Abstract:Chemical biology focuses on the discovery and use of chemical compounds to understand and manipulate biological systems. It has been applied in many fields, including stem cell research. Recently, stem cell research has made significant progresses. A better understanding of stem cell biology will also promote the translation of stem cell technology in regenerative medicine. Elucidating the mechanisms governing cell fate determination and developing strategies to precisely manipulate cell fates are the fundamental issues in stem cell research. The use of small molecules to manipulate stem cell behaviors, including self-renewal, differentiation and reprogramming, has become more and more popular and offered significant advantages over conventional genetic approaches for their convenience in use, high degree of temporal control and functional diversity. In addition, based on our long-term experience in small molecular drug development, the application of chemical compounds to modulate stem cell functions in vivo for regeneration and repair could be the future direction of regenerative medicine.

Abstract:Objective To assess the clinical efficacy of fibular osteotomy with autogenous iliac bone graft for treatment of nonunion of the tibia. Methods A cohort of 45 patients with postoperative nonunion of tibia between Jul. 2008 and Jun. 2013 were treated by fibular osteotomy combined with autogenous iliac bone graft in Changhai Hospital of Second Military Medical University. According to anatomical classification, there were 29 cases of hypertrophic nonunion, 17 cases of atrophic nonunion and two cases of pseudoarthrosis. For primary fixation, 32 cases had plates internal fixation, 11 had intramedullary nail and two had external fixation. Eight patients with stable plate internal fixation were treated by fibular osteotomy with autogenous iliac bone graft, 35 patients with failed internal fixation and two patients with failed external fixation were treated by removing implant and exchanging compression plate with fibular osteotomy using autogenous iliac bone graft. The status of fracture healing and relative complications were assessed by lateral and frontal X-ray. Functional recovery of the ankle was evaluated by Olerud-Molander Ankle Score (OMAS). Results The operation time was 1.3-2.5 (1.7±0.5) h, the intra-operation blood loss volume was 200-500 (250.0±59.6) mL, the fibular osteotomy length was 2-3 (2.4±0.5) cm, and the volume of iliac grafting was 3-23 (7.8±1.3) cm³. The follow-up time was 12-48 (16.5±3.3) months and the fraction healing time was 3-11 (5.6±2.4) months. The healing of 26(58%) patients took 3-5 months, 13(29%) patients took 6-8 months and 6(13%) patients took 9-11 months. Twenty-seven patients had no limb shortening, nine patients had limb shortening of <1 cm, six patients had limb shortening of 1-2 cm and three patients had limb shortening of >2 cm. The function of lower limb joints was excellent in 23 cases, good in 14 cases, common in 5 cases and bad in 3 cases at last follow-up. Conclusion The fibular osteotomy with autogenous iliac bone graft can create pressure on the broken bone end and increase the broken bone end contact area, promoting fracture healing and reducing complications.

Abstract:Objective To determine the expression of signal transducers and activators of transcription 3 (STAT3) in intrahepatic cholangiocarcinoma (ICC) and to evaluate its influence on the outcome and prognosis of patients. Methods The expression of STAT3 was examined in intrahepatic cholangiocarcinoma (ICC) by immunohistochemistry assays. The correlation between STAT3 expression and clinicopathological parameters was analyzed by Pearson χ² test and Fisher's exact test. Kaplan-Meier (KM) method was used to estimate and draw the survival curves, and the log-rank test was employed to compare the survival curves between groups. The effects of clinicopathological parameters and STAT3 expression on survival rate of patients were analyzed by Cox regression model. Results The expression of STAT3 in ICC tumor tissues was higher than that in peritumoral tissues, and was closely correlated with the tumor size, pathological satellite, microvascular invasion, undifferentiated-type histology and lymph node metastasis. Patients with high STAT3 expression had a poor prognosis with respect to overall survival (OS) and disease-free survival (DFS). The Cox multivariate survival analysis indicated that STAT3 was an independent prognostic factor for OS. Conclusion High STAT3 expression in ICC is correlated with worse surgical outcomes and it is an independent factor of prognosis, and may also serve as a potential target for treatment of ICC.

Abstract:Objective To prepare the paclitaxel-loaded poly(2-oxazolyl) nano-micelles and to investigate the morphological changes of nano-micelles after changing drug dosage, so as to establish a novel block copolymer micelles delivery system with high loading capacity. Methods The paclitaxel-loaded poly(2-oxazolyl) nano-micelles were prepared using filming-rehydration method. The physical and chemical properties of the prepared nano-micelles, including particle size, encapsulation efficiency and drug loading efficiency, were characterized. The in vitro release characteristics of the prepared nano-micelles were investigated by membrane dialysis method, and the cytotoxicity was determined by CCK-8 method. Results The morphology of micelles gradually extended from spherical to worm-like when the mass ratio of paclitaxel and poly(2-oxazoline) increased from 80:100 to 110:100. The particle size, encapsulation efficiency and drug loading efficiency of spherical micelles were (43.17±0.95) nm, (88.81±2.93)% and (40.49±2.03)%, respectively, while those of worm-like micelles were (107.83±1.51) nm, (77.08±0.97)% and (40.34±0.51)%, respectively. The 24 h cumulative release rates of spherical micelles and worm-like micelles in PBS were (76.58±3.07)% and (77.66±1.00)%, respectively; meanwhile, those in PBS with 2% bovine serum albumin were up to (100.31±1.80)% and (99.73±2.56)%, respectively. The IC₅₀ values of sphere micelles and worm-like micelles on human lung adenocarcinoma cell line A549 were 0.336 μg/mL and 0.342 μg/mL, respectively. Conclusion Paclitaxel-loaded spherical micelles and worm-like micelles with high loading capacity have been successfully prepared. In vitro cytotoxicity Results have found that both micelles have anti-tumor activities.

Abstract:Objective To explore the effect of sleep deprivation (SD) on cognitive evaluation of affective picture. Methods Forty-three undergraduates were recruited and assigned to sleep deprivation group (n=23) and sleep control group (n=20). Because two students in the sleep control group did not participate in retest task and one student data of the test were lost, 17 people was eventually included in the sleep control group. The students in the sleep deprivation group received sleep deprivation at the end of the test (from 22:00 to next day 8:00). The sleep control group had no intervention. A total of 206 affective pictures (108 test and 108 retest) were selected from International Affective Picture System (IAPS) and categorized as positive, neutral and negative pictures. The Positive and Negative Affect Scale (PANAS) was used to investigate the subjective mood ratings of participants at test and retest in two groups and to evaluate the effect of SD on cognitive evaluation of affective pictures. Results SD showed no significant effect on the evaluation of positive and negative pictures, but it showed a negative bias in valence ratings for neutral pictures, with significant difference found for neutral pictures between test and retest in sleep deprivation group (P<0.01), but not in the sleep control group (P=0.12). After controlling covariance subjective emotion, the negative bias caused by SD still existed for the neutral pictures. The arousal ratings for affective pictures in sleep deprivation group was significantly higher than that in sleep control group (P<0.05). Conclusion Our Results indicate that sleep is important in emotional evaluation, and SD can lead to a negative bias for neutral stimuli.

Abstract:Objective To explore the diagnostic value of dynamic multi-detector computer tomography (MDCT) with volume helical shuttle (VHS) technique in children with congenital heart disease (CHD) combined with tracheomalacia. Methods We retrospectively analyzed the imaging and clinical data of 26 patients (16 males, 10 females) with CHD who underwent both MDCT with VHS technique and fiber bronchoscope between Oct. 2014 and Aug. 2016. According to the Results of fiber bronchoscope, the patients were divided into tracheomalacia (n=7) and non-tracheomalacia (n=19) groups. The intracardiac structures and the anatomy of the great arteries were demonstrated by maximum intensity projection (MIP) and volume render (VR) reconstruction. The patterns of the tracheobronchial tree were demonstrated using minimum intensity projection (MinIP) reconstruction.The Mimics 17.0 software was employed to automatically segment the CT images of different respiratory phases of each patient and to measure the cross sectional area of the airway. According to the golden-standard of fiber bronchoscopic findings and operative results, we calculated the diagnostic accuracy of VHS for CHD and the sensitivity, specificity and accuracy for tracheomalacia. Results Compared with non-tracheomalacia group, the patients in tracheomalacia group showed significantly greater cross-sectional area change of the trachea (34.23%-74.95% vs 13.73%-78.87%, P=0.02). The diagnostic sensitivity, specificity and accuracy of VHS technique for tracheomalacia were 85.71%(6/7), 84.21%(16/19) and 84.62%(22/26), respectively. VHS showed accuracies of 100%(12/12) and 91.67%(11/12) in diagnosing extracardiac and intracardiac defects, respectively. Conclusion Dynamic MDCT with VHS technique can provide a one-step diagnosis of tracheomalacia with CHD in children.

Abstract:Objective To investigate the association of lovastatin overcoming gefitinib resistance with the levels of integrin β1 and Survivin in human non-small cell lung cancer (NSCLC) cell line PC9 in vitro, and to explore the possible mechanism. Methods The NSCLC cell line PC9 with acquired gefitinib-resistance were divided into 4 groups:control group (RPMI 1640), gefitinib group (1 μmol/L gefitinib), lovastatin group (5 μmol/L lovastatin), and gefitinib combined with lovastatin group (1 μmol/L gefitinib+5 μmol/L lovastatin). After treatment with different drugs in each group, the inhibition of cell proliferation was detected by cell counting kit-8 (CCK-8) test, the levels of integrin β1 and Survivin mRNA were detected by PCR, and the expressions of integrin β1 and Survivin protein were detected by Western blotting analysis. Results Compared with the control group, lovastatin group and gefitinib group, lovastatin combined with gefitinib treatment had significantly inhibited proliferation of PC9 cells with acquired gefitinib-resistance (P<0.01), and the expressions of integrin β1, Survivin protein and mRNA in PC9 cells were significantly decreased in the three groups (P<0.05, P<0.01). Conclusion Mechanisms of lovastatin combined with gefitinib in overcoming gefitinib resistance may be through blocking integrin β1-p-Akt-Survivin signaling pathway, indicating that the combination treatment might be an effective strategy for gefitinib resistance.

Abstract:Objective To analyze the characteristics of positional nystagmus in patients with vestibular migraine (VM) and to discuss its possible mechanism. Methods We retrospectively analyzed the types, intensities, and time of positional nystagmus recorded by video nystagmography during Dix-Hallpike and Roll-test in 14 patients with acute episode of VM and 16 patients with benign paroxysmal positional vertigo (HSC-BPPV). Results A mixture of geotropic, apogeotropic and downbeat components with a variable combination of each component and various types of positional nystagmus were identified in VM. There was no significant difference in the latencies or the duration of positional nystagmus between VM group and HSC-BPPV group (P>0.05). The peak slow-phase velocities (SPV_max) in horizontal component of positional nystagmus was (11.4±2.3)°/s in VM group, which was significantly lower than that in the HSC-BPPV group ([56.8±9.4]°/s, P=0.001). Compared with HSC-BPPV group, the time needed for reaching the SPV_max (t_m) was significantly longer in VM group ([18.1±2.0] vs[5.9±1.1] s, P<0.001), and the rate of velocity change was significantly slower in VM group ([0.54±0.14] vs[7.21±1.79]°/s², P<0.001). The asymmetry ratio of the stronger to softer SPV_max in HSC-BPPV group was significantly higher than that in the VM group (P=0.02). Conclusion Abnormal central integration mechanism in VM may lead to discordant transmission of semicircular canal rotation information, resulting in mixed nystagmus components and flat nystagmus that appeared at multiple positional maneuver.

Abstract:Objective To study the effect of long non-coding RNAs (lncRNAs) maternally imprinted genes 3 (MEG3) on human abortion villi development and to explore the related molecular mechanisms. Methods We collected the villi samples from 15 spontaneous abortion (SA) and 15 induced abortion (IA) patients. Immunohistochemistry was applied to detect the expressions of apoptosis factor Bax and apoptosis inhibitory factor Bcl-2 in villi samples. Real-time quantitative polymerase chain reaction (qPCR) was used to analyze the levels of MEG3 of villi samples. Overexpression of MEG3 in human trophoblast cell line HTR-8/SVneo was identified by qPCR; the invasion ability of HTR-8/SVneo cells was examined by matrigel invasion assay in MEG3 overexpression and control groups. Results Immunohistochemistry showed that the expression of Bax in IA group was lower than that in SA group, while the expression of Bcl-2 was higher (P<0.01). The level of MEG3 in IA group was significantly higher than that in SA group (P<0.01). The expression of MEG3 was obviously increased and invasion ability was inhibited in MEG3 overexpressed HTR-8/SVneo cells (P<0.01). Conclusion LncRNAs MEG3 may regulate the apoptosis and invasive ability of bizarre trophoblastic cells and influence on the development of human villi.

Abstract:Objective To prepare a 3D polymer scaffold capable of simultaneously releasing both bone morphogenetic protein (BMP)-2 and BMP-7 for osteogenic differentiation of hFOB1.19 cells in bone tissue engineering. Methods The BMP-2 and BMP-7 microspheres of poly(glycolic acid-co-lactic acid)-polyethylene glycol (PGLA-PEG) were prepared using an emulsion method, and the 3D porous scaffold of PGLA-PEG was produced by phase separation. Then in order to obtain composite scaffold loaded with BMPs, the two microspheres were fixed into scaffolds with methylene chloride fumigation technology, and the slow-release of BMP-2 and BMP-7 was observed. The human osteoblast line cells (hFOB1.19) were seeded on the prepared composite scaffolds for testing cell proliferation and osteogenic differentiation. Results It was showed that the produced 3D composite scaffolds could release the BMP-2 and BMP-7 gradually. The hFOB1.19 cells grew better on the 3D composite scaffolds than on the traditional scaffolds on day 10 of cell culture (P<0.01), and the cells had normal morphology. The mRNA levels of alkaline phosphatase, collagen type-Ⅰ, osteocalcin and osteopontin of cells on the 3D composite scaffolds were higher than those on the scaffold without BMPs (P<0.05, P<0.01). Conclusion We have successfully prepared a 3D polymer scaffold which can simultaneously release BMP-2 and BMP-7, and it may be used bone for tissue engineering.

Abstract:Objective To prepare the porous drug-containing membrane by poly (lactic-co-glycolic acid) (PLGA)/chitosan (CS)/nano-hydroxyapatite for guided periodontal tissue regeneration in surgery, and to evaluate its performance in vitro. Methods The samples were divided into four groups by different mass ratios of the PLGA to CS (100:0, 90:10, 80:20 and 70:30). The PLGA/CS/nano-hydroxyapatiteporous films were prepared by freeze-drying process, with polyvinylpyrrolidone (PVP) used as porogen. The best ratio was chosen by detecting the porosity, water absorption, mechanical properties and degradation of the films; and then it was used as drug carrier to prepare membrane material for clindamycin controlled release. The morphology of membrane was observed by scan electronmicroscope, the porosity was detected by anhydrous ethanol liquid displacement method, water absorption was determined by ratio of wet to dry weight of the film, the wet mechanical performance was tested by electronic universal material testing, the degradation was determined by weight loss and swelling degree, and the release character was investigated by ultraviolet spectrophotometric method. In the in vitro experiments, periodontal ligament fibroblast cells (PLFs) were cultured in the membrane for 1-7 days, and cell proliferation was measured by CCK-8. Results The optimal porosity and degradation were found when the mass ratio of PLGA to CS was 90:10, with the porosity being (28.66±1.35)%, water absorption being (108.65±2.27)%, tensile strength being (2.36±0.04) MPa, elongation at break of films being (203.64±3.89)%, breaking power being (45.98±2.46) N, and degradation being (17.60±0.86)%. The maximum drug release was 150 μg·mL^-1·d^-1, and the effective drug release concentration lasted for 15 d, which could promote the proliferation of PLFs. Conclusion The porous PLGA/CS/nano-hydroxyapatite film prepared in the present study has optimal porosity, its degradation in vitro fit well with the tissue growth, and can create and maintain a specific space for guided periodontal tissue regeneration, allowing for steady drug release for a certain period of time.

Abstract:Objective To investigate the protective effect of lithium chloride (LiCl)-activated Wnt/beta-catenin signaling pathway on glucocorticoid-induced bone loss. Methods C57BL6/J mice were randomly divided into 3 groups,osteoporosis (OP) group and LiCl group were injected intraperitoneally once daily with dexamethasone (50 mg/kg), while control group was injected with normal saline. LiCl group was given LiCl (200 mg/kg) through water administration. After 5 weeks of treatment, mice were sacrificed within 24 h. Anti-active beta-catenin antibody was used in immunohistochemical staining to detect the activity of Wnt/beta-catenin signaling pathway. Bone morphology was observed by HE staining. Meanwhile, bone histomorphometrical parameters were analyzed by microCT. Bone formation and bone resorption of different groups were detected by calcein labeling and TRAP staining, respectively. Results The protein level of active beta-catenin was higher in LiCl group compared with OP group. Bone histomorphometrical parameters including the trabecular bone volume as a percentage of total volume (BV/TV), bone mineral density (BMD), trabecular number (Tb. N) and trabecular space (Tb.Sp) were all significantly improved in LiCl group, even though obvious difference existed between LiCl group and control group (P<0.05). Calcein labeling showed that new bone formation was markedly improved in LiCl group, but was still lower than that in control group. Bone resorption was not significantly changed among three groups as indicated by TRAP staining. Conclusion LiCl administration effectively activates Wnt/β-catenin signaling pathway in vivo, which improve new bone formation and rescue glucocorticoid-induced bone loss.

Abstract:Objective To explore the effect of autophagy on the expression of synaptophysin (Syn) and postsynaptic density material 95 (PSD-95) in CA1 hippocampal region of vascular dementia rats. Methods A total of 96 healthy male SD rats were randomly divided into sham operation group (Sham group), vascular dementia model group (VD group), autophagy inhibitor 3-methyl adenine preconditioning group (3-MA group) and autophagy agonist rapamycin preconditioning group (Rap group). Each group was further randomized into 4 subgroups 1, 2, 4 and 8 weeks after model establishment. The rat model of vascular dementia was established using a modified Pulsinelli four-vessel occlusion method. The expressions of Syn and PSD-95 in CA1 hippocampal region of the vascular dementia rats were detected by Western blotting analysis. Results (1) Compared with the Sham group, the ratio of LC3-Ⅱ/LC3-Ⅰ in CA1 hippocampal region of the vascular dementia rats was significantly increased and the expressions of Syn and PSD-95 were significantly decreased in VD group at different time points (all P<0.01). Compared with the VD group, the ratio of LC3-Ⅱ/LC3-Ⅰ was significantly decreased and the expressions of Syn and PSD-95 were significantly increased in 3-MA group at different time points (P<0.05 or P<0.01); the ratio of LC3-Ⅱ/LC3-Ⅰ was significantly increased and the expression of Syn and PSD-95 were significantly decreased in Rap group at different time points (all P<0.01). (2) Correlation analysis showed that the ratio of LC3-Ⅱ/LC3-Ⅰ was negatively correlated with Syn and PSD-95 expression (all P<0.01). Conclusion Autophagy may inhibit the expression of synaptic plasticity related proteins, Syn and PSD-95, in CA1 hippocampal region of the vascular dementia rats, and suppressing autophagic activity is benefitial to the synaptic plasticity.

Abstract:Prostate cancer is the most common malignant tumor in men of western countries and its incidence is increasing in China. However,the traditional Methods of screening and diagnosing of prostate cancer are of limited value. Multiparametric magnetic resonance imaging (MRI) is an examination which combines morphologic sequences with one or more functional sequences. Multiparametric MRI can not only display the anatomical structures and morphologic changes of organs, but also reflect some histological components, providing pathophysiological and biochemical information of tissues and guiding prostate targeted biopsy at the same time. These advantages give multiparametric MRI high application value in the diagnosis and evaluation of prostate diseases. This review summarized the recent progress in multiparametric MRI diagnosis of prostate cancer.

Abstract:DNA methylation is one of the most common forms of epigenetic modification, and it is closely related to the development of bronchial asthma, but its mechanism is unclear. Without altering the sequences of genes, DNA methylation can transfer the cytosine on the 5' end of CpG dinucleotide into methyl cytosine by DNA methyltransferase. Hence, DNA methylation can regulate gene expression, leading to the development and progression of diseases. In this review, we summarized the roles of DNA methylation in bronchial asthma, including related predisposing factors and mechanisms of action.

Abstract:Objective To explore the clinical value of mini instruments in breast approach endoscopic thyroidectomy (BAET). Methods We retrospectively analyzed the data of 40 patients receiving BAET with mini instrument in our department of Changzheng Hospital from Sep. 2012 to Dec. 2013. The average age of patients was (33.53±8.76) years old and the tumor size was (21.10±10.96) mm. According to intraoperative frozen pathology, 19 cases underwent unilateral lobectomy, six cases underwent subtotal thyroidectomy, seven cases underwent total thyroidectomy, and eight cases underwent radical resection of thyroid carcinoma. Results Forty BAET procedures with mini instruments were completed successfully without conversion to open operation, and the complete tumor resection was achieved in all cases. The average operative time was (112.25±31.52) min in the patients, and the VAS-12 h, VAS-24 h, VAS-48 h and RSS (cosmetic score) were 2.48±1.13, 0.85±0.8, 0.25±0.44 and 8.75±1.26, respectively. Four patients had temporary hypocalcemia and one had recurrent laryngeal nerve paralysis after operation. Conclusion Application of mini instruments in BEAT can make endoscopic thyroidectomy less invasive and can improve the cosmetic results, without increasing the surgical difficulty and complications.

Abstract:Objective To analyze the spectrum and characteristics of common diseases in Chinese escort navy fleets in Aden Gulf, providing references for optimizing the allocation of medical resources and improving the efficiency of medical service. Methods A total of 3 068 navy soldiers who served in four escort missions between 2013 and 2016 in Aden Gulf were included in the present study, and they were marked as batch A, B, C and D according to the task sequence. The records of outpatient and emergency departments, data from weekly medical report and data from summary of health service were collected for analyzing the circadian disease incidence, morbidity per day and the composition of diseases. Results The incidence of diseases took a declining tendency from the beginning to the end of the mission. The latter two escort fleets had a significantly lower morbidity per day than the former two escort fleets (P<0.05). The incidence rates of the top six diseases were respiratory infection, gastrointestinal inflammation, trauma, neck lumbar spinal joint diseases, skin tinea and periodontal inflammation in the four fleets. However, significant differences were found for the composition of the top four diseases among different escort fleets (P<0.05). The incidence of insomnia kept steady in four batches of fleets (P>0.05). Conclusion With the normalization of the escort missions, the morbidity per day of the escort soldiers declines in the later escort fleets. More attention should be given to improve the sleeping quality and reduce the occurrence of insomnia while still keeping an eye on common diseases.

Abstract:Objective To investigate the relationships among resilience, perceived social support and acute stress reaction of naval soldiers. Methods Connor-Davidson resilience scale (CD-RISC), perceived social support scale (PSSS) and the military acute stress scale (MASS) were used to investigate 1 348 naval soldiers. The relationships among the involved variables were analyzed by structural equation model. Results Perceived social support was positively correlated with resilience in the participants (P<0.01), and both resilience and perceived social support were negatively correlated with the military acute stress reaction (P<0.01); both of them could independently explain the variance of acute stress reaction of navy soldiers, in which strength (β=-0.136, P<0.01) and external family support (β=-0.229, P<0.01) had significant negative predictive effects on military acute stress reaction. The mediating effect of resilience was significant between military acute stress reaction and perceived social support, accounting 16.22% of the total effect. The model fitting was good:χ²/df=27.91/11=2.537, P=0.003; root mean square error of approximation (RMSEA)=0.032, comparative fit index (CFI)=0.997 and goodness-of-fit index (GFI)=0.994, adjusted goodness of fit index (AGFI)=0.986, normed fit index (NFI)=0.995, relative fit index (RFI)=0.986, incremental fitness index (IFI)=0.997 and Tucker-Lewis Index (TLI)=0.992. Conclusion Perceived social support has direct effect on acute stress reaction of navy soldiers, and it also has indirect influence on the acute stress reaction through the mediating effect of resilience.

Abstract:Objective To compare the clinical efficacies of 3D and 2D laparoscopic partial nephrectomy for renal tumors and to investigate the pros and cons of 3D laparoscopic partial nephrectomy. Methods We retrospectively analyzed the clinical data of 134 patients with renal tumors; they underwent laparoscopic partial nephrectomy between Aug. 2013 and Mar. 2016 by the same surgical group in Changhai Hospital and Changzheng Hospital, Second Military Medical University. Fifty-three cases were included in the 3D laparoscopic partial nephrectomy group and 81 cases in the 2D laparoscopic partial nephrectomy group. The perioperative and follow-up data subjected to comparison and analysis included operative time, estimated blood loss, intraoperative transfusion, warm ischemic time, recovery time of bowel function, length of hospitalization, perioperative complications, and pre-and post-operative glomerular filtration rate (GFR). Results All operation procedures of this study were completed uneventfully without conversion to open surgery or radical nephrectomy, and surgical margins were negative in all cases. The operative time ([193.40±45.14] vs[217.00±59.19] min, P=0.015), warm ischemic time ([23.70±6.96] vs[26.60±8.10] min, P=0.032) and decrease of GFR of the operated kidney ([12.70±6.49] vs[15.10±6.45] mL·min^-1·1.73 m², P=0.036) in the 3D group were significantly improved compared with those in the 2D group. However, the estimated blood loss, intraoperative transfusion, recovery time of bowel function, length of hospitalization and perioperative complications were not significantly different between the two groups (P>0.05). All the patients with complications were discharged from the hospital after conservative therapy. During a follow-up of 1-32 months, no patients had acute or chronic renal failure, local recurrence or distant metastasis, and there was no death case. Conclusion Compared with 2D laparoscopic partial nephrectomy, 3D laparoscopic technology can reduce operative time and warm ischemic time, which can help to better conserve renal function.

Abstract:Objective To evaluate the value of urine neutrophil gelatinase-associated lipocalin (NGAL) combined with mortality in emergency department sepsis (MEDS) score in evaluating the severity and prognosis of sepsis patients with acute kidney injury (AKI). Methods A total of 64 septic patients were selected from the intensive care unit of emergency department of Shanghai Seventh People's Hospital, and they were treated from January 2013 to December 2015. According to the AKI diagnostic criteria of Kidney Disease:Improving Global Outcomes (KDIGO), the patients were divided into group AKI1 (21 cases), group AKI2 (24 cases) and group AKI (19 cases). The patients were also divided into death group (33 cases) and survival group (31 cases) according to their survival state within 28 days. The urinary NGAL levels and MEDS score were compared between groups of different AKI stages and different survival states. ROC curves were plotted to assess the predictive abilities of urine NGAL, MEDS score and the combination of both for the 28 day mortality of sepsis patients with AKI, with Youden index used to identify the optimal cut-off value. Results The urinary NGAL level and MEDS score in the three groups of different stages gradually increased with the severity of the disease, showing significant difference (P<0.01). We also found that NGAL level and MEDS score in the death group were significantly higher than those in the survival group (P<0.01). ROC curve analysis showed that the areas under the curve (AUC) of urinary NGAL and MEDS score were 0.885 and 0.841, respectively, with the optimal cut-off values being 157.5 ng/mL and 10.5 points, respectively. The AUC of urinary NGAL combined with MEDS score for predicting 28 day fatality rate was 0.936, with the sensitivity being 91.4% and specificity being 89.2%, which were better than using urinary NGAL or MEDS score alone. Conclusion Both urine NGAL and MEDS score can be used as for predicting severity of sepsis patients with AKI, and the combination use of the two has even a greater value for the prognosis.

Abstract:Objective To investigate the pharmacokinetic behavior and in situ intestinal absorption of evodiamine complex water-in-oil nanoemulation (WECNE). Methods WECNE was formulated with the titration stirring methods. Twelve male SD rats were intragastrically administered with evodiamine (EDA) and WECNE at the same EDA dose of 100 mg·kg^-1. Blood samples were collected from eye socket at 0.083, 0.25, 0.5, 0.75, 1, 2, 5, 8, 12, 24, 48 and 72 h after intragastrical administration, and the plasma concentrations of EDA were determined by RP-HPLC. DAS 2.1.1 software was applied to evaluate the pharmacokinetic behavior. Single-pass intestinal perfusion was carried out to test the intestinal absorption in situ. Results The area under the curve (AUC_{0-72 h}), peak concentration (C_max) and time to peak (T_max) of WECNE were (4 924.59±1 105.28) μg·L·h^-1, (305.47±51.23) μg·L^-1 and (0.83±0.29) h, respectively. The absorption rate constant (Ka) of WECNE in the stomach, duodenum, jejunum, ileum and colon were (1.05±0.82)×10^-5, (12.19±1.57)×10^-5, (12.66±1.35)×10^-5, (11.94±4.17)×10^-5 and (11.21±1.25)×10^-5 L·s^-1, respectively. In addition, the effective permeability (P_eff) of WECNE in the duodenum, jejunum, ileum and colon were (26.03±3.84)×10^-5, (18.48±5.99)×10^-5, (19.77±2.59)×10^-5 and (36.02±1.48)×10^-5 cm·s^-1, respectively. Conclusion WECNE can improve the bioavailability and the absorption in situ of EDA in different parts of the gastrointestinal tract.

Abstract:Objective To apply finite element method for analyzing the biomechanics status and stability of internal fixation for Vancouver type B1 periprosthetic femoral fractures. Methods CT image data of the left femur from 30 healthy middle-aged or elderly volunteers and the profile data of femur prosthesis and locking compression plate were collected and used for 3D reconstruction. Three different types of internal fixation Methods for Vancouver type B1 periprosthetic femoral fracture were simulated. The proximal part of the prosthesis was fixed with cable cerclage, single-cortical locking screw and a combination of both, and the load simulating full load or partial load was applied. Then the maximum displacement and Von Mises stress were observed. Results There was no significant difference in the maximum displacement or Von Mises stress between cable cerclage fixation and single-cortical locking screw fixation under full and partial loads. The maximum displacement and Von Mises stress were decreased and the internal fixation was more stable when the two fixations combined together, with significant difference found between cable cerclage fixation and single-cortical locking screw fixation (P<0.05, P<0.01). Conclusion Combination of cable cerclage and single-cortical locking screw is the first choice for internal fixation in the treatment of Vancouver type B1 periprosthetic femoral fracture.

Abstract:Objective To analyze the cause, diagnosis and treatment of delayed gastric emptying (DGE) after esophagectomy in a single center. Methods The clinical data of 1 294 patients who underwent esophagectomy from Jan. 2003 to Dec. 2012 in Changzheng Hospital were retrospectively analyzed. Nineteen (1.47%) cases with DGE was included in the observation group and 1 275 cases with no delayed gastric emptying were taken as controls. The age, history of diabetes, anastomotic site, surgical approach, and disassociation of stomach were compared between the two groups, and the causes which may influence gastric emptying were analyzed. The rules and treatment of DGE were summarized. Results A total of 19 cases with DGE after esophagectomy were cured by conservative treatment in our study. Univariate analysis showed that age, history of diabetes, anastomotic site,surgical approach, and disassociation of stomach were not correlated with DGE after esophagectomy (P>0.05). Conclusion The incidence rate of DGE after esophagectomy is low, with its causes remaining unclear. It directly affects patients' living quality and leads to delayed recovery, but can be cured by conservative management.

Abstract:

Abstract:This paper reported a rare case of across the thoracic and lumbosacral transitional vertebra spinal giant schwannoma,will combine literature to analyze the case and share treatment experience.