Objective To investigate cerebral functional remodeling of the rat with severe acute carbon monoxide poisoning transplanted with neural stem-like cells derived from bone marrow mesenchymal stem cells (MS-NSCs) . Method Forty Sprague-Dawley rats weighing 200 ～ 250 g were divided randomly into 4 groups: the normal control group, the poisoning control group, the bone marrow mesenchymal stem cells(BMSCs) transplantation group and the MS-NSCs transplantation group. BMSCs were harvested from whole bone marrow in vitro, then were differentiated into MS-NSCs under certain growth factors cocktail,and were followed by BrdU labelling.Twenty-four hours after poisoning, the seed cells were infused into brain via left internal carotid and the functional remodeling of cerebrum was assessed by neurological severity score(NSS) and Morris water maze(MWM) tests. Results There was no significant differences in NSS test between groups after transplantation. However, the differences in MWM test were very significant between 5 weeks after transplantation ( P < 0.01). Conclusions Transplantation of MS-NSCs may improved cerebral function of rats after severe acute CO poisoning. Moreover, the cultured and idfferentiated MS-NSCs induced in vitro preliminarily is potentially more efficient than directly transplanted BMSCs without culture and differentiation.

Objective To compare the clinical efficacy of postoperative analgesia between intercostal nerve freezing and con‐trolled intravenous analgesia in patients of thoracic surgery .Methods 80 patients of thoracic surgery from January 2012 to June 2013 were randomly divided into two groups :Intercostal nerve cryotherapy group (frozen group n=40) and intravenous analgesia group(control group n=40) .Frozen group :the intercostal incision and down each one intercostal and chest tube placement of inter‐costal nerve roots were frozen before sternal closure ;control group :intravenous analgesia pump were used postoperative .According to VAS method to evaluate pain level and observe adverse reactions ,complications and analgesic drug usage of postoperative pa‐tients .Results The analgesic effect of frozen group was better than that of control group within five days after thoracotomy .Com‐pared with the control group ,the incidence of adverse reactions ,postoperative complications ,and analgesic drug usage was signifi‐cantly reduced in frozen group ,there was a significant difference between the two groups (P<0 .05) .Postoperative follow‐up dis‐play :intercostal nerve area in some patients may appear numbness ,dysesthesia ,etc .,but the above situation can return to normal gradually .Conclusion The analgesic effect of intercostal nerve cryotherapy for thoracotomy patients is excellent ,and with few side effects and good safety ,and it is worthy of promotion .

OBJECTIVE To investigate the effect and mechanisms of chrysophanol on the expression of c-fos and c-jun mRNA induced by ammonia chloride(NH4Cl) in mouse astrocytes. METHODS Primary mouse astrocytes were cultured with NH4Cl 5 mmol·L-1+chrysophanol 0.1,1.0 or 10.0 mg·L-1 ,or NH4Cl 5 mmol · L- 1+extracellular regulated kinase1/2(ERK1/2) inhibitor UO126 10 mmol · L- 1 and NH4Cl 5 mmol · L-1+p38 mitogen-activated protein kinase(p38 MAPK)inhibitor SB239063 10 mmol · L-1 for 48 h. The levels of glutathione peroxidase(GSH-Px),superoxide dismutase(SOD),malondaldehyde(MDA), nitric oxide(NO)and nitric oxide synthase(NOS)were detected by UV spectrophotometry. The phos?phorylation levels of ERK1/2 and p38 MAPK were detected by Western blotting. The expression of c-fos and c-jun mRNA was detected by RT-PCR. RESULTS Compared with NH4Cl 5 mmol · L- 1 group, ammonia-induced astrocytes oxidative stress was improved by chrysophanol (1.0 and 10.0 mg · L-1). The content of MDA and NO and the activity of NOS were reduced(P<0.05). The activity GSH-Px and SOD was increased(P<0.05). The phosphorylation level of ERK1/2 and p38 MAPK induced by ammonia was reduced in chrysophanol groups (P<0.05). Ammonia-induced c-fos and c-jun mRNA expression downregulation was reversed by chrysophanol (0.1,1.0 and 10.0 mg · L-1)and UO126 and SB239063(P<0.05). CONCLUSION Chrysophanol may improve the downregulated expresion of c-fos and c-jun mRNA in mouse astrocytes exposed to NH4Cl by anti-oxidative stress by inhibiting the ERK1/2 and p38 MAPK phosphorylation.

OBJECTIVETo explore the safety and feasibility of extensive mediastinal lymphadenectomy during thoracoscopic esophagectomy in the treatment of esophageal carcinoma.

METHODSClinical data of 125 patients with esophageal carcinoma undergoing thoracoscopic and laparoscopic esophagectomy(TLE) in West China Hospital of Sichuan University between May 2009 and December 2011 were retrospectively analyzed. Patients were divided into 2 groups: non-extensive mediastinal lymphadenectomy group(non-extensive group, n=53) and extensive mediastinal lymphadenectomy group(extensive group, n=72). Perioperative outcomes of these two groups were compared.

RESULTSNo significant differences were found in the time of thoracic operation, length of intensive care unit stay and postoperative hospital stay, postoperative complication and the overall mortality between the two groups. Compared with non-extensive group, extensive group showed less blood loss during thoracic operation [(140.6±62.1) ml vs. (167.7±69.2) ml, P=0.023], more thoracic lymph nodes harvested (12.2±4.2 vs. 9.0±4.1, P<0.01). Seventeen patients (23.6%) in extensive group were found to have positive recurrent laryngeal nerve lymph nodes, which resulted in upstaging of TNM in 7 patients(9.7%). The incidence of recurrent laryngeal nerve palsy was higher in extensive group as compared to non-extensive group, but the difference was not statistically significant (6.9% vs. 1.9%, P=0.240).

CONCLUSIONExtensive mediastinal lymphadenectomy during thoracoscopic esophagectomy is a feasible and safe procedure for esophageal carcinoma patients, which can increase the number of harvested lymph node and the accuracy of tumor staging.

Carcinoma ; pathology ; surgery ; China ; Esophageal Neoplasms ; pathology ; surgery ; Esophagectomy ; methods ; Humans ; Laparoscopy ; Length of Stay ; Lymph Node Excision ; methods ; Lymph Nodes ; pathology ; Neoplasm Staging ; Postoperative Complications ; Retrospective Studies

OBJECTIVETo investigate the clinical efficacy and learning curve of thoracoscopic and laparoscopic esophagectomy(TLE) in the treatment of esophageal carcinoma.

METHODSClinical data of 350 consecutive patients with esophageal carcinoma undergoing TLE in the West China Hospital between February 2008 and October 2013 were retrospectively analyzed. Patients in the early stage(n=150) were chronologically and evenly divided into three groups, and perioperative outcomes were compared between the three groups in order to evaluate the learning curve.

RESULTSThere were no intraoperative deaths. Intraoperative complications occurred in 29(8.3%) patients. Thirteen(3.7%) cases were converted to open operation including 9 thoracotomy and 4 laparotomy. The mean operative time was 332.5(range 230-780) min and the mean blood loss was 160.8(range 15-4000) ml. The tumor free resection margins (R0) were completely in 333(95.1%) cases. The mean lymph nodes harvested was 21.6(range 6-42). The average length of postoperative hospital stay was 11.6(range 7-93) d. Postoperative complications occurred in 75(21.4%) patients, and 3(0.8%) patients died within 30 days after surgery. Compared with TLE 1 group, TLE 2 group presented shorter operative time, less blood loss, shorter postoperative hospital stay, lower postoperative complication rate, and more lymph nodes harvested(all P<0.05). Only blood loss was less in TLE 3 group as compared to TLE 2 group, and other perioperative results were found to be of no statistical differences between the two groups. There was no significant difference in 30-day mortality between the three groups.

CONCLUSIONSTLE is a technically feasible and safe procedure and provides comparable oncological outcomes with open esophagectomy, thus suggesting that TLE is an alternative approach in the treatment of esophageal carcinoma. A plateau of TLE skill can be reached after 50 surgical procedures.

China ; Esophageal Neoplasms ; Esophagectomy ; Humans ; Laparoscopy ; Length of Stay ; Lymph Node Excision ; Lymph Nodes ; Operative Time ; Postoperative Complications ; Retrospective Studies

Objective To explore the aortic remodeling after thoracic endovascular aortic repair for acute type stanford B aortic dissection. Methods Retrospective analysis the clinical data of 51 patients who diagnosed with acute type B aortic dis-section and received TEVAR between September 2015 and August 2016. The maximal diameters of false and true lumen were measured directly at the level of primary tear entry, the level of the bronchial bifurcation,and the level of the celiac trunk and the the lower edge of left renal artery,changes in diameter were evaluated between the preoperative and postoperative CT scan. Results The marked change in the true lumen dilatation and false lumen regression trend at the level of primary tear entry after thoracic endovascular repair(1 month vs 1 year, P<0. 05), while the changes of its diameter above level were not obvious af-ter thoracic endovascular repair(3 months vs 6 months, P>0. 05). the true lumen dilatation and false lumen regression trend at the level of the bronchial bifurcation along with time. The true lumen dilatation is a process of slow change at the level of the celiac trunk and the lower edge of left renal artery after TEVAR, and the false lumen changed not obviously. Conclusion En-dografting is effective for acute type B aortic dissection which can promote positive descending aortic remodeling changes,but it has no significant effect on abdominal aortic remodeling.

Objective: To investigate the effect of miR-23b/PTEN molecular axis on radio-sensitivity of lung cancerA549 cells and its mechanism. Methods: Lung cancer cell lines NCI-H1650, NCI-H175, Calu-1, LT-P-A-2, MSTO-211H, A549 and human normal lung epithelial cell line BEAS-2B were selected. The expression level of miR-23b in lung cancer cell lines was detected by qPCR. Dual-luciferase reporter gene assay was used to verify the relationship between miR-23b and PTEN. Plasmids miR-23b mimics, miR-23b inhibitor and pcDNA3.1-PTEN were transfected intoA549 cells by lipofection; PTEN expression levels in cells was detected by WB. CCK-8, Transwell andAnnexin V-FITC/PI staining flow cytometry were used to detect the effect of miR-23b/PTEN axis on proliferation, invasion and apoptosis ofA549 cells treated with 60Co γ-ray. Results: miR-23b was upregulated in lung cancer cell lines with the highest expression in A549 cells (P<0.05 or P<0.01). Knockdown of miR-23b reversed the inhibitory effect of 3 Gy 60Co γ-rays on proliferation and invasion of A549 cells, and induced apoptosis (P<0.05 or P<0.01). Dual-luciferase reporter gene assay results confirmed that miR23b could negatively regulate PTEN (P<0.05). Furthermore, knockdown of miR-23b up-regulated PTEN expression level, and furhter enhanced the inhibitory effect of 3 Gy 60Co γ-ray on the proliferation and invasion of A549 cells as well as induced apoptosis of A549 cells (P<0.05 or P<0.01). Conclusion: Knockdown of miR-23b can enhance the radio-sensitivity of A549 cells, the mechanism of which is that 60Co γ-ray down-regulates the inhibitory effect of miR-23b on PTEN, thereby inhibiting the proliferation, invasion and inducing apoptosis ofA549 cells.

Objective    To evaluate the clinical effects of segmentectomy versus lobectomy under single utility port video-assisted thoracic surgery on inflammatory factors and immune cells in peripheral blood of non-small cell lung cancer patients, and to analyze the effect of changes of postoperative inflammatory factors and immune cells on the prognosis of the patients. Methods    The clinical data of 256 patients who underwent segmentectomy or lobectomy under single utility port video-assisted thoracic surgery for non-small cell lung cancer in the First Affiliated Hospital of Hebei North University from January 2016 to October 2020 were retrospectively collected. According to the operation method, they were divided into a segmentectomy group (126 patients with 79 males and 47 females at an age of 63.4±6.2 years) and a lobectomy group (130 patients with 91 males and 39 females at an age of 62.9±5.6 years). The change of inflammatory factors (C reactive protein, interleukin-6, interleukin-8, tumor necrosis factor-α) and immune cells (CD4+T cells, CD8+T cells and natural killer cells) were recorded and analyzed before operation (T0) and 1 day (T1), 3 days (T2), 7 days (T3), 1 month (T4) after the operation between the two groups. According to postoperative recurrence situations, they were divided into a recurrence group and a non-recurrence group, multivariate logistic regression analysis was used to analyze the relationship between the change of postoperative inflammatory factors, immune cells, and the prognosis of patients with non-small cell lung cancer. Results    (1) There was no statistical difference in sex ratio, underlying diseases, body mass index, levels of preoperative inflammatory factors or immune cells between the two groups (all P>0.05). (2) The changes of postoperative inflammatory factors in the segmentectomy group were significantly less than those in the lobectomy group at T1-T3 (all P<0.05), and the changes of postoperative immune cells in the segmentectomy group were significantly less than those in the lobectomy group at T1-T4 (all P<0.05). (3) The changes of postoperative inflammatory factors and immune cells on postoperative day 3 in the recurrence group were significantly more than those in the non-recurrence group (all P<0.05). (4) Multivariate logistic regression analysis showed that the changes of postoperative inflammatory factors and immune cells on postoperative day 3 may be the risk factors for postoperative recurrence and metastasis in patients with non-small cell lung cancer (all P<0.05). Conclusion    Single utility port video-assisted thoracic surgery segmentectomy for the treatment of non-small cell lung cancer can reduce the inflammatory response and protect body's immune function, and the change of postoperative inflammatory factors and immune cells in postoperative day 3 may be the risk factors for postoperative recurrence and metastasis in patients with non-small cell lung cancer.