Objective To investigate the possible effects on radiosensitivity in human umbilical vein endothelial cells after transfection of pcDNA3.1+Ape1 plasmid. Methods The expressing vector pcDNA3.1+ Ape1, the control vector pcDNA3.1+or non-transfection cells was irradiated by 2, 4, 6, and 8 Gy photon beam at 48 h post-transfection. The value of initial and residual Oliver tail moment (OTM) under the alkaline single cell gelelectrophoresis assay and the colony forming test were utilized as the markers for the evaluaton of cells intrinsic radiosensitivity. The effect on radiosensitivity in human umbilical vein endothelial cells after transfection of the expressing vector pcDNA3.1+Ape1 was analyzed according to the radio-dose, compared to the empty vecor control and non-transfection cells. Results The initial and residual OTM value of endothelial cells transfected by 3 μg pcDNA3.1+Ape1 plasmid was lower significantly than ones of endothelial cells untransfected at 2 Gy irradiation (P<0.01), but was no significant difference at 8 Gy (P>0.05), and SF2 was higher remarkably in transfected cells than one in untransfected cells (P<0.05), but SF4, SF6 and SF8 were no significant differences (all of P>0.05). Conclusions The transfection of pcDNA3.1+Ape1 plasmid could enhance radioresistance of endothelial cells to the low-dose irradiation.

OBJECTIVE To investigate the ESBLs produced by clinical strains of Enterobacter cloacae.METHODS Production of ESBLs was identified with modification of the double-disk test(MDDT).Eight kinds of primers(CTXM,CTXM-1,CTX-M-2,CTX-M-9,SHV,TEM,VEB,and PER)were used for the PCR amplification.Gene clone and DNA sequencing were performed then.RESULTS The result of MDDT was positive,amplicons were gained by PCR amplification with CTXM-1.DNA sequencing of amplicons of this strain revealed ESBLs of CTX-M-3.CONCLUSIONS ESBLs are the important reason for E.cloacae resisting to the third-generation cephalosporins.

Objective To investigate the correlation between QRS amplitudes and left ventricular wall thickness in autopsy specimens of elderly men.Methods The data of autopsy cases in our hospital since 1990 were retrospectively analyzed.The cases with QRS duration≥0.12 s and the pacing electrocardiogram were excluded.QRS amplitudes of standard 12-lead electrocardiography in 3 months before death were measured and the correlation between QRS amplitudes and left ventricular wall thickness was analyzed in the elderly men.Results Correlations were found between the amplitudes of the R waves in leads V5 ,V6, Ⅰ ,aVL[(1.1±0.7) mV, (0.95±0.6) mV, (0.44±0.3)mV and(0.35±0.3)mV] and left ventricular wall thickness[(13.6±5.4)mm;r=0.22,0.14,0.22,0.23,all P<0.05], and between the combination of QRS amplitudes SV1 +RV5 or RV6(1.9±1.2) mV] and left ventrieular wall thickness [(13.8± 5.4) mm; r = 0.23, P < 0.05].The correlationbetween the combination of QRS amplitudes (SV1 + RV5 or RV6 ) and left ventricular wall thickness was the strongest in 60-79 years old cases (r=0.48, P<0.01) ,and was decreased in 80-89 years old cases (r= 0.23, P<0.05).There was no correlation between the combination of QRS amplitudes (SV1+RV5or RV6) and left ventricular wall thickness in 90-101 years old cases (r= 0.03, P> 0.05).Conclusions Electrocardiogram is a reliable method for diagnosis of left ventricular hypertrophy in elderly men aged < 90 years.

Objective To investigate the correlation between microvessel density (MVD) and expression of NET-1 protein in bladder carcinoma and its prognostic significance. Methods The expression NET-1 protein and MVD marked with CD_ 105 in 43 cases of bladder carcinoma and 10 normal bladder tissues were measured by means of immunohistochemistry SP.The association between them and the relation ship with WHO pathology classification,TNM stage and prognosis were studied. Results MVD were correlated with WHO pathology classification,TNM stage and prognosis (F_1=17.01,F_2=12.06,P

BACKGROUND: Isoflavone isolated from Trifolium pratense L. has been found to be able to effectively inhibit bone resorption, reduce bone turnover rate, improve osteocyte activity and bone mineral density by enhancing the effect of estrogen, which is helpful for the prevention and treatment of osteoporosis. OBJECTIVE: To investigate the effect of Trifolium pratense L. extracts on the bone resorption and differentiation of osteoclasts.METHODS: Rat bone marrow cells were extracted, isolated by lymphocyte separation and cultured for 5 hours; then, the non-adherent cells were selected followed by induced by 30 μg/L macrophage colony stimulating factor and 75 μg/L RANKL (control groups), or different concentrations of Trifolium pratense L. extracts (0.3, 0.6 and 1.2 g/L) to observe their effect on the osteoclast differentiation and bone resorption. The levels of osteoclast differentiation-associated proteins c-fos and NFATcl were determined by western blot assay. RESULTS AND CONCLUSION: Compared with the control group, different concentrations of Trifolium pratense L. extracts could suppress osteoclast differentiation and bone resorption to different degrees. Tartrate-resistant acid phosphatase staining showed that Trifolium pratense L. extracts could significantly reduce the number of osteoclasts. Western blot assay results suggest that Trifolium pratense L. extracts significantly inhibited the expression levels of c-fos and NFATcl. These results reveal that Trifolium pratense L. extracts can inhibit osteoclast differentiation and bone resorption.

Objective To retrospectively analyze the treatments of nonvalvular atrial fibrillation (nvAF) in elderly patients aged 80 years and over,and to investigate the influencing factors for occurrence of stroke and transient ischemic attack(TIA)and relationships between antithrombotic therapy and stroke or TIA.Methods 101 elderly patients with nvAF were enrolled and grouped according to the occurrence of stroke/TIA and antithrombotic-correlated bleeding.The influencing factors were retrospectively analyzed and antithrombotic schemes were compared.Results Incidence rate of stroke/TIA was 28.7％ (29/101).Among all patients,70 cases were treated with antiplatelet therapy,19 cases were treated with anticoagulation therapy,while 12 cases received no antithrombotic (antiplatelet or anticoagulation) therapy before stroke.Both the nvAF time course and the antithrombotic strategy were significantly different between post-AF stroke/TIA group and non-postAF stroke/TIA group(both P＜0.05).The difference was reflected in ratios of antiplatelet therapy/anticoagulation therapy.The proportion of anticoagulation therapy was higher in non stroke/TIA group(x2 =5.778,P =0.016).Different antiplatelet therapy scheme significantly affected occurrence of stroke/TIA(P＜0.05).There was no significant effect of antithrombotic schemes on hemorrhagic events(x2=0.708,P =0.702).Multiple logistic regression analysis showed that hypertension,coronary heart disease,cancer,diabetes and previous stroke history,as well as nvAF duration were the independent risk factors for post-AF stroke/TIA(OR=1.351,95 ％CI:1.129-1.617).Conclusions Currently,the proportion using anticoagulation therapy is low,and single antiplatelet therapy is the main regimen in the elderly patients with nvAF.For elderly patients with nvAF,anticoagulation therapy has a protective effect against the occurrence of post-nvAF stroke/TIA,meanwhile there is no significantly increased risk of bleeding,which makes anticoagulation therapy advisable in the elderly.The nvAF time course is one of the risk factors,which is worth experts' attention in risk evaluation of thrombus in elderly patients.

Objective To investigate the effectiveness and safety of drug-eluting stent implantation following rotational atherectomy (RA)for severe coronary arteries calcification in elderly patients. Methods A total of 21 patients receiving RA and drug-eluting stent implantation were enrolled in this study in our cardiology department from Sep.2014 to Sep.2017. Twenty-one patients with 27 severe calcified lesions were treated with the stent implantation following RA . The primary endpoints of the study were the immediate operation success rate and the rate of major adverse cardiac and cerebral events (MACCE)at 6 month after surgery ,including angina recurrence ,need for target vessel revascularization ,myocardial infarction ,stent thrombosis and cardiovascular death. Results 14 patients(66.7% ,14/21)received RA by using 1.5 mm burr ,and 7 patients(33.3% ,7/21)by using both 1.25 mm and 1.5 mm burrs. The average ratio of burr to artery diameter was (0.5 ± 0.1). A total of 29 stents were successfully implanted in all patients (100% ,21/21 patients).None of the patients experienced any acute coronary artery rupture or other severe complications during percutaneous coronary intervention (PCI ) after RA. Two cases (2/21 ,9.5% ) suffered from slow flow ,and the coronary blood flow was restored to TIMI grade Ⅲ after treatment. The coronary blood flow in the other 19 cases(19/21 ,90.4% )was TIMI grade Ⅲ after RA.Intravascular ultrasonography (IVUS) showed that the stents were well adhered without stent rupture and intimal tear in 12 cases(12/21 , 57.1% ) ,and postdilation was performed in 9 cases(9/21 ,42.9% ).All patients were followed up for at least 6 months ,and target vessel revascularization and death were not found. Conclusions A drug-eluting stent implantation following rotational atherectomy is effective and safe for treating severe coronary arteries calcification in elderly coronary heart disease patients. The IVUS-guided rotational atherectomy combined with drug-eluting stent implantation can reduce the risk of MACCE ,such as under-expansion stent ,stent thrombosis ,myocardial infarction ,cardiovascular death ,and improve clinical outcomes in elderly patients with severe coronary arteries calcification.

In recent years, subxiphoid uniportal video-assisted thoracoscopic surgery is one of the most important innovations in the field of mini-invasive thoracic surgery. Because it avoids the injury of intercostal nerve, previous studies have shown that it can significantly reduce the perioperative and long-term incision pain. The operation is technically more difficult, so the selection of patients is more strict compared with the traditional intercostal surgery. Some special surgical techniques are needed during the operation, and special lengthening instruments should be used. We hope that the experience described in this paper will be continuously supplemented and improved with the further development of this technique, and will produce greater reference value.

Background and objective As computed tomography (CT) screening for lung cancer becomes more common in China, so too does detection of pulmonary ground-glass nodules (GGNs). Although anumber of national or international guidelines about pulmonary GGNs have been published,most of these guidelines are produced by respiratory, oncology or radiology physicians, who might not fully understand the progress of modern minimal invasive thoracic surgery, and these current guidelines may overlook or underestimate the value of thoracic surgery in the management of pulmonary GGNs. In addition, the management for pre-invasive adenocarcinoma is still controversial. Based onthe available literature and experience from Shanghai Pulmonary Hospital, we composed this consensus about diagnosis and treatment of pulmonary GGNs. For lesions which are considered as adenocarcinoma in situ, chest thin layer CT scan follow-up is recommended and resection can only be adopt in some specific cases and excision should not exceed single segment resection. For lesions which are considered as minimal invasive adenocarcinoma, limited pulmonary resection or lobectomy is recommended. For lesions which are considered as early stage invasive adenocarcinoma, pulmonary resection is recommend and optimal surgical methods depend on whether ground glass component exist, location, volume and number of the lesions and physical status of patients. Principle of management of multiple pulmonary nodules is that primary lesions should be handled with priority, with secondary lesions taking into account.
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Adenocarcinoma ; diagnosis ; diagnostic imaging ; surgery ; Adenocarcinoma of Lung ; China ; Consensus ; Hospitals ; Humans ; Lung Neoplasms ; diagnosis ; diagnostic imaging ; surgery ; Physicians ; psychology ; Positron Emission Tomography Computed Tomography ; Practice Guidelines as Topic ; Retrospective Studies ; Solitary Pulmonary Nodule ; diagnosis ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed

Objective    To compare the clinical effects of segmentectomy and lobectomy for ≤2 cm lung adenocarcinoma with micropapillary and solid subtype negative by intraoperative frozen sections. Methods    The patients with adenocarcinoma who received segmentectomy or lobectomy in multicenter from June 2020 to March 2021 were included. They were divided into two groups according to a random number table, including a segmentectomy group (n=119, 44 males and 75 females with an average age of 56.6±8.9 years) and a lobectomy group (n=115, 43 males and 72 females with an average of 56.2±9.5 years). The clinical data of the patients were analyzed. Results    There was no significant difference in the baseline data between the two groups (P>0.05). No perioperative death was found. There was no statistical difference in the operation time (111.2±30.0 min vs. 107.3±34.3 min), blood loss (54.2±83.5 mL vs. 40.0±16.4 mL), drainage duration (2.8±0.6 d vs. 2.6±0.6 d), hospital stay time (3.9±2.3 d vs. 3.7±1.1 d) or pathology staging (P>0.05) between the two groups. The postoperative pulmonary function analysis revealed that the mean decreased values of forced vital capacity and forced expiratory volume in one second percent predicted in the segmentectomy group were significantly better than those in the lobectomy group (0.2±0.3 L vs. 0.4±0.3 L, P=0.005; 0.3%±8.1% vs. 2.9%±7.4%, P=0.041). Conclusion    Segmentectomy is effective in protecting lungs function, which is expected to improve life quality of patients.