Objective To observe the displacement of endotracheal tube during laparoscopic surgery,explore whether pneumoperitoneum and body position are associate with the displacement. Methods A total of 120 female patients were included in this study,60 cases underwent gynecological lapa-roseopic operation as group A,and 60 cases had laparoscopic cholecystectomy as group B.Intrabdominal pressure was maintained in 13 mm Hg during the operation.The length of trachea(Lac),the length from carina to the tip of an endotracheal tube(Lab),the length from glottis to the tip of an endotracheal tube (Lbc)and the cuff pressure (Pc)were measured after endotracheal intubation (T1 ),insufflation in the su-pine position (T2 ),insufflation in the Trendelenburg or reverse Trendelenburg position (T3 ),30 minutes after insufflation in the Trendelenburg or reverse Trendelenburg position (T4 ),deflation in the Trendelen-burg or reverse Trendelenburg position (T5 ),deflation in the supine position (T6 ).Results In both groups,Lac and Lab at T2-T4 were significantly shorter than those at T1 (P<0.05),but they were back to the original level at T5 ,T6 .Pc were higher at T2-T4 (P<0.05).Lac,Lab and Lbc didn’t show significant difference between the two groups at T1-T6 .At T2 and T3 ,in group B endotracheal tube distorting occurred in 2 patients and tube into right bronchus occurred in 3 patients,while tube into right bronchus occurred in 3 patients in group A.Conclusion Pneumoperitoneum can cause endotracheal tube displacement to-ward to carina.Body position unlikely to change endotracheal tube position.The displacement was blocking by cuff could cause distorting of the tube.

Objective To investigate the effect of hypoxia-inducible factor (HIF)-1α and vascular en-dothelial growth factor (VEGF) on the angioge-nesis of rheumatoid arthritis (RA). Methods The collagen-induced arthritis (CIA) model was set up in male Wistar rats. The pathological angiogenesis and expression of HIF-1α and VEGF in the synovia different time points were observed by H&E and immunohistochemistry staining. Results The expressions of HIF-1α and VEGF on CIA synovium were significantly elevated and their expression increased gradually with the prolonged disease course. Both synovial HIF-1α expression and VEGF expression were correlated significantly with the pathological angiogenesis score. Synovial lining and sublining HIF-1α expression were correlated significantly with VEGF expression respectively. Conclusion H1F-1α may play an important role in the pathogenesis of RA by upregulating the expression of VEGF and then promoting angiogenesis.

Obsessive-compulsive disorder (OCD) is a chronic,disabling,mental disorder,which has been linked to significant abnormalities in certain brain areas,including the orbital frontal cortex and the anterior cingulate cortex.Neuroimaging studies have also shown that brain areas related to the decision-making function include the orbital frontal cortex and the dorsal prefrontal lobes.Furthermore,the association between OCD and decision-making function has been consistently demonstrated from a neurobiological perspective.Clinically,impaired decision-making ability is commonly observed in OCD patients,and there is a correlation between OCD and abnormal decision function.Decision-making tasks are typically divided into two types,decision-making under risk and decision-making under ambiguity,with the former commonly evaluated using the Iowa Gambling Task (IGT) and the latter using the Game of Dice Task (GDT).In this article the neural mechanism and evaluation methods of decision making in OCD were reviewed.

Objective To identity the risk factors for supine hypotension syndrome (SHS) after spinal anesthesia in parturients.Methods A total of 204 parturients,scheduled for elective cesarean section,were divided into either control group or SHS group depending on whether or not SHS (systolic blood pressure [SBP] in the upper extremity decreased by ＞ 30 mmHg or decreased to ＜ 80 mmHg) developed after spinal anesthesia.The baseline patient characteristics such as age,body height and weight,gestational weeks and biparietal diameter were recorded.Supine stress test (SST) was performed.Heart rate,blood pressure in upper and lower extremities,perfusion index,pleth variability index and intravesical pressure were recorded when patients were in supine position and in left lateral position before spinal anesthesia.The risk factors of which P values were less than 0.05 would enter the multi-factor logistic regression analysis to stratify the risk factors for SHS.Results Among the 204 patients,99 cases developed SHS after spinal anesthesia,and the incidence was 48.5％.Logistic regression analysis showed that maternal body weight,biparietal diameter,the difference in SBP between upper and lower extremities in supine position,the difference in SBP in upper extremities caused by changing position and positive SST were risk factors for SHS after spinal anesthesia (P＜0.05 or 0.01).Conclusion Maternal body weight,biparietal diameter,the difference in SBP between the upper and lower extremities in supine position,the difference in SBP in upper extremities caused by changing position and positive SST are risk factors for SHS after spinal anesthesia in parturients.

Objectives To observe the effect of Luoyutong capsule on neurological function following focal cerebral ischemia-reperfusion in rats and to preliminarily study the protective mechanism of Luoyutong capsule for focal cerebral ischemia-reperfusion in rats. Methods A rat model of middle cerebral artery occlusion (MCAO)was induced by the modified Longa method. After 1. 5 h of ischemia,reperfusion started. Ten male SD rats were selected as sham operation group,and forty male SD rats were randomly divided into 4 groups:Model (MCAO),Luoyutong moderate-dose (LYTM),Luoyutong high-dose (LYTH),and citicoline sodium (CS)groups (n=10 in each group). At day 3 and 7 after modeling,the neurological function of the rats was evaluated by using 12 neurological score and forelimb placing test. Western blotting was used to detect the expression levels of brain derived neurotrophic factor (BDNF),basic fibroblast growth factor (b-FGF),and phosphor/protein kinase (p-AKT/AKT)on the ischemic side of the rats and in the ipsilateral brain tissue at day 3 after modeling,as well as the expression level of Caspase-12 at day 7 after modeling in the ipsilateral brain tissue,and a comparison was performed among the groups. Results (1 )Neurological score:At day 3 after modeling,there was no significant difference between the 12 neurological score and the forelimb placing test score (all P>0. 05);At day 7 after modeling, there were obvious improvement in the LYTM,LYTH,and CS groups compared with model group (all P<0.05). (2)The results of western blot showed that①compare with the sham operation group,the expression levels of BDNF and b-FGF were reduced obviously (all P<0.05);compare with the MCAO group,the expression levels of the LYTM,LYTH and CS groups could be up-regulated,particularly in the LYTH group (P<0. 01);② compare with the sham operation group,the expression level of p-AKT/AKT in MCAO group was decreased obviously (P<0. 05);compare with the MCAO group,the expression levels of p-AKT/AKT of the LYTM,LYTH,and CS groups were increased,particularly in the LYTH and CS groups (all P<0. 05);③ compared with the sham operation group,the expression of cleavage Caspase-12 was increased obviously in the MCAO group (P<0. 05). Compared with the MCAO group,the expression levels of proCaspase-12 and cleavage Caspase-12 had a decreasing trend in the LYTM and LYTH groups,but there were no significant differences (all P >0. 05);the expression levels of proCaspase-12 and cleavage Caspase-12 in the CS group were obviously lower than those of the MCAO group (P<0. 05). Conclusion Luoyutong capsule may play a protective effect for focal cerebral ischemia-reperfusion injury in rats by promoting neural survival and regeneration,and this protective effect may be associated with the inhibition of neuronal apoptosis.

Objective To evaluate the application of a self-designed handy body position scaffold in the fluoroscopy for lower limb surgery.Methods We reviewed the intraoperative X-ray films of 161 patients with lower limb fracture who had undergone intraoperative fluoroscopy using our self-made handy body position scaffold during surgery from October 2013 to May 2017.They were 105 males and 56 females,aged from 10 to 91 years (mean,39.7 years).There were 42 femoral fractures of middle or lower shaft,12 fractures of medial or lateral condyle or tibial plateau,96 tibiofibular fractures,7 ankle fractures and 4 foot fractures.The operation time,intraoperative fluoroscopy time,intraoperative bleeding,rate and time of fracture union,and complications were recorded.Results All the 161 patients completed intraoperative fluoroscopy and radiography uneventfully,indicating that the handy body position scaffold effectively maintained the body position of the affected ipsilateral lower limb.The body position scaffold was slightly deviated due to one overweight (121 kg) patient when the knee joint was flexed 90°,but the fluoroscopy and radiography was completed after adjustment of the C-arm roentgenographic machine.The operation time averaged 71.5 minutes (from 28 to 119 minutes),the X-ray exposure time 9.8 seconds (from 6 to 31 seconds),and the intraoperative bleeding 157.2 mL (from 80 to 500 mL).The 161 patients obtained follow-up for 5 to 22 months (average,14.1 months).The rate of primary union was 97.5％ (157/161).The time for fracture union averaged 8.8 weeks (from 4 to 17 weeks).Fracture nonunion occurred in one case,and delayed union in 3 cases.The final follow-ups revealed normal functional recovery of the affected knees and ankles,but no limb shortening,or no rotational,lateral or anteroposterior angulation deformity.Conclusion In the lower limb surgery,the intraoperative fluoroscopy can be completed better with the aid of our self-designed handy body position scaffold that prevents movement of the affected lower limb and lowers the risk of radiation exposure.

In mankind, the circulation system is a closed pressure-loaded system; the pressure in circulation flow field would change with the variation of natural or pathological geometry of the local bloodvessel, and the pressure shift induced by the variation of vascular geometry would lead to a series of physiological and pathological changes in the endothelial cells (ECs). This experiment is designed to elucidate the effects of different pressure shift on F-actin alignment and expression in cultured endothelial cells in vitro, and to investigate the relationship between the altered pressure shift and the expression intensity of Vascular adhesion molecule (VCAM) and Integrin alphaVbeta3. Non-activated cultured ECs and single shear stress loaded ECs as control group were set, the double-immuno-fluoro-cytochemistry, laser confocal scanning microscopy and image analysis system were used to observe the expression of VCAM, Integrin alphaVbeta3 and F-actin in endothelial cells which were exposed to levels of pressure shift in an improved parallel plate flow chamber. When exposed to different decreased pressure shift, the expression intensity of VCAM, Integrin alphaVbeta3 and F-actin showed regular changes. The decreased pressure shift resulted in changes in cell alignment and cytoskeleton F-actin, and also affected ECs adhesion function and transmembrane mechanotransduction function which were represented by VCAM and Integrin alphaVbeta3 respectively.
Actins ; genetics ; metabolism ; Cell Adhesion ; Cells, Cultured ; Endothelial Cells ; cytology ; metabolism ; Hemodynamics ; Humans ; Integrin alphaVbeta3 ; genetics ; metabolism ; Pressure ; Umbilical Veins ; cytology ; Vascular Cell Adhesion Molecule-1 ; genetics ; metabolism

A significant proportion of patients with chorea-acanthocytosis (ChAc) fail to respond to standard therapies. Recent evidence suggests that globus pallidus internus (GPi) deep brain stimulation (DBS) is a promising treatment option; however, reports are few and limited by sample sizes. We conducted a systematic literature review to evaluate the clinical outcome of GPi-DBS for ChAc. PubMed, Embase, and Cochrane Library databases were searched for relevant articles published before August 2021. The improvement of multiple motor and nonmotor symptoms was qualitatively presented. Improvements in the Unified Huntington’s Disease Rating Scale motor score (UHDRS-MS) were also analyzed during different follow-up periods. A multivariate linear regression analysis was conducted to identify potential predictors of clinical outcomes. Twenty articles, including 27 patients, were eligible. Ninety-six percent of patients with oromandibular dystonia reported significant improvement. GPi-DBS significantly improved the UHDRS-motor score at < 6 months (p < 0.001) and ≥ 6 months (p < 0.001). The UHDRS-motor score improvement rate was over 25% in 75% (15/20 cases) of patients at long-term follow-up (≥ 6 months). The multiple linear regression analysis showed that sex, age at onset, course of disease, and preoperative movement score had no linear relationship with motor improvement at long-term follow-up (p > 0.05). GPi-DBS is an effective and safe treatment in most patients with ChAc, but no reliable predictor of efficacy has been found. Oromandibular dystonia-dominant patients might be the best candidates for GPi-DBS.

Objective:To evaluate the short-term influence of bilateral subthalamic deep brain stimulation (STN-DBS) in anxiety symptoms and quality of life in patients with Parkinson's disease (PD).Methods:Thirty-nine PD patients underwent bilateral STN-DBS in our hospital from August 2017 to August 2018 were chosen in our study. Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) scales were performed in these patients before and one month after surgery, and at the last follow-up, respectively. Parkinson's Disease Questionnaire-8 (PDQ-8) was performed before surgery and at the last follow-up. Statistical methods were used to analyze the differences of the above scores at different time points, and correlations between each two improvement degrees of above scores. The participants were subsequently divided into four groups based on preoperative BAI scores: no anxiety group ( n=18), mild anxiety group ( n=10), moderate anxiety group ( n=8), and severe anxiety group ( n=3); the above scales were performed. Results:(1) The BAI scores of 39 patients one month after surgery and at the last follow-up (14 [8, 20] and 9 [3, 14]) were significantly lower than those before surgery (16 [9, 27]), and the BDI scores (8[6, 16]) and PDQ-8 scores (3 [2, 6]) at the last follow-up were significantly lower than those before surgery (15 [8, 21] and 9 [6, 13], P<0.05). (2) Correlation analysis revealed that the improvement degree of BAI scores was positively correlated with that of BDI scores ( r s=0.722, P=0.000), and negatively correlated with preoperative baseline scores of BDI and PDQ-8, respectively ( r s=-0.714, P=0.000; r s=-0.378, P=0.018). (3) The BAI scores in the mild and moderate anxiety groups at the last follow-up were significantly lower as compared with the preoperative baseline BAI scores ( P<0.05). The improvement degree of BAI scores in mild, moderate, and severe anxiety groups was significantly higher than that in the no anxiety group ( P<0.05). Conclusion:The bilateral STN-DBS has considerable benefit effect on anxiety symptoms and health-related quality of life in PD patients during short-term follow-up, suggesting an involvement of STN in the pathogenesis of anxiety in PD.