Abstract:In genomic transcripts of mammalians, long non-coding RNA (lncRNA) is an important group due to its considerable absolute number as well as numerous types. By means of base complimentary paring or spatial conjunction with certain three-dimensional structures, different lncRNAs interact with other biological molecules such as proteins, RNAs and DNAs to exert different biological functions. Together, they constitute a regulatory network both intricate and delicate. More and more researches show that lncRNAs play important roles in the regulation of innate immunity, such as determining differentiation of innate immune cells, adjusting expression of inflammatory factors and participating in host-virus interaction. In this review, we described the biological effects of lncRNAs in innate immunity, and further illuminated the molecular mechanisms. Finally, we discussed the strategies and technologies for carrying out researches on innate immunity-related lncRNAs.

Abstract:Artificial intelligence (AI) has become a national strategy in developed countries. AI has been a great success in many scenarios of medicine and health fields, including virtual assistant, medical imaging, drug mining, nutrition, hospital management, health management, mental illness, wearable devices, risk management, pathology and clinical diagnosis and treatment. Here, we reviewed and commented the recent progresses on the application of AI in the pathological diagnosis, ocular diseases, skin disorders, medical imaging, traditional Chinese medicine, electrocardiographic monitoring, medical robots, oncotherapy and translational researches, and summed up and prospected the problems of AI application in medicine and health fields. With the development of technology, AI will lead to a revolutionary progress in medical treatment.

Abstract:Objective To explore the influencing factors of operative time, blood loss and nerve-sparing of robot-assisted laparoscopic radical prostatectomy (RALP). Methods A total of 184 patients with local or locally advanced prostate cancer were enrolled, and they underwent RALP by the single surgeon in Department of Urology of Changhai Hospital of Navy Medical University (Second Military Medical University) from January 1, 2016 to October 1, 2017. The effects of age, prostate volume, postoperative pathological Gleason score, pelvic lymph node dissection and biopsy approach on the operative time, blood loss and nerve-sparing of RALP were analyzed. The influencing factors of operative time and blood loss were analyzed by multivariate linear regression analysis. Linear correlation analysis was used to identify the correlation between operative time and prostate volume. LSD-t test was used to detect the difference of operative time among the patients with different lymph node dissections. The influencing factors of nerve-sparing during RALP were analyzed by multivariate logistic regression analysis. The difference of age was analyzed by one-way ANOVA and the differences of postoperative pathological Gleason score, lymph node dissection and biopsy approach were analyzed by Kruskal-Wallis H test between the patients with unreserved, reserved unilateral and reserved bilateral nerves. Results Multivariate linear regression analysis showed that prostate volume and lymph node dissection were independent influencing factors of RALP operative time (both P<0.01). There was a significantly positive linear correlation between prostate volume and operative time (r=0.201, P=0.006). The patients with extended lymph node dissection had significantly longer operative time than those with obturator lymph node dissection, and the latter had significantly longer operative time than those without lymph node dissection (both P<0.01). Age, prostate volume, postoperative pathological Gleason score, pelvic lymph node dissection, and biopsy approach had no significant effect on intraoperative blood loss (all P>0.05). Multivariate logistic regression analysis showed that age, postoperative pathological Gleason score, lymph node dissection and biopsy approach were independent influencing factors of nerve-sparing during RALP (OR=0.949, 95% CI 0.906-0.995, P=0.027; OR=0.742, 95% CI 0.551-0.999, P=0.049; OR=0.540, 95% CI 0.322-0.903, P=0.019; OR=0.457, 95% CI 0.230-0.905, P=0.025). The cases with unreserved, reserved unilateral and reserved bilateral nerves were 108, 20 and 56, respectively; and the age, postoperative pathological Gleason score, lymph node dissection and biopsy approach were significantly different among the three groups (all P<0.05). Conclusion The patients with prostate cancers, who have larger prostate volume or undergo lymph node dissection during RALP, may have longer operative time. Older age, higher postoperative pathological Gleason score, undergoing lymph node dissection or transrectal biopsy are not conductive to nerve-sparing during RALP.

Abstract:Objective To develop an integrated standard operation procedure (SOP) for in-hospital emergency care of severe acute pancreatitis (SAP), and to explore the clinical application value. Methods We designed an integrated SOP for in-hospital emergency care of SAP by consulting some experts from emergency intensive care unit (ICU) quality control centers in Shanghai, referencing relevant literature and SAP guidelines at home and abroad, and considering the clinical practice and the experience gained in the integration of "emergency-ICU" contraction at Changzheng Hospital of Navy Medical University (Second Military Medical University). Forty-two SAP patients meeting the SOP criteria, who were admitted to Department of Emergency of Changzheng Hospital of Navy Medical University (Second Military Medical University) between Jul. 2015 and Jan. 2017, were included and set as optimization group. Forty SAP patients, who were admitted to the Department of Emergency between Jan. 2014 and Jun. 2015, were set as routine group. Clinical data of the patients were compared between the two groups, including treatment efficiency, white blood cell count, neutrophil ratio, C-reactive protein level, procalcitonin level, blood amylase level, blood glucose level, blood lactic acid level, serum creatinine level, oxygenation index, modified CT severity index (MCTSI) score, intra-abdominal pressure, urinary neutrophil gelatinase-associated lipocalin (NGAL) level and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score on 72 h and 1 week after admission, complications and survival. Results The proposed SOP mainly referred to the international standard for diagnosis and treatment of SAP in 2012. The updates were mainly in the emergency first visit and comprehensive treatment scheme. In the former, the emergency surgery doctor was changed to emergency green channel (resuscitation room). In the latter, several clinical protocols were added, such as intrarenous injection of a large dose of ulinastatin, rapid infusion of human albumin (intravenous injection of furosemidum when necessary), standardized full-thatch mirabilite external application and coloclysis of sterile solution of rheum officinale. Compared with the routine group, the total rate of treatment efficiency was significantly better, and hospital stay, exhaust recovery time, bloating relief time, ICU duration time, and continuous renal replacement therapy time were significantly shorter in the optimization group (all P<0.05). There were significant differences in the white blood cell count, neutrophil ratio, oxygenation index, MCTSI score and intra-abdominal pressure and the levels of C-reactive protein, procalcitonin, blood glucose, lactic acid, serum creatinine, urinary NGAL on 72 h and 1 week after admission between the two groups (all P<0.05). The levels of blood amylase were significantly different between the two groups on 72 h after admission (P<0.01). The incidences of acute renal failure, acute respiratory distress syndrome, ascites, abdominal compartment syndrome, pancreatic pseudocyst and pancreatic abscess were significantly lower in the optimization group than those in the routine group (all P<0.05). Compared with the routine group, the survival time was significantly longer and the survival rate within two months was significantly higher in optimization group (P<0.05). Conclusion The proposed in-hospital integrated emergency SOP can standardize the diagnosis and treatment process of SAP, improve the efficiency of treatment, and reduce mortality of patients.

Abstract:Objective To explore the inhibitory mechanism of timosaponin B-Ⅱ against the proliferation and migration of human gastric cancer cell lines BGC-823 and MGC-803. Methods BGC-823 and MGC-803 cells were treated with timosaponin B-Ⅱ (50 ng/mL) for 48 h, and the mRNA and protein expressions of scavenger receptor A5 (SCARA5) were measured by qPCR and Western blotting, respectively. The binding site of hsa-miRNA-766-3p in SCARA5 gene 3'UTR was predicted by bioinformatics, and was validated by luciferase report assay. After transfecting with hsa-miRNA-766-3p mimic or siRNA-SCARA5 for 24 h, the BGC-823 and MGC-803 cells were treated with timosaponin B-Ⅱ(50 ng/mL) for 48 h. The relative levels of hsa-miRNA-766-3p and SCARA5 protein expression were detected by qPCR and Western blotting, respectively. The proliferation and migration abilities of cells were determined by MTT. Results The expressions of SCARA5 protein in BGC-823 and MGC-803 cells treated with timosaponin B-Ⅱ (50 ng/mL) for 48 h were significantly increased versus the control group (P<0.01), while no significant difference was found in relative mRNA level of SCARA5 between the timosaponin B-Ⅱ treated cell group and the control group (P>0.05). Compared with transfection of reporter gene expression vector alone group, the luciferase activity was significantly inhibited or enhanced in the cells co-transfected with hsa-miRNA-766-3p mimic or hsa-miRNA-766-3p inhibitor and wild-type luciferase reporter gene (P<0.05, P<0.01). No change was observed between the cells co-transfected with hsa-miRNA-766-3p mimic or hsa-miRNA-766-3p inhibitor and mutant-type luciferase reporter gene expression vector and the cells transfected with reporter gene expression vector alone (P>0.05). Hsa-miRNA-766-3p levels were significantly decreased and SCARA5 protein expressions were significantly increased in BGC-823 and MGC-803 cells treated with 50 ng/mL timosaponin B-Ⅱ (P<0.01). Compared with the timosaponin B-Ⅱ treatment group, hsa-miRNA-766-3p levels were significantly increased and SCARA5 protein expressions were significantly decreased in the BGC-823 and MGC-803 cells of the hsa-miRNA-766-3p mimic transfection+timosaponin B-Ⅱ treatment group (P<0.01). There were no differences in the hsa-miRNA-766-3p levels between the hsa-miRNA-766-3p mimic transfection+timosaponin B-Ⅱtreatment group and the timosaponin B-Ⅱ treatment group (P>0.05), but SCARA5 protein expressions were significantly decreased (P<0.01). Compared with cell control group and vehicle control group, the proliferation and migration abilities of BGC-823 and MGC-803 cells were significantly inhibited by timosaponin B-Ⅱ (P<0.01). Compared with the timosaponin B-Ⅱ treatment group, the proliferation and migration abilities of BGC-823 and MGC-803 cells were significantly increased in the siRNA-SCARA5 transfection+timosaponin B-Ⅱ treatment group (P<0.01). Conclusion Timosaponin B-Ⅱ can inhibit the proliferation and migration of BGC-823 and MGC-803 cells via suppressing hsa-miRNA-766-3p and upregulating the target gene SCARA5.

Abstract:Objective To explore the role of dexmedetomidine (DEX) in the inflammatory response of alveolar epithelial cells in sepsis mice. Methods Male C57BL/6 mice were randomly divided into cecal ligation and puncture (CLP) group and CLP+DEX group (n=36). The mice in the CLP group were intraperitoneally treated with 1 mL sterile normal saline and the mice in the CLP+DEX group were intraperitoneally injected with DEX (50 μg/kg) at 15 min before CLP. The survival rate of mice was recorded within 24 h after CLP. The serum and bronchoalveolar lavage fluid (BALF) were collected on 0, 6, 12, 24 h after CLP, and the levels of interleukin (IL)-6, IL-1β and tumor necrosis factor α (TNF-α) were detected by enzyme-linked immunosorbent assay (ELISA). The mouse alveolar epithelial cell lines MLE12 were cultured in vitro, and were divided into lipopolysaccharide (LPS) group (1 μg/mL LPS) and LPS+DEX group (1 μg/mL LPS+0.2 μg/mL DEX). The levels of IL-6, IL-1β and TNF-α in the cell supernatants were measured by ELISA, and the phosphorylation levels of extracellular signal-regulated kinase (ERK) 1/2 and c-Jun N-terminal kinase (JNK) were determined by Western blotting on 6, 12 and 24 h of cell culture. Results Compared with the CLP group, the survival rate of mice was significantly higher in the CLP+DEX group within 24 h after CLP (P<0.05). The IL-6, IL-1β, and TNF-α levels of serum and BALF were significantly lower in the CLP+DEX group than those in the CLP group (P<0.05, P<0.01). Compared with the LPS group, the levels of IL-6, IL-1β and TNF-α were significantly lower in the MLE12 cell supernatant of the LPS+DEX group on 6, 12 and 24 h of cell culture (P<0.05, P<0.01). Western blotting results showed that the phosphorylation levels of ERK1/2 on 6, 12 and 24 h of cell culture and the phosphorylation levels of JNK on 6 and 12 h of cell culture were significantly lower in the LPS+DEX group than those in the LPS group (P<0.05, P<0.01). Conclusion DEX can reduce the production of inflammatory cytokines in the serum and BALF of sepsis mice and increase the survival rate in sepsis mice, which may be related to the inhibition effect of DEX against activation of ERK1/2 and JNK signal pathways.

Abstract:Objective To explore the application value of high-definition magnetic resonance imaging (MRI) in the assessment of preoperative stage ⅠB-ⅡB cervical cancer. Methods A retrospective analysis was conducted on 94 patients with cervical cancer who had received preoperative pelvic examination in Changhai Hospital of Navy Medical University (Second Military Medical University) from Mar. 2015 to Jun. 2017. Fifty-eight of them received conventional MRI examination and 36 received high-definition MRI examination. The accuracy, sensitivity and specificity of the three methods for vaginal and parametrial invasion were evaluated using the postoperative pathological assessments as the gold standard. And the Kappa test was used to perform consistency analysis. Results For vaginal invasion, the accuracy, sensitivity and specificity of pelvic examination were 63.8% (60/94), 53.7% (29/54) and 77.5% (31/40), respectively; those of conventional MRI examination were 58.6% (34/58), 48.5% (16/33) and 72.0% (18/25), respectively; and those of high-definition MRI examination were 83.3% (30/36), 76.5% (13/17) and 89.5% (17/19), respectively. Kappa test showed that the consistency of pathology and pelvic examination and high-definition MRI examination assessments was good in evaluating vaginal invasion (Kappa=0.297, 0.664; P=0.002, 0.001). For parametrial invasion, the accuracy, sensitivity and specificity of pelvic examination were 79.8% (75/94), 20.0% (1/5) and 83.1% (74/89), respectively; those of conventional MRI examination were 74.1% (43/58), 31.2% (5/16) and 90.5% (38/42), respectively; and those of high-definition MRI examination were 86.1% (31/36), 60.0% (6/10) and 96.1% (25/26), respectively. Kappa test showed that the consistency of pathology and conventional MRI examination and high-definition MRI examination assessments was good in evaluating parametrial invasion (Kappa=0.251, 0.618; P=0.040, 0.001). Conclusion High-definition MRI examination and pathological examination have a good consistency in preoperative assessment of cervical cancer at stage ⅠB-ⅡB, and can be a common method for preoperative evaluation of cervical cancer.

Abstract:Objective To explore the effect of ras-related C3 botulinum toxin substrate 3 (RAC3) on the proliferation, migration and invasion abilities of early trophoblast cells. Methods Villius samples from 20 unexplained spontaneous abortion (SA) and 20 induced abortion (IA) patients were collected between May 2015 and May 2016 in Changzheng Hospital of Navy Medical University (Second Military Medical University). qPCR was used to detect the expression of Rac3 mRNA in the villus tissues. mRNA Chip detection was performed on the placental tissues of 6.5, 14.5 and 19.5 days in mice. After interfering or overexpressing RAC3 in early human trophoblast cell line HTR-8/SVneo, the proliferation, migration and invasion abilities were detected by CCK-8 and Transwell assay, respectively. Results The expression of Rac3 mRNA was significantly lower in the villus tissue of unexplained SA patients than that in the villus tissue of IA patients (P<0.05). Rac3 mRNA expressions were significantly higher in the placental tissues of 6.5 and 14.5 days in mice than that in the placental tissues of 19.5 days (both P<0.05). Compared with the control group, the proliferation, migration and invasion abilities of the HTR-8/SVneo cells were significantly reduced by interfering RAC3 expression (all P<0.05), and the proliferation, migration and invasion abilities were significantly enhanced by overexpressing RAC3 (all P<0.01). Conclusion RAC3 plays an important role in regulating of the proliferation, migration and invasion of early trophoblast cells.

Abstract:Objective To explore the curative effect of optimized selective arterial perfusion approach in the total aortic arch replacement of the Stanford type A aortic dissection. Methods From Sep. 2016 to Oct. 2017, 31 Stanford A aortic dissection patients received total aortic arch replacement with cardiopulmonary bypass of optimized selective arterial perfusion approach (O-CPB group, 25 males and 6 females, aged[50.87±9.08] years old) in our hospital. And 60 Stanford A aortic dissection patients, who underwent total aortic arch replacement with cardiopulmonary bypass of traditional approach in our hospital from Jan. 2015 to Oct. 2017, were included as control (T-CPB group, 52 males and 8 females, aged[48.38±12.46] years old). The perioperative blood biochemistry parameters and clinical data were compared between the two groups. Multivariate logistic regression was used to analyze the risk factors for postoperative 30-day mortality. Results Compared with the T-CPB group, the O-CPB group had significantly shorter extracorporeal circulation time, circulatory arrest time and operation time ([206.90±39.92] min vs[276.37±29.92] min,[5.03±1.54] min vs[21.73±6.67] min and[396.68±58.57] min vs[469.28±69.77] min, all P<0.01). The blood consumption volume and ICU detention time were significantly less in the O-CPB group versus the T-CPB group ([1 401±738] mL vs[1 705±580] mL and[5.94±2.45] d vs[7.42±3.53] d, both P<0.05). The postoperative blood lactate and C-reactive protein concentrations in the O-CPB group were significantly lower than those in the T-CPB group ([6.10±3.80] mmol/L vs[8.11±4.51] mmol/L and[72.13±22.86] mg/L vs[84.78±17.07] mg/L; P<0.05, P<0.01). The patients in the O-CPB group were awake earlier than those in the T-CPB group ([3.32±1.11] h vs[4.14±1.59] h, P<0.05). The absolute value of postoperative Richmond agitation-sedation scale (RASS) score of the O-CPB and T-CPB groups were 1.23±1.06 and 2.15±1.30, respectively, and the difference was statistically significant (P<0.01). In O-CPB group, the oxygenation index was significantly higher and mechanical ventilation time was significantly shorter versus the T-CPB group ([234.42±79.51] mmHg vs[183.10±77.26] mmHg and[50.19±37.63] h vs[70.12±40.84] h; P<0.01, P<0.05; 1 mmHg=0.133 kPa). There was no significant difference in the postoperative 30-day mortality rate between the O-CPB and T-CPB groups (6.45%[2/31] vs 11.67%[7/60], P>0.05). Multivariate logistic regression showed that circulatory arrest time ≥ 31 min and blood consumption volume ≥ 1 390 mL were independent risk factors of postoperative 30-day mortality of Stanford A aortic dissection patients undergoing total aortic arch replacement, with OR(95% CI) being 1.517 (1.153-1.995) and 1.006 (1.002-1.010), respectively. Conclusion With bilateral antegrade selective cerebral perfusion and moderate hypothermia perfusion in lower body, the optimized selective arterial perfusion approach needs shorter circulatory arrest time, and less blood consumption compared with cardiopulmonary bypass of traditional approach. Moreover, it has a good protective effect on the brain and lung during total aortic arch replacement of Stanford type A aortic dissection.

Abstract:Objective To prepare an angiopep-2 modified disulfide cross-linked lipoic acid-polyarginine polypeptide and histidine nanomicelle loading anticancer agent doxorubicin (DOX) brain-targeting drug delivery system for glioma (LHRss-An/DOX). Methods LHRss-An/DOX was prepared by ultrasonic emulsification method, and the particle size, zeta potential and appearance were detected. The loading content (LC) and encapsulation efficiency (EE) of DOX in the polymeric micelles and the in vitro release profiles were determined. Transmembrane transport efficiency of LHRss-An/DOX was evaluated using in vitro blood-brain barrier (BBB) model. The intracellular distribution of DOX and glioma targeting ability were observed by laser scanning confocal microscopy. Results Spherical micelles LHRss-An/DOX were successfully obtained. The mean particle size of the LHRss-An/DOX was (100.9±8.7) nm, polymer dispersity index was 0.232, zeta potential was (28.8±3.3) mV, optimal drug loading ratio was 40%, LC was 15.8% and EE was 55.3%. Cumulative DOX release within 72 h reached (60.3±2.6)%, (84.1±3.9)% and (96.6±2.7)% in the solutions of pH 7.4, pH 5.5 and pH 5.5 with 10 mmol/L DL-dithiothreitol (DTT), respectively. The transporting BBB efficiency of LHRss-An/DOX was 2.04 and 4.27 times of that of LHRss/DOX and free DOX, respectively (both P<0.05). The fluorescence intensity of LHRss-An/DOX uptake by of glioma cells U251 was stronger than that of LHRss/DOX and free DOX. Conclusion Angiopep-2-modified loading drug nanomicelles have good penertrating capacity of BBB and glioma-targeting, and it can be a potential drug delivery system for brain-targeting.

Abstract:Retinal ganglion cells are closely related to visual function. Retinal ganglion cell apoptosis and axonal injury can be found in many blinding eye diseases, such as primary glaucoma, optic neuritis, diabetic retinopathy, and atrophic age-related macular degeneration. Ganglion cells mainly exist in the retinal nerve fiber layer, the ganglion cell layer and the inner plexiform layer of the macular area. These three structures are collectively referred to as the retinal ganglion cell complex, and change of the thickness reflects the state of the retinal ganglion cell. It has been reported that ganglion cell complex thickness is thinner in the injured retinal ganglion cells. Therefore it is important to detected thickness of retinal ganglion cell complex in the diagnosis of ocular disease and the evaluation of its severity and prognosis. In this paper, we reviewed the recent progress in the detection of retinal ganglion cell complex thickness in various eye diseases to assist the early diagnosis, treatment and evaluating prognosis of associated ophthalmopathy.

Abstract:Cellular senescence is a state of permanent growth arrest characterized by an irreversible exit from the cell cycle and the secretion of senescence-associated secretory phenotype (SASP). The secretory process of SASP can be roughly divided into three steps:DNA damage response (DDR)-rapid paracrine, early and mature stages. The complex molecular regulation mechanisms of SASP involve DDR, p38 mitogen-activated protein kinase (MAPK) signal pathway, activation of nuclear factor κB (NF-κB) and CCAAT/enhancer-binding protein β (C/EBPβ), epigenetic alterations of SASP gene, post-transcriptional regulation of gene and autophagy. SASP regulates a variety of pathological states caused by microenvironment changes and has been a drug target to regulate the aging effect, which providing a new therapeutic method for tumor and age-related pathological states. In this paper, we classified the different types of SASP, reviewed the role of SASP in biological processes and discussed the related molecular mechanisms.

Abstract:The ossification of ligamentum flavum (OLF) is a major cause of thoracic spinal stenosis. Due to insidious onset, OLF usually results in severe compression of spinal cord when discovered, and the clinical outcomes are poor. Therefore, novel and effective diagnostic and therapeutic approaches for OLF are greatly needed. Bone morphogenetic protein 2 (BMP-2), a member of the transforming growth factor β family, possesses a critical role in the differentiation of mesenchymal stem cells towards osteoblastic lineage and endochondral ossification in the early stage of embryonic development. Increasing researches revealed that OLF, especially the continuous multilevel ossification, correlates closely with BMP-2. In this review, we summarized the advances on the role of BMP-2 in the occurrence and development of OLF, and prospected the application of BMP-2 as a potential target in the diagnosis, therapy and prognosis monitoring of OLF.

Abstract:Chemotherapy is an effective method for malignant tumors, but chemotherapy-associated adverse effects not only bring great suffering to patients, but also reduce patients' compliance to chemotherapy. Auricular point sticking is a disease treatment method which fixes the particles, such as pills, medicine seeds and plant seeds to specific auricular points using adhesive tape, stimulating relevant points by manual pressure. It has a great potential in reducing chemotherapy-associated side effects. In this paper we reviewed the recent progress on auricular point sticking in treating chemotherapy-associated side effects, and summarized the advantages, limitations, and adverse reactions of auricular point sticking.

Abstract:Chronic heart failure is a major public health problem threatening people's life. As an important measure of non-drug treatment and secondary prevention, cardiac rehabilitation can improve the quality of life and reduce readmission rate of chronic heart failure patients. Training exercises are important elements in cardiac rehabilitation and play a key role in cardiac rehabilitation of patients with chronic heart failure. Moreover, tele-monitoring exercise training has been widely used in cardiac rehabilitation of patients with chronic heart failure overseas. With the tremendous development of "internet + healthcare", it is worth thinking about how to carry out tele-monitoring exercise training of chronic heart failure. In this review, we introduced the progress of tele-monitoring exercise training in patients with chronic heart failure.

Abstract:Objective To observe the success rate and rewarming curve of different water bath rewarming in rats with severe seawater immersed hypothermia. Methods A total of 490 male SD rats were intraperitoneally implanted with temperature recorder before experiment, were randomly divided into immersion group (n=450) and control group (n=40). In immersion group 100 rats were immersed in (15.0±0.2)℃ seawater for 2 h, 150 rats for 5 h, and 200 rats for 10 h. The survival rats of each group were randomly divided into five subgroups and given different rewarming treatments:passive rewarming (passive rewarming subgroup), 37℃ hot water bath rewarming for 0.5 h (37℃ active rewarming 0.5 h subgroup), 37℃ hot water bath rewarming for 1 h (37℃ active rewarming 1 h subgroup), 42℃ hot water bath rewarming for 0.5 h (42℃ active rewarming 0.5 h subgroup), 42℃ hot water bath rewarming for 1 h (42℃ active rewarming 1 h subgroup). The rats in the control group were without seawater immersion, and were randomized into four subgroups as above. The success rate of rewarming was calculated in each group. The serum levels of creatine kinase isoenzyme (CK-MB), alanine aminotransferase (ALT) and lactate dehydrogenase (LDH) were determined in the survival rats after rewarming for 20 h. Dynamic intraperitoneal temperature was recorded at the end of the experiment, and then the passive rewarming velocity, delay afterdrop effect of hot water bath rewarming were calculated. Results With the prolongation of immersing time, the survival rate of rats was significantly decreased in the immersion group (P<0.05). The rewarming success rates were significantly decreased in both the passive and active rewarming groups (both P<0.05). The rewarming success rate in the 37℃ active rewarming 1 h subgroup was greater than or equal to other active rewarming subgroups and the passive rewarming subgroup. All rats in the control group survived after hot water bath. Compared with the control group, the serum levels of CK-MB, ALT and LDH were significantly increased in the surviving rats of the active rewarming subgroups with the prolongation of immersion time (P<0.05). At the same immersing time, the levels of CK-MB, ALT and LDH were significantly lower in the 37℃ active rewarming 1 h subgroup than those in the other active rewarming subgroups (P<0.05 for some results), and were lower than those in the passive rewarming subgroup (P<0.05 for some results). Rewarming curve showed that the rewarming velocity of the passive rewarming subgroup significantly decreased with the prolongation of immersing time (P<0.05), and the rewarming velocity of the dead rats was significantly lower than that of the surviving rats (P<0.05). Delayed afterdrop effect was found in abdominal temperature of hot water rewarming rats, and the greater the effect was, the higher the mortality rate was. The delayed afterdrop effect of 37℃ hot water bath was not obvious in the control group, but it was significantly obvious in 42℃ hot water bath subgroups (P<0.05). Conclusion The success rate of proper hot water bath rewarming is greater than that of passive rewarming in the treatment of severe seawater immersed hypothermia. Hot water bath can be used as a rewarming option in emergency situations, while improper rewarming conditions can decrease the treatment success rate, which may be related to the delayed afterdrop effect.

Abstract:Objective To analyze the calculus composition of upper urinary tract and to explore its distribution and variation trend in patients of different genders and ages, so as to provide a basis for the prevention and treatment of urinary stone. Methods Stone specimens from 1 832 patients with upper urinary tract stone were collected in our hospital from Jan. 2012 to Jan. 2016. The stone composition was detected and analyzed by infrared spectrum automatic analysis system. The proportion and gender difference of stone composition, and the related risk factors and concomitant diseases of major types of stones were analyzed. Results Among the 1 832 cases of stone specimens, there were 478 (26.1%) cases of single component stones, of which the calcium oxalate monohydrate stone accounted for 10.6% (193 cases), followed by anhydrous uric acid stone (7.9%, 144 cases). Mixed stone accounted for 73.6% (1 349 cases), and the most common mixed stone consisted of calcium oxalate monohydrate, calcium oxalate dihydrate and carbonate apatite, accounting for 39.6% (725 cases). For the main composition of stones, calcium oxalate stone accounted for 1 545 cases (84.3%), followed by carbonate apatite stone (1 048 cases, 57.2%), anhydrous uric acid stone (208 cases, 11.4%), magnesium ammonium phosphate stone (111 cases, 6.1%) and cystine stone (29 cases, 1.6%). There were also 5 cases of other types of stones. The overall incidence was significantly higher in men than that in women (70.1%[1 285/1 832] vs 29.9%[547/1 832],P<0.01). The overall high-incidence age of stone ranged from 31 to 60 years old, with 41-50 years for men and 51-60 years for women. Body mass index and incidences of diabetes and gout were obviously higher in anhydrous uric acid stone patients than those in the other stone patients. Conclusion This variation trend of upper urinary tract stone composition has great significance for the prevention and treatment of urinary stones.

Abstract:Objective To introduce the microsurgery treatment method for large parasellar meningiomas by pterional craniotomy and its curative effect. Methods The clinical data of 34 patients with large parasellar meningiomas, who underwent microsurgery via pterional or extensive pterional craniotomy in Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine Jul. 2006 to Aug. 2016, were retrospectively analyzed. The patients included 13 men and 21 women with ages ranging from 21 to 72 (average, 49±13) years old. The course of disease ranged from 1 to 55 (average, 13±10) months. Maximum diameter of tumors ranged from 3.3 to 5.2 (average,[4.3±0.6]) cm. Results No surgical death occurred in this study. Postoperatively, the cranial imaging examination showed that 24 of 34 cases were totally removed, 5 cases were subtotally removed, and 5 cases were partially removed. The postoperative follow-up time was 24-48 (average, 36±13) months. Twenty-eight cases had good prognoses with Karnofsky score being 80 to 100, and six cases had fair prognoses with Karnofsky score being 60 to 79. Five cases had postoperative oculomotor paralysis, which was improved with nutritional nerve treatment. Conclusion The microsurgical treatment via pterional or extensive pterional craniotomy can improve the total resection rate of the large parasellar meningiomas. Palliative operations combined with postoperative radiotherapy may be employed for the tumors that can only be subtotally and partially removed.

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