Abstract:Objective To explore the re-constitution rule of T lymphocyte subsets in bone marrow of patients with hematological malignancies after allogenic hematopoietic stem cell transplantation (allo-HSCT), and its differences with those in the peripheral blood. Methods This study was a prospective study. We collected the bone marrow and peripheral blood samples from 41 patients with hematological malignancies receiving allo-HSCT treatment in Department of Hematology of our hospital from Sep. 2015 to Jan. 2017. During the same period, bone marrow and peripheral blood samples of 7 healthy donors were collected as control samples. Flow cytometry was used to evaluate the distribution of T lymphocyte subsets, including CD4⁺ T cells, CD8⁺ T cells, T-helper cell (Th)1 and Th2 before transplantation and 15, 30, 60, 90 and 180 d after transplantation. Luminex technique was used to evaluate Th1-related cytokines (interleukin 2 receptor[IL-2R] and interleukin 18[IL-18]). Results The proportions of CD4⁺ T cells in bone marrow of the patients with hematological malignancies were significantly lower versus the healthy controls 15 and 30 d after transplantation (both P<0.05), and no recovery was found 180 d after transplantation. The proportions of CD8⁺ T cells in bone marrow of the patients with hematological malignancies were significantly lower versus the healthy controls 15 and 30 d after transplantation (both P<0.01), and it recovered to normal level 60 d after transplantation. The total proportions of CD4⁺ and CD8⁺ T lymphocytes in bone marrow were both significantly lower than those in the peripheral blood of the patients with hematological malignancies (P=0.001, 0.002). The proportions of Th1 in bone marrow of the patients with hematological malignancies were significantly higher than those of the healthy controls 15, 30, 60, 90 and 180 d after transplantation (all P<0.05), and the total level was significantly higher than that in peripheral blood (P=0.006). The proportions of Th2 in bone marrow did not change significantly within 90 d after transplantation, but it was significantly higher 180 d after transplantation than that of the healthy controls (P=0.034), and the total level was similar to the total level of peripheral blood (P>0.05). The ratio of CD4⁺/CD8⁺ T lymphocytes in bone marrow was gradually decreased after transplantation, and significantly lower versus the healthy controls 180 d after transplantation (P=0.040). The ratios of Th1/Th2 in bone marrow were significantly higher than those of the healthy controls 15, 30, 60 and 90 d after transplantation (all P<0.01), while it was similar to the healthy control level 180 d after transplantation (P>0.05). The levels of IL-2R in bone marrow and peripheral blood of the patients with hematological malignancies were significantly higher than those of healthy controls 15, 30, 60 and 90 d after allo-HSCT (all P<0.05). The levels of IL-18 were significantly higher than those of healthy controls 15, 30 and 60 d after allo-HSCT (all P<0.05), and that in peripheral blood 90 d after transplantation was also significantly different from that of healthy controls (P=0.021). There were no significant differences in IL-2R or IL-18 between bone marrow and peripheral blood (both P>0.05). Conclusion After allo-HSCT, the re-constitution rules of different T lymphocyte subsets in bone marrow of patients with hematological malignancies are different, and are different from those in peripheral blood.

Abstract:Objective To analyze the computed tomography (CT) and magnetic resonance imaging (MRI) features of solid pseudopapillary tumor of pancreas (SPTP) and to study the growth characteristics, so as to improve the understanding and diagnosis of SPTP. Methods The clinical data, and CT and MRI data of 103 patients with SPTP confirmed by postoperative pathology, who underwent surgical resection in our hospital between May 2012 and Nov. 2018, were analyzed retrospectively. The gender, age, tumor maximum diameter, tumor location, tumor shape, pseudocapsule, cystic degeneration, intratumoral hemorrhage and calcification were analyzed, and the stratified analysis was carried out according to gender, age, tumor maximum diameter and tumor location. Results A total of 104 lesions (25 lesions in males and 79 in females) of 103 SPTP patients (25[24.3%] males and 78[75.7%] females) were included. The average ages of the males and females were (40.4±11.3) years old and (32.9±12.0) years old, respectively, and the difference was significant (P=0.004). The mean tumor maximum diameters of the males and females were (36.8±25.3) mm and (50.0±31.2) mm, respectively, and the difference was significant (P=0.046). The results of stratified analysis showed that the females were more likely to have pseudocapsule (62 cases), cystic degeneration (41 cases) and intratumoral hemorrhage (37 cases) compared with the males (13 cases, 3 cases and 6 cases, respectively), and the differences were significant (all P<0.05). The patients aged ≤ 40 years old were more likely to have tumor cystic degeneration (37 cases) and intratumoral hemorrhage (37 cases) compared with the patients aged > 40 years old (7 cases and 6 cases, respectively), and the differences were significant (both P<0.01). The tumors with maximum diameter > 3 cm were mainly distributed in the tail of the pancreas (33 cases), and were more likely to have pseudocapsule (59 cases), cystic degeneration (40 cases) and intratumoral calcification (26 cases) compared with the tumors with maximum diameter ≤ 3 cm (14 cases, 16 cases, 4 cases and 5 cases, respectively), and the differences were significant (all P<0.01). The tumors in the tail of the pancreas were more likely to have pseudocapsule (40 cases) and cystic degeneration (25 cases), followed by the tumors in the head of the pancreas (26 cases and 17 cases, respectively), and the differences were significant (both P<0.01). Conclusion The development and progression of SPTP may be a dynamic process of complete solid, cystic solid and cystic changes. At different stages of this process, the imaging manifestations vary with the internal components of the tumors. The tumors in females, in patients aged ≤ 40 years old, in the tail of the pancreas or with the maximum diameter > 3 cm are more likely to have pseudocapsule, cystic degeneration, hemorrhage and calcification.

Abstract:Objective To determine the cerebrospinal fluid/serum albumin ratio (QALB) in patients with neurosyphilis, and to explore the correlation between the blood-brain barrier permeability and the cognitive impairment. Methods A retrospective study was conducted on the clinical data from 93 patients with anti-human immunodeficiency virus (HIV)-negative neurosyphilis diagnosed by Changhai Hospital of Naval Medical University (Second Military Medical University) from Jan. 2010 to Jan. 2018. According to the mini-mental state examination (MMSE) score, the patients were divided into cognitive dysfunction group (n=38) and non-cognitive dysfunction group (n=55), and the demographic data, clinical data and cerebrospinal fluid biochemical data were compared between the two groups. Pearson bivariate correlation analysis was used to analyze the relationship between blood-brain barrier permeability and cognitive dysfunction in neurosyphilis patients. Results There were no significant differences in gender, age, education level, marital status, cerebrospinal fluid leukocyte count, cerebrospinal fluid protein, immunoglobulin G (IgG), IgG index, 24-h intrathecal IgG synthesis, or oligoclonal band between the cognitive dysfunction group and non-cognitive dysfunction group (all P>0.05). The QALB was significantly higher in the cognitive dysfunction group than that in the non-cognitive dysfunction group ([16.42±9.24]×10^-3 vs[3.60±1.11]×10^-3, t=10.907, P<0.01). The incidence of cognitive dysfunction was significantly higher in the elevated QALB (> 7×10^-3) patients versus the normal QALB (≤ 7×10^-3) patients (92.11%[35/38] vs 67.27%[37/55], χ²=7.927, P=0.002). Pearson bivariate correlation analysis showed that QALB was negatively correlated with MMSE score (r=-0.410, P=0.024). Conclusion The neurosyphilis patients with blood-brain barrier damage are prone to cognitive dysfunction, and the higher the blood-brain barrier permeability, the more serious the cognitive dysfunction. Monitoring the permeability of blood-brain barrier can contribute to the assessment of intelligent damage in patients with neurosyphilis.

Abstract:Objective To explore the causes, and prevention and treatment strategies of postoperative bleeding after gastrectomy. Methods We retrospectively analyzed the clinical data of 36 reoperation patients with bleeding after radical gastrectomy in our hospital from Jan. 2014 to Dec. 2018. The gender, age, body mass index (BMI), first operation time, resection scope, reconstruction way, combined organ resection, bleeding interval, bleeding site, bleeding cause, intraoperative treatment, complications and hospital stay after second operation were recorded. According to the location of bleeding after operation, the patients were divided into intraperitoneal bleeding group and gastrointestinal bleeding group. Aforementioned clinical features were compared between the two groups. Results Thirty-six cases of bleeding occurred 1-247 h after operation. Totally, 29 cases underwent second operation immediately and 7 cases underwent second operation after conservative treatment. During the reoperation, 18 cases of active bleeding of blood vessels were identified and ligated or sutured; 1 case of bleeding of spleen was diagnosed and the spleen was resected; 10 cases of hemoperitoneum were found, removed fully drained; and 7 cases of gastrointestinal bleeding were identified, strengthened and sutured. One patient died of malignant arrhythmia 2 d after reoperation. One patient had duodenal stump fistula, 1 patient had pancreatic fistula, and 1 patient had pneumonia; all the 3 patients were discharged after symptomatic treatment. One patient was complicated with postoperative wound disruption and was discharged after resewing treatment. The rest patients were discharged smoothly without continuous bleeding after reoperation. There were no significant differences in age, BMI, gender, first operation time, reconstruction way, hospital stay after reoperation, combined organ resection or bleeding interval between the intraperitoneal bleeding group (29 cases) and gastrointestinal bleeding group (7 cases) (all P>0.05). In the intraperitoneal bleeding group, there were 2 cases (6.9%) receiving proximal gastrectomy, 5 cases (17.2%) distal gastrectomy, 17 cases (58.6%) total gastrectomy, and 5 cases (17.2%) residual gastrectomy, which was significantly different from the gastrointestinal bleeding group (0, 5[71.4%], 2[28.6%] and 0, respectively) (P=0.035). Conclusion Postoperative bleeding can be manifested as intraperitoneal bleeding and gastrointestinal bleeding, and active reoperation is an effective treatment.

Abstract:Objective To detect the expression of peroxisome proliferator-activated receptor (PPAR) in ovarian tissues of rats with chronic low-grade inflammation, and to explore the effect of PPAR-γ agonist rosiglitazone on ovarian dysfunction induced by chronic low-grade inflammation. Methods A chronic low-grade inflammation model of rats was established by intraperitoneal injection of lipopolysaccharide (LPS). Two hundred rats were randomly assigned to control group (NS group) and chronic low-grade inflammation group (LPS group), and the rats were intraperitoneally injected with normal saline and LPS, respectively. The ovarian function of rats was assessed by detecting the serum levels of estradiol (E2), follicle stimulating hormone (FSH), luteinizing hormone (LH), and anti-Müllerian hormone (AMH) during different stages of the estrus cycle (proestrus, estrus, metestrus and diestrus). The protein expression levels of PPAR-α, PPAR-δ and PPAR-γ in ovarian tissues were detected using Western blotting. Eighty rats of each group were randomly divided into two subgroups, which were administered intragastrically by normal saline and rosiglitazone, respectively. Fourteen days after intragastric administration, the levels of pro-inflammatory cytokines, including interleukin (IL)-1β, IL-6 and tumor necrosis factor α (TNF-α), in ovarian tissues and ovarian function of rats in each subgroup were observed during different stages of the estrus cycle. Results Compared with the NS group, during different stages of the estrus cycle, the serum levels of E2 and AMH of rats in the LPS group were significantly decreased (all P<0.05), while the serum levels of FSH and LH were significantly increased (all P<0.05). During different stages of the estrus cycle, the expression levels of PPAR-γ in ovarian tissues were significantly decreased in the LPS group compared with the NS group (all P<0.05), while the expression levels of PPAR-α and PPAR-δ were not significantly different between the two groups (all P>0.05). Compared with the intraperitoneal injection of LPS+intragastric administration of normal saline subgroup, during different stages of the estrus cycle, the expression levels IL-1β, IL-6 and TNF-α in ovarian tissues of rats were significantly decreased in the intraperitoneal injection of LPS+intragastric administration of rosiglitazone subgroup (all P<0.05), the serum levels of E2 and AMH were significantly increased (all P<0.05), and the serum levels of FSH and LH were significantly decreased (all P<0.05). Conclusion PPAR-γ agonist rosiglitazone can attenuate LPS-induced chronic low-grade inflammatory and improve ovarian function in rats.

Abstract:Objective To determine the expression of anoikis factor Bcl2 inhibitor of transcription 1 (Bit1), epithelial-mesenchymal transformation (EMT) marker E-cadherin and P16^INK4a in tumor budding and central tumor of cervical squamous cell carcinoma, and to explore the significance of Bit1 and E-cadherin expression in the process of obtaining high invasiveness of cervical cancer and their relationship with P16^INK4a expression. Methods A total of 77 paraffin-embedded specimens of cervical squamous cell carcinoma were collected from the Department of Pathology of Gansu Provincial Cancer Hospital between 2014 and 2018. The expression levels of Bit1, E-cadherin and P16^INK4a in tumor budding and central tumor of these specimens were detected by immunohistochemistry. Taking the median scores of protein expression in the central tumor and tumor budding as dividing points, the specimens were divided into high expression group and low expression group. The differences of Bit1 and E-cadherin expression under different p16INK4a expression and their relationship with the clinicopathological characteristics of the patients were analyzed. The correlation between Bit1 and E-cadherin expression in central tumor and tumor budding was explored. The χ² test, continuous correction χ² test and Spearman rank correlation analysis were used for statistical analysis. Results In 77 cases of paraffin-embedded specimens of cervical squamous cell carcinoma, the high expression rates of P16^INK4a, E-cadherin and Bit1 in central tumor and tumor budding were 32.5% (25/77), 67.5% (52/77) and 63.6% (49/77), and 67.5% (52/77), 33.8% (26/77) and 37.7% (29/77), respectively, and the differences were significant (χ²=18.935, 17.561 and 10.391, all P<0.01). Both in central tumor and in tumor budding, there were no significant differences in Bit1 or E-cadherin expression between high and low P16^INK4a expression regions (all P>0.05). In central tumor, the low expression of Bit-1 was related to lymphovascular invasion and lymph node metastasis (χ²=5.053 and 4.400, both P<0.05). In tumor budding, the low expression levels of E-cadherin and Bit-1 were both associated with lymph node metastasis (χ²=5.580 and 7.573, both P<0.05). Spearman rank correlation analysis showed that there was positive correlation between E-cadherin and Bit1 expression in central tumor and tumor budding (r=0.287, P=0.011; r=0.236, P=0.039). Conclusion The increased invasiveness of cervical cancer may be related to the decreased expression of Bit1 and E-cadherin and the increased expression of P16^INK4a. Cervical cancer cells may acquire high invasiveness by inhibiting Bit1 to obtain anoikis resistance and affecting the EMT, but P16^INK4a is not involved in this process.

Abstract:Objective To explore the expression and effect of p75 neurotrophin receptor (p75NTR) in human neuroblastoma cell line (SH-SY5Y cells) under the condition of oxygen-glucose deprivation (OGD). Methods The OGD model of SH-SY5Y cells was established by glucose-free and serum-free culturing using tri-gas incubator, and then was assigned to 3 groups, including serum-free regular culturing group (control group), OGD group and OGD+LM11A-31 (a competitive blocker of p75NTR) group. After 12 h of culturing, the cell viability was measured by methyl thiazolyl tetrazolium (MTT) assay, lactate dehydrogenase (LDH) release activity was determined by LDH activity assay kit, cell apoptosis proportion was detected by flow cytometry, and p75NTR protein expression was detected by Western blotting. Results The OGD model of SH-SY5Y cells was successfully established. Twelve hours after cell culture, the cell viability of the control, OGD and OGD+LM11A-31 groups was (94.80±4.06)%, (50.34±5.55)% and (64.68±4.59)%, the LDH release activities were (46.93±5.49) U/L, (353.09±30.67) U/L and (282.20±25.60) U/L, the proportions of apoptosis cells were (1.82±0.45)%, (14.98±2.59)% and (7.36±1.98)%, and the relative expression levels of p75NTR were 0.06±0.01, 0.41±0.02 and 0.19±0.03, respectively, and the differences were all significant (F=67.94, 142.10, 36.28 and 221.20, all P<0.05). Post hoc analysis showed that the cell viability of the OGD group was significantly lower than that of the control group, and the LDH release activity, the proportion of apoptosis cells and the relative protein expression level of p75NTR of the OGD group were significantly higher (Bonferroni test, all P'<0.05). After treatment with LM11A-31, the cell viability of the OGD+LM11A-31 group was significantly higher than that of the OGD group, and the LDH release activity, the proportion of apoptosis cells and the relative protein expression level of p75NTR of the OGD+LM11A-31 group were significantly lower (Bonferroni test, all P'<0.05). Conclusion The expression of p75NTR is increased in human neuroblastoma cell line SH-SY5Y cells under OGD condition, which may promotes neuronal injury and apoptosis.

Abstract:Objective To investigate the expression of circular RNA circSP3 (hsa-circ-0002642) in hepatocellular carcinoma (HCC) and its effect on proliferation and migration of HCC cells. Methods The tumor tissue and the adjacent paratumor tissue samples were collected from 42 HCC patients who underwent surgery from Jun. 2017 to Dec. 2018 in Department of Hepatobiliary Surgery, the First Affiliated Hospital of Chongqing Medical University. The expression of circSP3 in the samples was detected by real-time quantitative PCR, and the relationship between circSP3 expression in the tumor tissues and clinicopathological parameters of the patients was analyzed. Human HCC cell lines (Hep-3B, Huh7, SMMC-7721 and Bel-7402) and human normal liver cell line (HL-7702) culturion, and the expression of circSP3 was detected. After circSP3 overexpression and interference plasmids transfection into Hep-3B and Huh7 cells, the cell proliferation was detected by cell counting kit-8 (CCK-8) method, the invasion and migration abilities were detected by Transwell assay, and expression levels of epithelial-mesenchymal transformation (EMT)-associated markers (vimentin and E-cadherin) were determined by Western blotting. Results The expression of circSP3 of tumor tissues was significantly higher than that of the paratumor tissues in the HCC patients (P<0.01), and the expression of circSP3 was positively correlated with the tumor maximum diameter and clinical TNM stage (both P<0.05). The expression levels of circSP3 in the 4 HCC cell lines were significantly higher than that in the normal liver cell lines (all P<0.01). Overexpression of circSP3 could significantly promote proliferation, invasion and migration of HCC cells (P<0.05, P<0.01), while interference circSP3 expression could significantly inhibit the proliferation, invasion and migration (P<0.05, P<0.01). The expression of vimentin was significantly higher in circSP3-overexpressed cells than that in control cells (P<0.05), while it was significantly lower in circSP3-interfered cells than that in control cells (P<0.05). The expression of E-cadherin was significantly lower in circSP3-overexpressed cells than that in control cells (P<0.01), while it was significantly higher in circSP3-interfered cells than that in control cells (P<0.01). Conclusion The abnormal expression of circSP3 is positively correlated with tumor size and TNM stage of HCC, and determining its expression is helpful to evaluate the severity and prognosis of HCC. CircSP3 can promote the proliferation of HCC cells, and may promote the migration and invasion by promoting the EMT process.

Abstract:Objective To explore the effect and mechanism of intraoperative remifentanil (RF) on renal ischemia/reperfusion (I/R) injury. Methods Fifty male C57/BL mice were randomly divided into 5 groups:sham group, I/R group, I/R+LY294002 (a phosphatidylinositol 3-kinase[PI3K] inhibitor) group, I/R+RF group and I/R+RF+LY294002 group, with 10 mice in each group. Venous blood or renal tissue samples were collected from the mice of each group 6 h after I/R operation. The levels of blood urea nitrogen (BUN) and serum creatinine (SCr) were detected using automatic biochemical analyzer. The expression levels of PI3K/protein kinase B (Akt)/endothelial nitric oxide synthase (eNOS) pathway-related proteins in renal tissues of mice were detected using Western blotting. The aggregation of inflammatory cells was observed by H-E staining. The expression levels of tumor necrosis factor α (TNF-α), interleukin (IL)-1β, IL-6 and IL-10 in renal tissues of mice were detected by enzyme-linked immunosorbent assay. The mRNA expression levels of anti-apoptotic factor Bcl2 and apoptotic factor Caspase-3 in renal tissues were determined by real-time quantitative PCR. Results Compared with the sham group, the BUN and SCr levels in venous blood were increased in the I/R group, the PI3K expression, phosphorylated-Akt (p-Akt)/Akt ratio and phosphorylated-eNOS (p-eNOS)/eNOS ratio in renal tissues were decreased, the release levels of inflammatory factors (TNF-α, IL-1β, IL-6 and IL-10) were increased, Bcl2 mRNA expression was decreased, and Caspase-3 mRNA expression was increased; and the differences were significant (all P<0.05). The mice of the I/R group had increased inflammatory cell recruitment in renal tissues. After RF treatment, the mice of the I/R+RF group had decreased levels of BUN and SCr in venous blood, increased PI3K expression, p-Akt/Akt ratio and p-eNOS/eNOS ratio in renal tissues, decreased release levels of inflammatory factors (TNF-α, IL-1β, IL-6 and IL-10), increased Bcl2 mRNA expression, and decreased Caspase-3 mRNA expression; and the differences were significant compared with the mice of the I/R group (all P<0.05). The inflammatory cell recruitment was decreased in the I/R+RF group. Moreover, compared with the mice of the I/R+RF group, the mice of the I/R+RF+LY294002 group had increased levels of BUN and SCr in venous blood, decreased p-eNOS/eNOS ratio in renal tissues, increased IL-1β and IL-6 release, and increased Caspase-3 mRNA expression; and the differences were significant (all P<0.05). The inflammatory cell recruitment was increased in the I/R+RF+LY294002 group. Conclusion RF exerts protective effect on kidney with I/R injury by alleviating renal inflammation and cell apoptosis through activating PI3K/Akt/eNOS pathway.

Abstract:Objective To explore the correlation between umbilical artery blood erythropoietin (EPO) level and perinatal factors in premature infants and its clinical significance. Methods Umbilical artery blood samples from 107 premature infants born in the Eastern Branch of Shanghai First Maternity and Infant Hospital of Tongji University between Jan. 2019 and Jun. 2019 were collected. The levels of EPO and ferritin were measured by ELISA and chemiluminescence assay, respectively. The 107 infants were divided into three groups according to the quartile EPO level:low level group, medium level group and high level group. The relationship between umbilical artery blood EPO level and gestational age, birth body mass and other perinatal factors, the incidence of anemia of prematurity (AOP), necrotizing enterocolitis (NEC), patent ductus arteriosus (PDA) and atrial septal defect (ASD) in premature infants, and the clinical characteristics of pregnant mothers was analyzed. Results The EPO level of umbilical artery blood in 107 newborn premature infants was 5.94-137.18 mU/mL, and the median level was 23.51 (14.60, 51.28) mU/mL. There were 26 cases in the low level group (the EPO level < 14.60 mU/mL), 54 in the medium level group (14.60-51.27 mU/mL), and 27 cases in the high level group (≥ 51.28 mU/mL). Univariate analysis showed that the gestational age of the infants in the low level group was significantly lower than those in the medium level group and the high level group (both P<0.05), the age of the pregnant mothers was significantly higher than those in the medium level group and the high level group (both P<0.05), the natural pregnancy rate was significantly lower than that in the high level group (P<0.05), and the continuous positive airway pressure (CPAP) usage rate of the infants was significantly higher than that in the medium level group (P<0.05). The ferritin level of umbilical artery blood was significantly higher in the midium level group than that in the high level group (P<0.05). The incidence of AOP in the high level group was significantly higher than that in the midium level group (P<0.05). Multiple linear regression analysis showed that the EPO level of umbilical artery blood was positively correlated with the gestational age of newborn premature infants and the natural pregnancy rate of pregnant mothers (both P<0.01). Multivariate logistic regression analysis showed that the higher the natural pregnancy rate, the higher the level of EPO in umbilical artery blood, and the higher the natural delivery rate, the lower the level of EPO in umbilical artery blood. The risks of PDA and NEC decreased and the risk of ASD increased with the increase of EPO level in umbilical artery blood (all P<0.05). Conclusion Conception method and delivery mode are the influencing factors of EPO level in umbilical artery blood. Monitoring the EPO level of umbilical artery blood is helpful to diagnose the common complications such as AOP, PDA, ASD and NEC in premature infants.

Abstract:Intervertebral disc degeneration is a series of degenerative diseases characterized by intervertebral disc dehydration, degradation of extracellular matrix, decrease of proteoglycan content, change of collagen type and rupture of outer layer of annulus fibrosis, and it is the main cause of movement function loss and poor quality of life. Due to the high incidence, high disability rate, high society and family economic burden and poor quality of patients' life, intervertebral disc degeneration is one of the urgent health problems to be solved globally. Macrophages, as the main phagocytes in the body, have established a close relationship with the body at the early stage of growth and development. Research has shown that macrophages are the only inflammatory cells infiltrating into the closed nucleus pulposus, and the count of macrophages is positively correlated with the severity of intervertebral disc degeneration. Moreover, evidences have suggested that macrophages, as inflammatory cells, may directly play a role in phagocytosis or synergistically regulate intervertebral disc metabolism through the neuro-immune mechanism, and macrophage dysfunction can cause the aggregation, chemotaxis and diffusion of inflammatory factors, leading to the degradation of extracellular matrix of intervertebral disc and intervertebral disc degeneration. This review summarizes the relevant mechanisms of macrophages involved in intervertebral disc degeneration in recent years, so as to understand the molecular mechanism of intervertebral disc degeneration and promote the reform and progress of clinical treatment mode.

Abstract:Over the past few decades, surgical treatment for spinal tumors has experienced many technological innovations, including surgical methods, implantations, biological agents, computer-assisted navigation equipment and so on. The real-time intraoperative imaging guidance and 3D imaging reconstruction provide theoretical and technical support for accurate location and resection of spinal tumors. The intraoperative navigation has been widely introduced into the surgical treatment of orthopaedic diseases, such as pedicle screw placement, pelvic fracture fixation, etc., and achieved satisfactory effectiveness. The application of navigation technology platform has greatly improved the minimally invasive treatment and precise resection of spinal tumors, and reduced the radiation exposure injury during operation. In this review, we sum up the effectiveness, safety and development prospects of navigation technology for spinal tumor treatment.

Abstract:Vascular injury is common in war and is mainly caused by explosion and other causes. It is the key cause for the increase of war casualties. The incidence of vascular injury is the highest in extremities, followed by neck, pelvis, chest and abdomen, and arterial injury is more than venous injury. The animal model of vascular injury is an animal model used in military medical research. It can simulate vascular trauma on the battlefield, and is essential to reduce the battlefield casualties caused by vascular injury. At present, there are two kinds of animal models of vascular injury used in clinical research, including traumatic vascular disease model and traumatic bleeding model. Rabbits, murine and pigs are the common experimental animals for the animal models of vascular injury. In this review, we sum up the recent research advances, future development and difficulties of animal models of vascular injury.

Abstract:Objective To investigate the relationship between sleep and suicidal ideation of officers and soldiers in a marine corps. Methods A total of 459 military personnels were investigated using a self-designed demographic questionnaire, Pittsburgh sleep quality index (PSQI) scale, self-rating depression scale (SDS), self-rating anxiety scale (SAS) and self-rating idea of suicide scale (SIOSS). Results A total of 459 questionnaires were sent out and 434 effective questionnaires were recovered, with an effective rate of 94.6%. The PSQI score of 434 military personnels was 5.85±3.37, and the SIOSS score was 7.05±3.98, the SDS score was 35.29±9.52, and the SAS score was 31.80±7.36. Suicidal ideation of the military personnels was positively correlated with sleep quality, difficulty in falling asleep, nocturnal wakefulness or early wakefulness and nightmare, while negatively correlated with sleep duration (all P<0.01). After controlling for general demographic factors (gender, age and education level), substance use conditions (smoking, drinking alcohol, drinking tea and drinking coffee), anxiety symptoms and depressive symptoms, the military personnels with poor sleep quality (β=0.289, P<0.01), difficulty in falling asleep (β=0.110, P=0.019) and higher education level (β=0.080, P=0.013) had stronger suicidal ideation. Conclusion Sleep quality and symptoms of difficulty in falling asleep are independent predictors of suicidal ideation in military personnels.

Abstract:Objective To explore the clinical characteristics, treatment and prognosis of eye injury of soldiers in Tibet, so as to propose suggestions for treatment improvement. Methods The clinical data of soldiers with eye injury admitted to 6 hospitals serving soldiers in Tibet from Jan. 1, 2011 to Dec. 31, 2017 were collected, including demographic information, cause of injury, time for medical treatment, and visual acuity at admission and at discharge. Then the mentioned data were compared with the data of soldiers with eye injury admitted to other military hospitals. Results In total, 112 cases (116 eyes) were involved, including 110 males and 2 females. Among them, 111 cases (114 eyes) had mechanical globe injury accounting for 99.11% (98.28%), 55 cases (49.11%) had training injury, 35 cases (31.25%) had injury in spare time, and 22 cases (19.64%) had injury at worksite. Thirty-nine cases (34.82%) arrived at the central hospital or general hospital for treatment after 3 days of injury. The 24-h visit rate (41.07%, 46/112) was significantly lower than those reported by General Hospital of Jinan Military Command of PLA (82.37%, 271/329) and overall troops of full training (89.73%, 131/146) (both P<0.01). The visual acuity of 70 eyes restored better visual sight at discharge versus at admission, accounting for 76.09% of the 92 eyes with sight recording. Totally 35.87% of eyes (33/92) had poor sight or single eye blindness. The incidence rates of poor sight (29.35%[27/92]) and single eye blindness (6.52%[6/92]) were significantly higher than the data reported by General Hospital of Jinan Military Command of PLA (8.03%[31/386] and 2.07%[8/386]) and overall troops of full training (6.16%[9/146] and 0.68%[1/146]) (all P<0.05). The incidence of single eye blindness was significantly lower and the incidence of poor sight was significantly higher than the data reported by 15 grade three military hospitals (15.28%[118/772] and 10.23%[79/772]) (both P<0.05). Conclusion Mechanical injury is the main cause of eye injury in soldiers in Tibet. Eye injury in training has the highest incidence, which may be related to hypoxia at high altitude. More injured eyes are of poor sight or single eye blindness. It is necessary to strengthen treatment capacity of eye injuries and evacuation capacity of military hospitals in Tibet.

Abstract:Objective To propose a multimodal epilepsy assessment system to guide the surgical treatment of patients with focal cortical dysplasia (FCD)-related epilepsy, and to explore its significance in improving the prognosis of patients with FCD-related epilepsy. Methods Twenty-two epilepsy patients with FCD confirmed by postoperative pathology, who underwent surgical treatment at Second Hospital of Lanzhou University from Oct. 2016 to Nov. 2018, were enrolled. All patients were evaluated by multimodal epilepsy assessment system during the perioperative period. The assessment techniques included onset symptom assessment, structural imaging, long-term scalp video electroencephalogram monitoring, positron emission tomography-computed tomography, image fusion analysis, and magnetic resonance imaging (MRI). Engel efficacy grading system was used to assess the prognosis. Engel Ⅰ grade was defined as good control for epilepsy and Engel Ⅱ to Ⅳ as poor control. Fisher exact test was used to explore the influences of gender, age, pathological type, MRI examination, lesion location, duration of disease, and electroencephalogram-clinical characteristic-anatomical localization consistency on the prognosis of patients. Results Twenty-two patients (13 males and 9 females) underwent surgical resection of the lesions, and were followed up for 4 to 28 months. There were 18 cases of Engel Ⅰ grade, 2 cases of Engel Ⅱ grade, 1 case of Engel Ⅲ grade, and 1 case of Engel Ⅳ grade, with the good control rate being 81.8% (18/22). Fisher exact test analysis showed that disease duration and electroencephalogram-clinical characteristic-anatomical localization consistency were independent factors of efficacy of FCD-related epilepsy (P=0.045 and 0.005). While age, lesion location, gender, pathological type and MRI findings had no significant effect on prognosis (all P>0.05). Conclusion The multimodal epilepsy assessment system can more accurately locate epileptogenic foci of patients with FCD-related epilepsy, providing a theoretical basis for epilepsy surgery. It is a comprehensive and accurate assessment method for epileptogenic foci.

Abstract:Objective To explore the expression and clinical significance of aldo-keto reductase 1-A1 (AKR1A1) in hilar cholangiocarcinoma tissues. Methods Immunohistochemical assay was used to detect the expression of AKR1A1 in 49 hilar cholangiocarcinoma and adjacent normal tissues (at least 2 cm from the edge of the tumor). The correlation between the AKR1A1 expression and clinical variables of hilar cholangiocarcinoma patients was analyzed by χ² test. Results The high-expression rate of AKR1A1 in cancer tissues was 59.2% (29/49), which was significantly higher than that in matched adjacent normal tissues (25.0%[3/12], P<0.05). We also noticed that the high-expression of AKR1A1 in hilar cholangiocarcinoma patients tissues was associated with tumor size (P=0.028) and lymph node metastasis (P=0.001). Survival analysis showed that the overall survival (median 15 months vs 39 months, P=0.012) and progression free survival (median 15 months vs 32 months, P=0.022) of AKR1A1-high-expression patients were significantly shorter compared with the low-expression patients. Multivariate analysis showed that the depth of invasion was associated with overall survival (odds ratio[OR] 0.174, 95% confidence interval[CI] 0.041-0.741, P=0.018) and progression free survival (OR 0.083, 95% CI 0.011-0.618, P=0.015). Conclusion AKR1A1 is involved in the progression and metastasis of hilar cholangiocarcinoma, suggesting that it might be a potential biomarker for predicting tumor recurrence and prognosis of patients with hilar cholangiocarcinoma.

Abstract:Objective To investigate the relationship between mobile phone addiction and sleep quality of military medical students, so as to provide evidence for improving their mental health. Methods A total of 237 cadets from freshman to senior majored in medicine were tested by the Pittsburgh sleep quality index (PSQI) scale and mobile phone addiction tendency scale (MPATS). Results Eventually, 227 valid questionnaires were collected, with the effective response rate being 95.8%. The mean score of PSQI was 5.78±2.26, and the mean score of MPATS was 38.65±11.32. Females had a worse sleep quality than male military medical students (6.12±2.11 vs 5.49±2.35, P<0.05). Junior cadets had the highest MPATS score (42.51±10.81). The score of PSQI was positively correlated with the score of MPATS among military medical students (r=0.280, P<0.01). Regression analysis showed that mobile phone addiction had significant impact on sleep quality of military medical students (P<0.01). Conclusion Mobile phone overuse has a negative impact on sleep quality among military medical students, especially in females. It is necessary to strengthen the management mobile phone use among junior cadets.

Abstract:Objective To compare the postoperative cognitive function of patients undergoing general anesthesia using three strategies:sevoflurane alone, sevoflurane plus propofol, and sevoflurane plus dexmedetomidine. Methods Ninety patients aged 18 to 65 years who were scheduled to undergo laparoscopic hysteromyomectomy were selected for this study. The American Society of Anesthesiologists (ASA) was classified as Grade Ⅰ or Grade Ⅱ. Ninety patients were divided into three groups by random number table:sevoflurane group, sevoflurane-propofol group and sevoflurane-dexmedetomidine group, with 30 patients in each group. The induction drugs of anesthesia were the same in the three groups. Sevoflurane group was maintained with 1-1.2 minimum alveolar concentration (MAC) sevoflurane; sevoflurane-propofol group was maintained with 0.5 MAC sevoflurane and target controlled infusion propofol (target blood concentration was 2-3 μg/mL); and sevoflurane-dexmedetomidine group was maintained with 0.5 MAC sevoflurane, intravenous pump loading dose of dexmedetomidine was 1 μg/kg (pump infusion for 10 min), and dexmedetomidine was continuously pumped at a dose of 0.2 μg/(kg·h) until 30 min before the end of the operation. Cognitive function was measured 1 d before operation and 7 d after operation, and plasma levels of inflammatory factors were measured before operation and 24 h after operation. Results There were no significant differences in age, body mass index, preoperative score of mini-mental state examination scale, operation time or blood loss among the three groups (all P>0.05). The Hopkins visual learning test (HVLT1) and forward digit span test (FSDT) scores 7 d after operation (23.22±4.75, 2.39±0.69) were significantly higher in the sevoflurane-dexmedetomidine group than those in the sevoflurane group (21.00±4.96, 2.17±0.39), but lower than those in the sevoflurane-propofol group (24.89±6.20, 2.84±0.96), and the differences were statistically significant (all P<0.05). The plasma interleukin 6 (IL-6) level ([19.93±10.04] pg/mL) in the sevoflurane-dexmedetomidine group was significantly lower than those in the sevoflurane group ([36.06±17.03] pg/mL, P<0.05) and sevoflurane-propofol group ([39.99±19.39] pg/mL, P<0.05). Conclusion Compared with sevoflurane alone and sevoflurane plus propofol, patients with sevoflurane plus dexmedetomidine for general anesthesia have better postoperative cognitive function, which may be related to the low level of IL-6 after surgery.

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