mechanism of action of FMT in the treatment of refractory diarrhea, its clinical application, research progress and current problems.  
      关键词:fecal microbiota transplantation;intestinal flora;refractory diarrhea   
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    • Yang Chi,Luo Chang-Jiang
      Vol. 49, Issue 2, Pages: 236-244(2024) DOI: 10.11855/j.issn.0577-7402.0364.2022.0831
      Research progress on cholesterol metabolism in the regulation of colorectal cancer
      摘要:Cholesterol metabolism is a hot topic in exploration of cancer treatment in recent years, and its complex mechanism of action potentially lays a molecular foundation related to lipid-cancer. However, most studies focus only on cholesterol as a product to understand and analyze the progress of cancer, ignoring the phased effects of related derivatives, regulatory proteins and immune cells in its metabolic process, so whether to find targets to regulate colorectal cancer (CRC) from the cholesterol metabolic pathway has become a research focus. This paper reviews the molecular mechanism and the role of signaling pathways in metabolic reprogramming of CRC starting from the abnormal intracellular cholesterol metabolic pathway in order to provide new ideas for the targeted cholesterol therapy of CRC.  
      关键词:cholesterol metabolism;colorectal cancer;molecular mechanism;targeted therapy   
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