Objective:To explore influence of percutaneous coronary intervention (PCI)on brain natriuretic peptide (BNP)level and ventricular remodeling in patients With acute ST elevation myocardial infarction (STEMI).Meth-ods:According to their therapeutic methods,a total of 151 patients diagnosed as STEMI Were divided into group A (n=52,received emergency PCI treatment),group B (n=49,received selective PCI treatment)and group C (n=50,received standard medication).BNP level and left ventricular remodeling Were compared among three groups before treatment and after treatment.Results:There Was no significant difference in BNP level among three groups before treatment (F=0.01,P>0.05),BNP level significantly decreased among three groups after treatment,com-pared With group B and C,there Was significant decrease in BNP level [(466.2±113.5)ng/L vs.(601.4±126.7) ng/L vs.(242.7±101.3)ng/L]in group A (P<0.01 all).There Were no significant difference in left ventricular end-diastolic volume (LVEDV),left ventricular end-systolic volume (LVESV),left ventricular ejection fraction (LVEF)and left ventricular fractional shortening (LVFS)among three groups before treatment (P>0.05 all);af-ter treatment,there Were significant increase in above ventricular indexes in three groups (P<0.05 all),compared With group C,there Were significant increase in LVFS [(22.6±6.9)% vs.(28.9±7.6)% vs.(27.5±7.3)%]in group A and B,compared With group B and C,there Was significant increase in LVEF [(53.1±6.5)% vs.(50.9± 5.7)% vs.(57.9±6.2)%]in group A (P<0.01 all).Conclusion:PCI could effectively improve ventricular re-modeling and decrease BNP level in STEMI patients,and emergency PCI shoWs more significant therapeutic effects than selective PCI.

Objective To investigate the efficacy of laparoscopic cholecystectomy(LC)for patients with acute cholecystitis.Methods From May 2003 to November 2007,238 patients with acute cholecystitis underwent LC in our hospital.Four trocars were used in the operation.During the procedure,intraperitoneal pressure was controlled at 11 to 13 mm Hg(10 mm Hg for elderly patients).Retrograde cholecystectomy was performed on the patients with difficult anatomy caused by edema of the cystic triangle.For cases with calculi incarcerated in the cystic duct,the LC was performed after the stones were removed into the cyst(cholangiography was performed to exclude bile duct calculi).Results Of the 238 cases,LC was completed successfully in 220 patients,the other 18 cases were converted into open surgery because of massive hemorrhage and difficult anatomy(12 cases)or bile duct calculi(6 cases).After the LC,two patients received a second surgery because of postoperative hemorrhage;six patients developed bile leakage(occurred at 2-4 days after the LC with 50-80 ml of drainage)and were cured by conservative therapy including fasting,intravenous nutrition and anti-biotic therapy.This series were followed up for 1 to 12 months(mean,6 months).No post-operative complications were noticed during the period.Conclusions LC is a safe and effective for patients with acute cholecystitis or acute episode of chronic cholecystitis.Controlling the operation opportunity properly and dissecting the Calot's triangle area carefully to expose the cystic duct are the key steps during the operation.Convertion to open surgery is necessary in some difficult situations.

To study the attachment, proliferation and differentiation of neural stem cells (NSCs) on surface modified PHBHHx films and to establish the theory of PHBHHx application in NSCs-based brain tissue engineering. PHBHHx film was fabricated by a solution-casting method, and the morphology of the film was observed under scanning electron microscopy(SEM). The films were treated by NaOH or lipase, then the surface hydrophilic property was characterized using water contact angle measurement. NSCs were isolated from the cerebral cortex of rat embryos on embryonic day 14.5, and cultured on surface treated PHBHHx films. The morphology of NSCs attached on the film was visualized under SEM, and the survival and differentiation of NSCs were observed through immunocytochemical staining. Compared with the untreated PHBHHx films, the water contact angle of NaOH or lipase treated PHBHHx films decreased dramatically, and the number of NSCs attached significantly increased. NSCs survived well on treated PHBHHx films and differentiated into neurons and glial cells. The amelioration of hydrophilic property of PHBHHx film improved its biocompatibility with NSCs. PHBHHx can serve as a novel CNS tissue engineering biomaterial applied for NSCs transplantation, brain repairing and regeneration.
3-Hydroxybutyric Acid ; chemistry ; Animals ; Caproates ; chemistry ; Cell Adhesion ; physiology ; Cell Differentiation ; drug effects ; Cell Proliferation ; Cells, Cultured ; Cerebral Cortex ; cytology ; Coated Materials, Biocompatible ; chemistry ; Embryonic Stem Cells ; cytology ; Female ; Neural Stem Cells ; cytology ; Rats ; Surface Properties ; Tissue Engineering

【Objective】 To introduce the repair application in medium-flow cerebrospinal fluid leakage during transsphenoidal pituitary tumor resection by using autologous material from the surgical site in situ， combined with dural suture and bone-mucosa embedding technique， and evaluate its effect. 【Methods】 We conducted a retrospective case analysis of medium-flow cerebrospinal fluid leakage during endoscopic transsphenoidal approach pituitary tumor resection in our hospital from September 2016 to March 2020. All the collected cases were divided into two groups. In situ material harvest group： dural suture + in situ bone-mucosa embedding， avoiding additional trauma to the thigh and nasal cavity， referred to as in situ group. Traditional multi-layer reconstruction group： fat + fascia lata + pedicled nasoseptal flap （PNSF）， referred to as traditional group. The important indexes related to repair were compared and analyzed between the two groups. 【Results】 The in situ group and the traditional group consisted of 108 and 63 cases， respectively. The baseline data of the two groups were comparable. For the incidence of postoperative cerebrospinal fluid leakage ［（1/108， 0.9%） vs. （1/63， 1.6%）， P>0.05］ and intracranial infection rate ［（2/108， 1.9%） vs. （2/63， 3.2%）， P>0.05］， no statistical difference was shown between the groups. While compared with that in the traditional group， the mean postoperative bed stay time ［（3.7±1.6） vs. （4.4±1.5） days， P<0.001］ and the mean postoperative hospital stay ［（5.8±1.8） vs. （6.5±1.7） days， P<0.001］ of the in situ group were significantly shorter. The in situ group had significantly lower incidences of postoperative olfactory disturbance ［（0/108， 0%） vs. （3/63， 4.8%）， P<0.05］ and nasal discomfort ［（3/108， 2.8%） vs. （7/63， 11.1%）， P<0.05］. Follow-up imaging and endoscopic examination showed that the reconstructed structure of the in situ group was stable， and there was no delayed cerebrospinal fluid leakage. 【Conclusion】 This technique showed a reliable effect in repairing medium-flow leaks during transsphenoidal pituitary tumor resection by restoring the anatomical structure while avoiding the additional trauma. It is beneficial to shortening bed stay and hospitalization time and improving the subjective experience of patients， thus having a great value in clinical application.

【Objective】 To evaluate the efficacy and weight of sellar floor repair techniques such as different dura suture, bone reconstruction, and pedicled nasoseptal flap (PNSF) on the skull base reconstruction of medium and high flow cerebrospinal fluid leakage during endonasal endoscopic pituitary adenoma surgery. 【Methods】 We collected the data of Grade 2-3 cerebrospinal fluid leakage (Kelly grade) during endonasal endoscopic pituitary adenoma resection in our hospital from January 2015 to April 2021. Multiple reconstruction techniques such as dura suture, bone reconstruction and PNSF, and related factors such as age, sex, body mass index (BMI), diabetes, tumor size and diameter of diaphragmatic defect were recorded and introduced to multivariate regression to analyze the effects of the above factors on the duration of postoperative cerebrospinal fluid rhinorrhea and bed rest time, with a special focus on the weight priority of dura suture, bone reconstruction, and PNSF. 【Results】 A total of 281 patients were included, with the average age of (47±12.6) years, males accounting for 52.6%. There were 93 cases of PNSF, 268 cases of bone reconstruction, 109 cases of dura anchor suture, 50 cases of patch suture, and 122 cases without suture. The results of multivariate analysis indicated that the application of PNSF, bone reconstruction, and dura suture significantly reduced postoperative rhinorrhea time [reduced by 18.524, 35.876, and 16.983/19.791 (anchor suture/patch suture) hours, respectively; all P<0.001] and bed time [reduced by 16.797, 58.233, and 18.063/21.604 (anchor suture/patch suture) hours, respectively; all P<0.001], and there was no significant difference between anchor suture and patch suture. The weight of the standardized coefficient in reducing postoperative rhinorrhea time was dura suture>PNSF>bone reconstruction [Standard β=0.211/0.207 (anchor suture/patch suture)>0.200>0.165]. The weight of reducing bed time was bone reconstruction >dura suture > PNSF [Standard β=0.239>0.206/0.210 (anchor suture/patch suture) >0.164]. After stabilizing the learning curve in 25-30 cases, the average time for bone reconstruction was (3.9±0.4) minutes. After stabilizing learning curve in 30-40 cases, the dura suture technique took an average of (3.7±0.3) minutes per stitch, (3.7±1.0) stitches per case, and (13.6±2.7) minutes of total time consumption per case. 【Conclusion】 Dural anchoring and patching suture can both effectively shorten the duration of cerebrospinal fluid rhinorrhea and bed rest time. Bone reconstruction significantly improves the stability of reconstruction, especially in prompting patients’ early disengagement of bed rest. Moreover, the learning curves of the above two methods are economical and reasonable, and their weight is close to or even exceeds that of PNSF. Therefore, they can be an effective supplement or even substitute for PNSF.

Somatostatin (SST) is an inhibitory polypeptide hormone that plays an important role in a variety of biological processes. Somatostatin receptor 2 (SSTR2) is the most widely expressed somatostatin receptor. However, the specific cell types expressing Sstr2 in the tissues have not been investigated. In this study, we detected the expression pattern of SSTR2 protein in mouse at different development stages, including the embryonic 15.5 days and the postnatal 1, 7, 15 days as well as 3 and 6 months, by multicolour immunofluorescence analyses. We found that Sstr2 was expressed in some specific cells types of several tissues, including the neuronal cells and astrocytes in the brain, the mesenchymal cells, the hematopoietic cells, the early hematopoietic stem cells, and the B cells in the bone marrow, the macrophages, the type Ⅱ alveolar epithelial cells, and the airway ciliated cells in the lung, the epithelial cells and the neuronal cells in the intestine, the hair follicle cells, the gastric epithelial cells, the hematopoietic stem cells and the nerve fibre in the spleen, and the tubular epithelial cells in the kidney. This study identified the specific cell types expressing Sstr2 in mouse at different developmental stages, providing new insights into the physiological function of SST and SSTR2 in several cell types.
Mice ; Animals ; Receptors, Somatostatin/metabolism* ; Hematopoietic Stem Cells/metabolism* ; Epithelial Cells