Objective To investigate the surgical exposure of the subtemporal approach and explore clinical indications using a minimal-access.Methods Ten adult cadaveric heads fixed with formalin were used in this study.The holes with 3.0 cm × 2.5 cm of zygomatic arch vertically were operated on each head with subtemporal approach.During the anatomical procedures,measured the maximal exposure lengths of tentorial margin,posterior cerebral artery,and anterior border of brain stem,vertical distances between highest structure in the field of view and posterior clinoid process,the shortest distances form the zygomatic arch 1/3 to tentorial edge,sulcus lateralis mesencephali and anterior clinoid process; After tentorium of cerebellum was cut,measured the straight distance form the internal carotid artery to the optic nerve and form the posterior communicating artery to the tentorial edge.Results Oculomotor,trochlear nerve,tentorial edge,superior cerebllar artery.,P1-P2 segment of posterior cerebral artery,ventrolateral surface of mesencephalon and pon higher than root of trigeminal nerve,anterior and posterior clinoid process,posterior communicating artery and anterior choroidal artery,and superior portion of pituitary stalk could be observed via subtemporal approach using a minimal-access.Conclusion 1.The subtemporal approach using a minimal-access can protect the superficial temporal artery and the facial nerve branches especially in the process of the flap formation.It does little damage to the temporallis,reduces the invalid exposure of brain tissue,farthest lowers the damage to the scalp,skull and adjacent tissue ; 2.The subtemporal approach using a minimal-access can obtain the exposure rang.It can see the upper pons,petroclival region,tentorial notch area,ventrolateral brain stem.

[ ABSTRACT] AIM:To investigate the role of chronic psychological stress on periodontitis and the effects of hy-perbaric oxygen ( HBO) on periodontitis with psychological stress in rats.METHODS:Male special pathogen-free Wistar rats (n=80) were randomly divided into 4 groups:(1)normal control group;(2)experimental periodontitis group:the pe-riodontitis model was induced by wrapping 3/0 silk ligature inoculated with Porphyromonas gingivalis around the left maxil-lary second molar of the rats; ( 3 ) psychological stress stimulation group; ( 4 ) periodontitis model with stress stimulation group.Psychological stress was removed at the 9th week after ligature, and 4 rats from each experimental group were ran-domly chosen for HBO treatment.The rats were sacrificed at the 2nd, 4th, 8th and 10th weeks after ligature.The levels of blood glucose, adrenocorticotropic hormone ( ACTH) , corticosterone and adrenaline were measured as the stress markers. The histological changes of periodontal tissues were observed under microscope with HE staining.RESULTS:The levels of blood glucose, ACTH, corticosterone and adrenaline in psychological stress stimulation group and periodontitis with stress group were significantly higher than those in control group and experimental periodontitis group at the 2nd and 4th weeks af-ter ligature (P<0.05).The levels of the stress markers were significantly lower than those in untreated groups in the 10th week after HBO (P<0.01).The sites of gingival attachment were normal in control group and psychological stress stimu-lation group.Periodontal pocket, and periodontal attachment loss ( AL) were observed in experimental periodontitis group. The tissue damage was much heavier in periodontitis model with stress stimulation group as the furcation of tooth was ex-posed and the tissue damage was observed on both sides of the adjacent teeth.No significant difference of AL between psy-chological stress stimulation group and normal control group during the experiment was observed.The AL in periodontal model with stress stimulating group was significantly higher than that in experimental periodontitis group at the 2nd, 4th and 8th weeks (P<0.01).The level of AL was attenuated at the 10th week after HBO (P<0.01).No difference of histologi-cal change in periodontal tissues was observed between control group and psychological stress stimulation group.Severer in-flammatory changes and alveolar bone destruction were observed in periodontitis with stress group than those in experimental periodontitis group.The levels of inflammation reduced at the 10th week after HBO.CONCLUSION:Stress stimulation is one of the inducing factors of periodontitis in rats, which aggravates periodontitis.HBO may represent a useful way in trea-ting psychological stress periodontitis.

Objective To test experimentally Fluoro-Jade B(FJB) stain method for detecting degeneration of neurons in the basal ganglia. Methods Kainic acid(KA)-lesion model by stereotaxical injection of KA into striatum of rats,MPTP-lesion model by injection of MPTP into intraperitoneal cavity of mice,as well as KA-lesion model of cultured striatal cells were firstly prepared.FJB stain dye was then used to visualize degeneration of neurons in above KA-or MPTP-lesion models. Results KA-or MPTP-induced degenerative neurons including cell bodies and processes could be clearly visualized by FJB stain dye.In the brain sections,FJB-positive stained degenerative neurons were numerously observed in the striatum of KA-lesion rats and the substantia nigra pars compacta of MPTP-treated mice,but not detected in the control animals.Moreover,degenerative neurons were also detected with FJB stain in cultured striatal neurons.Semi-quantitative analysis on percentage(?s) of FJB-positive neurons constituting total cultured striatal neurons in unit area showed that degenerative neurons of KA-lesion group (8.42?1.09)% was evidently more than that of controls (3.42?0.45)%,P

Objective:To summarize the epidemiology and clinical characteristics of cerebral alveolar echinococcosis (CAE) in the Tibetan region of Sichuan.Methods:A retrospective analysis of hospitalised cases of CAE from 6 medical units in the Garze Tibetan Autonomous Prefecture, Sichuan Province from January 2016 to June 2021 was conducted. The study focused on the characteristics, clinical presentation, and imaging features of the disease. Simple random sampling method was used to select equal number of cases of hepatic and cerebral blastomycosis to form the data sample, and the susceptibility factors of CAE were analyzed by Logistic regression.Results:Out of 119 CAE patients, 76 were male and 43 were female. Occupationally, 62 were farmers, 46 were herdsmen, 9 were monks, and 2 were students. The age was (43.9±13.9) years. The primary clinical manifestations were dizziness, headaches, and epilepsy. The incidence of CAE was most concentrated within 4 years after the diagnosis of hepatic alveolar echinococcosis (77/119, 64.7%). There were 86 cases (72.3%) with multiple intracranial echinococcosis lesions, with an average size of 2.0 cm×2.5 cm. The imaging features showed that the lesion was mainly concentrated in the anterior circulation blood supply area, surrounded by a wide edema band, which was significantly enhanced after enhanced scanning, and the lesion had multiple aggregated small vesicular structures as its unique imaging features. Among 98 follow-up cases, 62 could live independently (63.3%), with 18 deaths (18.4%), and an approximate five-year survival rate of 81.6%. The results of multiple regression analysis showed that susceptibility factors for CAE included female ( OR=2.742, 95% CI 1.039-7.236, P=0.042), consumption of raw meat/raw water ( OR=7.638, 95% CI 1.216-47.966, P=0.030), a history of hepatic encephalopathy ( OR=0.380, 95% CI 0.178-0.811, P=0.012), the presence of other parts of echinococcosis ( OR=2.968, 95% CI 1.113-7.910, P=0.030). Conclusions:CAE predominantly affects farmers and herdsmen, with a higher susceptibility among young and middle-aged individuals. Regular examination of patients with first diagnosis of hepatic alveolar echinococcosis without a combination of echinococcosis in other parts of the body can help to monitor and prevent the occurrence of CAE, improve the understanding of CAE in Tibetan areas of Sichuan, and strengthen the early diagnosis and prevention of CAE in all aspects.

Objective:To investigate the expression of long non-coding RNA HOXA transcript at the distal tip(HOTTIP)in oral squamous cell carcinoma(OSCC)and examine its effect on the biological function of OSCC cells.Methods:A total of 52 patients with OSCC who received surgical treatment in The First Affiliated Hospital of Zhengzhou University from January 2020 to June 2021 were collected.The expression levels of HOTTIP in OSCC and adjacent tissues,human OSCC cell lines HSC-4,SCC-9 and CAL-27,and human normal oral keratinocyte line HOK were detected by quantitative real-time polymerase chain reaction(RT-qPCR),and its correlation with clinicopathological data and overall survival(OS)of OSCC patients was analyzed.The effects of down-regulating HOTTIP or co-down-regulating HOTTIP and miR-637 on the proliferation,apoptosis,migration,invasion,and epithelial-mesenchymal transition(EMT)of CAL-27 cells were analyzed using Cell Counting Kit-8(CCK-8),flow cytometry,Transwell assays,and Western blot.The targeting relationship between HOTTIP and miR-637 was analyzed by dual luciferase reporter gene assays.Results:The expression level of HOTTIP in OSCC tissues was significantly increased com-pared with adjacent tissues(P<0.05)and was correlated with tumor size,TNM stage,degree of differentiation,lymph node metastasis,and OS(P<0.05).The expression of HOTTIP in HSC-4,SCC-9,and CAL-27 cells significantly increased compared with normal HOK cells(P<0.05).After down-regulation of HOTTIP expression,the proliferation,migration,invasion,and EMT abilities of CAL-27 cells were significantly weakened,whereas the apoptosis rate significantly increased(P<0.05).HOTTIP had a targeting relationship with miR-637;after down-regu-lating HOTTIP,the expression of miR-637 in CAL-27 cells significantly decreased(P<0.05).After the simultaneous downregulation of HOTTIP and miR-637,the proliferation,migration,invasion,and EMT abilities of CAL-27 cells were significantly enhanced,whereas the apoptosis rate significantly decreased(P<0.05).Conclusions:HOTTIP is highly expressed in OSCC tissues and cells and can target miR-637 to regulate the proliferation,apoptosis,migration,invasion,and EMT of OSCC cells.

Objective To investigate the effect of perineal nerve electroacupuncture combined with tolterodine in the treatment of female overactive bladder(OAB).Methods A total of 150 female OAB patients treated in Huzhou Hospital of Traditional Chinese Medicine,Zhejiang Chinese Medical University from April 2020 to May 2021 were selected and divided into control group and study group according to random number table method,with 75 cases in each group.The control group was treated with tolterodine,and the study group was treated with pudendal nerve electroacupuncture combined with tolterodine.Clinical symptoms,urinary symptoms,and urodynamic indicators[maximum cystometric capacity(MCC),maximum urethral closure pressure(Pura clos max),maximum detrusor pressure(Pdet max),and maximum urine flow rate(Qmax)],bladder function indicators(initial bladder sensation volume,bladder volume during strong micturition desire),nerve growth factor(NGF)mediated transient receptor potential(TRP)pathway indicators[NGF,NGF/urine creatinine(UCr),TRPV1,TRPV4]and clinical efficacy of two groups were compared.Results After treatment,the number of night urination and urgent urination in study group were significantly less than those in control group,and the average volume of urination was significantly more than that in control group(P＜0.05).The overactive bladder symptom scores and visual analogue scale scores of study group were significantly lower than those of control group(P＜0.05).The MCC and Pura·clos·max in study group were significantly higher than those in control group,while Pdet max and Qmax were significantly lower than those in control group(P＜0.05).The initial bladder sensation volume and bladder volume during strong micturition desire in study group were higher than those in control group(P＜0.05).NGF,NGF/UCr,positive expression rates of TRPV1 and TRPV4 in study group were lower than those in control group(P＜0.05).The total effective rate was significantly higher in study group than in control group,(x2=5.374,P=0.020).There was no significant difference in the incidence of total adverse reactions between two groups(x2=0.362,P=0.547).Conclusion Perineal nerve electroacupuncture combined with tolterodine can significantly improve bladder function and inhibit clinical symptoms in female OAB patients,possibly by inhibiting bladder sensitivity caused by NGF-mediated increase of TRP channel proteins TRPV1 and TRPV4.

As the robotic assisted single port surgery arousing attention, a novel single-arm single-port micro-traumatic laparoscopic robotic surgical system is proposed in this study. From the perspective of the mechanics, joints with high rigidity and high reliability were utilized to realize the remote center of motion (RCM). Besides, the cost of consumables was reduced by adding the support of the rigid endoscope. From the perspective of the algorithm, high-precision motion control method and feedback force protection mechanism were implemented. The effectiveness of the aforementioned characteristics were verified by five clinical experiments of cholecystectomy. The results showed that the system is able to reduce the amount of bleeding, accelerate the patient recovery, reduce the infection risk and shorten the learning period. The robotic surgical system had significant clinical application value.
Humans ; Robotic Surgical Procedures ; Reproducibility of Results ; Laparoscopy ; Motion

Autophagy is an intracellular degradation process that maintains cellular homeostasis. It is essential for protecting organisms from environmental stress. Autophagy can help the host to eliminate invading pathogens, including bacteria, viruses, fungi, and parasites. However, pathogens have evolved multiple strategies to interfere with autophagic signaling pathways or inhibit the fusion of autophagosomes with lysosomes to form autolysosomes. Moreover, host cell matrix degradation by different types of autophagy can be used for the proliferation and reproduction of pathogens. Thus, determining the roles and mechanisms of autophagy during pathogen infections will promote understanding of the mechanisms of pathogen‍‒‍host interactions and provide new strategies for the treatment of infectious diseases.
Autophagy ; Bacteria ; Host-Pathogen Interactions ; Lysosomes ; Signal Transduction