[Objective]To investigate the value of double plates in the anterior approach for the treatment of jumping multilevel CSM.[Method]From July 2003 to July 2004,21 cases of jumping multilevel CSM and 7 cases of CSM were operated with single level discectomy/anterior corpectomy and self-iliac bone graft and fixation by double plates.During the 6,9,12 month follow-up,bone fusion were assessed and neurological function、complications were recorded.[Result]All patients were followed up for 16~32 months(24 months on average).Based on JOA evaluation,the average improving rate was 88.5%.And 82.1% fusion was achieved at 6 months,the fusion rate reached 89.3% and 93% at 9 and 12 months accordingly.There were 6 cases with complications in the donor site of grafting.Indications of this approach:the compressing pathology was located anterior to the spinal cord.This included central,broad-based disc herniations and large bridging osteophytes at or adjacent to the level of the disc space.And it was especially indicated for patients with jumping multilevel CSM who did not have a lordotic spine.Complications:complications occurring with this approach could be related to injuries to the soft tissue during dissection or to the neurological elements.In addition,postoperative fusion or hardware failure could occur.[Conclusion]Single level discectomy/anterior corpectomy and self-iliac bone graft and fixation by double plates is an effective treatment to the jumping multilevel CSM.It allows restoration of the spinal canal and neural foramen to normal dimensions to decompress the spinal cord.To the cases of jumping multilevel CSM that have a kyphotic deformity,it allows anterior decompression and reconstruction of the spine to help restore a lordotic curvature.

Objective To investigate the expression changes of Ire1α and caspase-12 in rats with spinal cord ischemia-reperfusion injury.Methods Fifty-five adult SD rats(250-300 g)were randomly divided into control group(re=5)and operation group(n=50).The spinal cord ischemia-reperfusion models were established and the neuronal apoptosis was detected by terminal deoxynucleotidyl transferasemediated dUTP nick end labeling(TUNEL).The expressions of Ire1α and caspase-12 in spinal cord tissue were detected by immunohistochemistry,immunofluorescence and Western blot analysis at 1,4,8,16and 24 hours after ischemia-reperfusion.Results TUNEL staining showed that the number of apoptotic cells was gradually elevated with time.The expressions of Ire 1α and caspase-12 were increased at 1 hour after reperfusion,and peaked at 16 hours,but began to decline at 24 hours after reperfusion.The number of neurons with positive expressions of Irelaand caspase-12 was significantly higher than that of control group(P＜0.05).Conclusion Ire 1α and caspase-12 synergistically participate in the neuronal apoptosis induced by the endoplasmic reticulum stress.

Platypnea orthodeoxia syndrome is associated with dyspnea and arterial oxygen desaturation accentuated by an upright posture. It can be secondary to an intracardiac shunt. We report a case of platypnea-orthodeoxia syndrome (POS) in a 58-year old male patient who had a pre-existing patent foramen ovale (PFO) and substantial pulmonary pathologies. He was successfully treated by percutaneous transcatheter closure of the PFO. Our case highlights the importance of recognition of this rare syndrome in patients who present with unexplained hy-poxia for whom transcatheter closure of the interatrial shunt can be safely carried out.

To construct the lentiviral vector containing Peroxiredoxin 2(Prdx2) gene and the colorectal cancer cell line stably transduced with Prdx 2-containing vector , so as to provide a useful tool for studying the role of Prdx 2 in colorectal cancer.Methods: Prdx2 was amplified by PCR and inserted into lentiviral expression vector Ubi-MCS-EGFP-IRES-Puromycin (GV218) to generate Ubi-Prdx2-EGFP-Puromycin(LV-Prdx2) vector.The inserted Prdx2 gene was verified by double enzyme digestion and DNA sequencing.Subsequently ,lentiviruses were produced and transduced into SW 480 cells.EGFP expression was examined under fluorescence microscopy ,the expression of Prdx2 was detected with qRT-PCR and Western blot.Cell growth and colony forming ability were detected with MTT and plate cloning technique.Results: The lentiviral Prdx2 expression vector was successful construc-ted.Overexpression of Prdx2 was verified in SW480 cells with LV-Prdx2 vector.Prdx2 promoted SW480 cell growth and colony forming ability(P<0.05).Conclusion:Ubi-Prdx2-EGFP-Puromycin(LV-Prdx2) vector is successfully constructed,and the SW480/LV-Prdx2 cell line with stable transduction of Prdx2 containing vector is established.Overexpression Prdx2 can significantly promote the proliferation of colorectal cancer SW 480 cells.

Human intestinal absorption (HIA) is a crucial indicator for measuring the oral bioavailability of drugs.This study aims to use artificial intelligence methods to predict and evaluate the HIA of drugs in the early stages of drug discovery, thus accelerating the drug discovery process and reducing costs.This study used MOE''s 2D, 3D descriptors, and ECFP4 (extended connectivity fingerprints) to characterize the molecules and established eight models, including support vector machine (SVM), random forest (RF), and deep neural network (DNN).The results showed that the SVM model constructed using a combination of 2D, 3D descriptors and ECFP4 fingerprints was the optimal model according to comprehensive evaluation of various evaluation indicators.The area under the receiver operating characteristic curve (AUC), Matthews correlation coefficient, and Kappa coefficient of the optimal model were 0.94, 0.75, and 0.74, respectively.In conclusion, this study established a robust and generalizable machine learning model for predicting HIA properties, which can provide guidance for early molecular screening and the study of pharmacokinetic properties of drugs.

OBJECTIVETo compare the long-term survival of total laparoscopic radical distal gastrectomy (TLDG) with delta-shaped anastomosis and laparoscopic assisted radical distal gastrectomy (LADG) with tubular anastomosis.

METHODSThe study retrospectively analyzed the clinical and pathologic data of 160 distal gastric cancer patients who underwent laparoscopic radical distal gastrectomy with Billroth I anastomosis at the First Affiliated Hospital of Chongqing Medical University from December 2012 to March 2015. All the patients were definitively diagnosed as primary gastric carcinoma before operation, and no evidences of invasion to adjacent organs, distant metastasis or enlarged fused lymph nodes around important vessels were discovered by image tests. Eighty-six patients underwent TLDG with delta-shaped anastomosis (delta-shaped anastomosis group, DSG) and 74 patients underwent LADG with tubular anastomosis (tubular anastomosis group, TAG) in two surgery teams who had different experience of gastroduodenostomy. All the patients agreed the operation and signed informed consent. All patients followed until October 2015 when the final cumulative survival rate was counted. Survival was analyzed by Kaplan-Meier method.

RESULTSThe baseline data were comparable and operations were successfully completed. Postoperative follow-up time of DSG was 7-32 months, follow-up rate was 91%(78/86), and 11 of whom died of the gastric cancer. The cumulative survival rate by the end of the follow-up was 82.8%. Postoperative follow-up time of TAG was 7-33 months, follow-up rate was 95%(70/74), 7 of whom died of the gastric cancer. The cumulative survival rate by the end of the follow-up was 81.7%. The intergroup difference of cumulative survival rate was not significant(χ(2)=1.210, P=0.271). No stage I patient died of gastric cancer in both groups. The cumulative survival rate by the end of the follow-up of stage II was 87.2% vs. 93.3%(DAG vs. TAG, χ(2)=0.426, P=0.514) ,and in stage III was 65.3% vs. 37.6%(DAG vs. TAG, χ(2)=0.718, P=0.397), and the differences were not significant.

CONCLUSIONThe TLDG with delta-shaped anastomosis and LADG with tubular anastomosis have similar long-term survival for distal gastric cancer treatment.

Anastomosis, Surgical ; Carcinoma ; surgery ; Gastrectomy ; methods ; Gastroenterostomy ; Humans ; Laparoscopy ; Lymph Nodes ; pathology ; Postoperative Period ; Reconstructive Surgical Procedures ; Retrospective Studies ; Stomach Neoplasms ; surgery

Objective: To compare the efficacy and safety of Cardi-O-fix patent foramen ovale (PFO) occluder and Amplatzer PFO occluder for the treatment of patients with PFO. Methods: A total of 246 consecutive patients (105 males and 141 females) with PFO were prospectively enrolled from May 30, 2013 to March 30, 2015 in our hospital. PFO interventional closure was applied according to the anatomical structure of the disease and patients′ wishes.Cardi-O-fix PFO occluder was used in 180 cases (COF group), Amplatzer PFO occluder was used in the remaining 66 cases (Amp group). Post-procedure safety including recurrent stroke, transient ischemic attack, death, and complete closure rate, and efficacy including procedure related complications of different devices were compared during the 12 months follow-up. Results: (1) Rate of transient ischemic attack was similar between COF group and Amp group at 12 months after procedure(1.1%(2/180) vs. 1.5%(1/66), P=1.000). There was no recurrent stroke and death during the 12 months follow-up period.Complete closure rate was similar between COF group and Amp group at 12 months after the procedure(90.6%(163/180)vs. 86.4%(57/66), P=0.355). (2) Three cases(1.7%) of paroxysmal atrial fibrillation were observed in COF group during the 12 months follow-up period, 1 patient converted spontaneously to sinus rhythm and 2 patients received successful pharmacologic conversion and converted to sinus rhythm. One patient(1.5%)developed paroxysmal atrial fibrillation and was pharmacologically converted to sinus rhythm in the Amp group. There was no significant difference in rate of paroxysmal atrial fibrillation between the two groups(P=1.000). There was no complications such as occluder translocation, erosion, pericardial effusion and puncture site bleeding in the 2 groups during the 12 months follow-up. Conclusion Efficacy and safety are similar for PFO treatment with Cardi-O-fix PFO occluder or Amplatzer PFO occluder in this patient cohort.

The posterior iliac crescent fracture is a typical manifestation of injury to the posterior ring in the lateral extrusion type Ⅱ of the Young-Burgess classification for pelvic fractures. In recent years, scholars have put forward new ideas about injury mechanisms, imaging features, classification, pelvic stability and surgical procedures of this type of fractures. Minimally invasive reduction and internal fixation with percutaneous screws has been used more and more widely in the treatment of posterior iliac crescent fractures. This article reviews the clinical features, classification, treatment, problems and prospects of these fractures.

Objective To investigate the role of human umbilical cord mesenchymal stem cell-derived extracellular vesicle (hUC-MSC-EV) in the regeneration of fibrotic liver. Methods C57BL/6 mice were randomly divided into the 70% normal liver resection group (Oil+PHx group), 70% liver fibrosis resection group (CCl₄+PHx group) and 70% liver fibrosis resection+mesenchymal stem cell-derived extracellular vesicle (MSC-EV) treatment group (CCl₄+PHx+MSC-EV group), with 8 mice in each group. LX-2 cell lines were assigned into the phosphate buffer solution (PBS) group, transforming growth factor (TGF)-β group and TGF-β+MSC-EV group. The serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) in mice after partial liver resection were detected in each group. The expression levels of liver fibrosis and proliferation-related parameters were analyzed in each group. The messenger RNA (mRNA) expression levels of epidermal growth factor (EGF), fibroblast growth factor (FGF), vascular endothelial growth factor (VEGF) and hepatocyte growth factor (HGF) in LX-2 cells were detected in each group, and their effects on HGF expression in mouse liver were observed. Results Compared with the Oil+PHx group, the serum levels of AST, ALT and LDH were up-regulated, and the degree of fibrosis was more severe, the positive area of Sirius red and α-smooth muscle actin (α-SMA) staining was larger, and the expression level of α-SMA protein was up-regulated in the CCl₄+PHx group. Compared with the CCl₄+PHx group, the serum levels of AST, ALT and LDH were decreased, the degree of fibrosis was slighter, the positive area of Sirius red and α-SMA staining was decreased, and the expression level of α-SMA protein was down-regulated in the CCl₄+PHx+MSC-EV group, and the differences were statistically significant (all P < 0.05). Compared with the Oil+PHx group, the protein expression levels of Ki67 and proliferating cell nuclear antigen (PCNA) were lower in the CCl₄+PHx group. Compared with the CCl₄+PHx group, the protein expression levels of Ki67 and PCNA were increased in the CCl₄+PHx+MSC-EV group, and the differences were statistically significant (all P < 0.05). Compared with the PBS group, the expression level of CollagenⅠ mRNA in LX-2 cells was increased, the expression level of α-SMA protein was up-regulated and the expression level of HGF protein was decreased in the TGF-β group. Compared with the TGF-β group, the expression level of CollagenⅠ mRNA in LX-2 cells was decreased, the expression levels of HGF mRNA and protein were increased, and the expression level of α-SMA protein was decreased in the TGF-β+MSC-EV group, the differences were statistically significant (all P < 0.05). The expression level of HGF protein in the CCl₄+PHx group was lower than that in the Oil+PHx group, whereas the difference was not statistically significant (P > 0.05). The expression level of HGF protein in the CCl₄+PHx+MSC-EV group was higher than that in the CCl₄+PHx group, and the difference was statistically significant (P < 0.05). Conclusions The regenerative capacity of fibrotic liver is weaker than that of normal liver. hUC-MSC-EV may alleviate liver fibrosis and improve liver regeneration by promoting HGF secretion from actived hepatic stellate cells and effectively enhancing the regenerative capacity of fibrotic liver.

Objective:To compare the clinical value of CTA and CDU in perforator flap of peroneal artery.Methods:From February 2013 to October 2016, 47 patients who suffered with soft tissue defects and were hospitalised in the Department of Orthopaedics, the 920th Hospital of Joint Logistic Support Force of Chinese PLA were retrospectively reviewed and evaluated. All the defects were reconstructed by the perforator flap of peroneal artery. All patients received preoperative CTA and CDU scans before surgery. Appropriate perforator vessels were selected and the locating points in body surface and external diameters of the perforator vessels were recorded and compared with intraoperative findings. SPSS 22.0 statistical software was used for data analysis. P<0.05 was considered statistically significant. Results:The intraoperative coincidence rate of the proposed perforator vessels was 97.87% for CDU and 95.74% for CTA, with no significant difference between the 2 groups( P>0.05). It was found that the preoperative CTA and CDU measurements were consistent with the actual intraoperative measurements, and there was no significant difference between the 2 groups( P>0.05). For CTA combined with CDU, an intraoperative coincidence rate was 100% in the location of peroneal perforating vessels. All flaps were followed-up for 1 to 18(mean 13.5) months. All the flaps survived well with good texture and appearance without complication. Conclusion:CDU and CTA are reliable and useful in preoperative vascular evaluation of peroneal perforator flap, and both can be used in a complementary or combined manner.