Objective To investigate the clinical effects of remifentanil and propofol anesthesia in patients undergoing mammary plastic surgery. Methods Forty patients (ASA Ⅰ -Ⅱ ) were random-ized into two groups with 20 cases in each. Group R was administered remifentanil and propofol and Group F was administered fentanyl and propofol. The variation of blood pressure (BP) and heart rate (HR) during induction, endotracheal intubation and maintenance, the time of spontaneous breathing recovery, extubation, response to vebal commands, the incidence of intraoperative awareness and postoperative complications, such as vomiting and nausea, were observed. Results There were signif-icant difference in the changes of BP and HR during surgery between two groups (P<0.05). As to the tracheal extubation and the response to vebal commands, the time of group R was significantly shorter than that of group F (P<0.05). There was no significant difference in the incidence of post-operative complications, such as vomiting and nausea, between the two groups. Conclusions The he-modynamie variables are stable in the procedure of total intravenous anesthesia with remifentanil and propofol for mammary plastic surgery. The consciousness recovery is faster in remifentanil and propo-fol anesthesia. Attention should be paid on earlier postoperative analgesia setting for patients undergo-ing remifentanil and propofol anesthesia.

Objective To investigate the effect of Gardiner bacteria infection on preterm delivery and changes of endocrine hor-mone levels.Methods Application of Gardiner bacteria fluorescent marker detection kit in 120 cases of suspected Gardiner bacteria infection pregnant women with immunofluorescence assay,and the levels of serum follicle stimulating hormone (FSH),luteinizing hormone (LH),estradiol (E2),progesterone (P)were measured at the same time,90 cases of non maternal Gardiner bacteria infec-tion were enrolled as control.Results After the treatment,98 cases of pregnant women with Gardiner bacteria infection should ex-perienced premature delivery (24-37 week),accounted for 81.67%,compared with the normal pregnant women were statistically significant (P <0.05);and 22 cases of Gardiner bacteria infection pregnant women after treatment no premature birth,accounted for 18.33%,and to all pregnant women infected Gardiner bacteria and experiencing preterm delivery and the control group levels of endocrine hormone were determined,compared the results of FSH,LH,found no significant differences(P >0.05),E2 increased,P decreased,changed significantly (P <0.05 ).Conclusion The probability of premature delivery in women infected with Gardiner bacteria is significantly higher than that of normal pregnant women,at the same time the secretion of hormone changes,so dealing with pre pregnancy and early pregnancy should carry owt Gardiner bacteria examination.

Objective To evaluate the effect of the gastric signet ring cell cancer(SIG)on the T,N,M stages. Methods Three hundred and fifty-one patients undergoing D2 or greater gastrectomy for gastric cancer were ana lyzed retrospectively.The T,N,M stages of 59 patients with SIG and 161 patients with tubular adenocarcmonla (TUB)were compared using univariate and multivariate analysis.Results The chi-square test showed that there were not significant differences in T,N,M stages between TUB and SIG.Multivariate Logistic regression analysis indicated that SIG Was not a independent factor influencing the T,N.M stage.Conclusion Gastric cancer with SIG has not higher T,N,M stages than that with TUB.

Objective To study the clinicopathologic features of brain tumors in patients with medically intractable epilepsy. Methods The clinical, radiologic and pathologic features of brain tumors in thirty-six patients with intractable epilepsy encountered during the period from 2008 to 2014 in the Epilepsy Center of Haidian Hospital were retrospectively reviewed. Results There were 18 males and 18 females in thirty-six patients. The mean age of seizure onset and disease duration were (14.05 ± 1.67) years and (10.04 ± 1.19) years respectively. The histological types of brain tumors included ganglioglioma (12/36, WHO gradeⅠ,1/36, WHO gradeⅡ), dysembryeplastic neuroepithelial tumor (2/36, WHO gradeⅠ), pleomorphic xanthoastrocytoma (1/36, WHO gradeⅡ), angiocentric glioma (1/36, WHO gradeⅠ), astrocytoma (4/36, WHO gradeⅡ), oligoastrocytoma (1/36, WHO gradeⅡ, 2/36, WHO gradeⅠ-Ⅱ), oligodendroglioma (1/36, WHO gradeⅠ-Ⅱ,1/36, WHO grade Ⅱ), cavernous hemangioma (4/36) and Sturge-Weber syndrome (1/36). Most of these tumors were located in temporal lobe (25/36, 69.4%). Patients were followed up for 0.5-7 years after operation. One patient was lost for follow up. Seizure outcome after the epilepsy operation revealed that 28 patients (77.8%) had Engel gradeⅠ, 4 patients (11.1%) had Engel gradeⅡ,2 patients (5.6%) had Engel gradeⅢ,1 patient (2.8%) had Engel gradeⅣ. Conclusion Brain tumors in patients with medically intractable epilepsy are almost low grade tumors of the nervous system. Focal cortical dysplasia is existed in most brain tissues from the epilepsy operation. Low grade tumors of the nervous system have close relation with focal cortical dysplasia in patients with medically intractable epilepsy. It is possible that the classifications of pathology diagnosis has connection with prognosis.

Objective To investigate the effects of Yindan Xinnaotong Soft Capsule on oxidative stress and vascular endothe‐lial function in the patients with type 2 diabetes mellitus(T2DM ) .Methods A total of 86 patients with T2DM were randomly di‐vided into the routine glucose‐reducing group(routine group ,40 cases) and the Yindan Xinnaotong Soft Capsule group(Yindan Xin‐naotong group ,46 cases) .On the basis of diet control and exercise ,the routine group was given the glucose‐reducing therapy for blood glucose reaching the standard for 12 successive weeks ,while on the basis of blood glucose reaching the standard by the rou‐tine therapy ,the Yindan Xinnaotong group was added with Yindan Xinnaotong Soft Capsule ,1 .2 g per time ,3 times daily for 12 successive weeks .The changes of blood lipids ,MDA ,SOD ,NO and ET were determined before treatment and after 12‐week treat‐ment .The flow mediated endothelium‐dependent diastolic function (FMD) and non‐flow mediated endothelium‐dependent diastolic function (NMD) in brachial artery were simultaneously detected using ultrasonography .Results After 12 weeks of treatment ,the levels of TC ,TG ,LDL‐C ,MDA and ET in the two group were obviously decreased compared with before treatment ,the levels of HDL‐C ,SOD ,NO and FMD in both groups were increased (P<0 .05);moreover the above indexes after treatment in the Yindan Xinnaotong group had significant changes compared with the routine group (P<0 .05) .Conclusion Yindan Xinnaotong Soft Cap‐sule can down‐regulate oxidative stress and regulate the lipid metabolic abnormality and obviously improve the injured vascular en‐dothelial function in T2DM .

Objective:To assess respondents' understanding of the items in the Neck Dissection Impairment Index (NDII) through cognitive interviews and to revise the items accordingly.Methods:Totally 30 postoperative neck dissection patients returning for follow-up at Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University from November 2023 to February 2024, were selected by purposive sampling for two rounds of cognitive interviews. Based on the interview results, the Chinese version of the NDII was revised.Results:The Chinese version of the NDII included ten items. The first round of interviews identified issues such as "incomplete expression, abstract language, and written form, " leading to revisions of five items. The second round of interviews showed that all respondents understood the revised items, and no new suggestions for modification were made.Conclusions:Cognitive interviews can improve respondents' comprehension of the Chinese version of the NDII, identify cognitive biases caused by cultural differences and improper linguistic expressions during the translation process, and enhance the understanding and acceptance of the scale's content among the target population.

OBJECTIVE: To evaluate the effect of the combined application of dissociate skin flap and vacuum sealing drainage (VSD) for the repairing for defect after surgical management of huge neck neoplasms. METHOD: Nineteen patients with huge neck malignant tumor involving the skin of the neck were given radical operation, making use of VSD covering the wound surface. After giving 6.65-7.98 mm Hg continuous negative pressure drainage for 72 h, the patients turned to be treated by intermittent negative pressure therapy with 2 min free interval after each treatment period for 5 min. After dismantling the VSD at 7th to 10th day postoperatively, the good wounds covered by granulation tissue were treated by the skin graft operation with dissociate skin flap from thighs; as for the wounds of which the granulation tissue didn't grow well and important cervical tissues was not fully covered by the granulation tissue, VSD was applied again for 1 week, followed by the skin graft operation. RESULT: Nineteen patients have received a total of 23 times of VSD wound treatment, one-stage operation time was significantly shortened. The granulation tissue grew faster on the wound after VSD treatment, and the important cervical tissues such as great vessels could be well covered. The infection and tumor recurrence were observed directly after dismantling the VSD. The skin graft transplantation would be performed after 1-3 weeks. CONCLUSION The treatment by vacuum sealing drainage combined with skin graft for surgical wounds of huge neck tumor postoperatively has the advantages of simple operation, little injury and promotion of the wound healing, which is an effective way for treatment of neck skin defect by surgical operation for the huge tumor.
Adult ; Aged ; Female ; Head and Neck Neoplasms ; surgery ; Humans ; Male ; Middle Aged ; Negative-Pressure Wound Therapy ; Skin Transplantation ; methods ; Soft Tissue Injuries ; etiology ; surgery ; Surgical Flaps

[摘 要] 目的：探讨白术（Atractylodes macrocephala）水提物抑制胃癌SGC-7901细胞活性的潜在机制。方法：分别使用蒸馏水（对照）和白术水提物（白术治疗组）灌胃SD大鼠后，采集静脉血后分离其血清、过滤并分别命名为对照组血清（CON-S）和白术组血清（AM-S）。将胃癌SGC7901细胞分为对照组、10% AM-S组和20% AM-S组，其中两个AM-S组细胞分别在相应浓度的AM-S血清中培养24 h，对照组细胞用正常培养基培养相同时间，收取SGC7901细胞和上清液用于进一步分析。使用MTT法检测各组细胞活力，通过商业试剂盒测定乳酸脱氢酶（LDH）、丙二醛（MDA）和超氧化物歧化酶（SOD）的水平，采用ELISA试剂盒检测各组细胞中IL-6和TNF-α的含量，采用WB法评估各组细胞中PI3K-Akt-NF-κB信号通路相关蛋白的表达。结果：10% AM-S组和20% AM-S组的SGC7901胃癌细胞增殖活力相较于对照组分别降低48.9%和53.25%（P<0.05或P<0.01）；胃癌细胞上清液中，相较于对照组，10% AM-S组和20% AM-S组LDH水平分别升高29.25%和123%、SOD活性分别升高18%和54.60%、MDA水平分别降低27.8%和40.0%，IL-6水平分别降低15%和17.5%、TNF-α水平分别降低29.71%和40.16%（P<0.05或P<0.01）。相较于对照组，AM-S组中PI3K-Akt-NF-κB信号相关蛋白的水平显著下降（P<0.05或P<0.01）。结论：白术水提物可以通过抑制癌细胞增殖活力、促进凋亡、抑制肿瘤微环境中的促炎因子分泌以及改变细胞内的氧化应激水平等方式抑制胃癌，其机制可能是通过抑制PI3K-Akt-NF-κB通路来实现这些抗癌作用的。

[Abstract] Objective: To investigate the function and mechanism of ferroptosis in the radiation resistance of colorectal tumor-repopulating cells. Methods: Human colorectal tumor cells HCT116 (defined as Control cells) were cultured in two-dimensional normal conditions, and tumor regenerative cells with high tumorigenicity (defined as TRCs) were cultured and screened in three-dimensional fibrin soft gels by the mechanical force method. Both the control group and TRC group cells were exposed to X-rays with different doses (2, 4, 6, 8 Gy) and MTS and the clone formation assay were used tomeasure the cell viability rate and proliferation ability. After the Control cells and TRCs were treated with ferroptosis inducer (Erastin) and X-rays respectively, they were stained with C11-BODIPY reagent, and the lipid peroxidation level of the cells was observed and determined by confocal microscopy and flow cytometry. qPCR was used to determine the effects of Erastin and X-rays treatments on the expressions of ferroptosis-related genes glutathione peroxidase 4 (GPX4) and acyl-coenzyme A synthetase long-chain family member 4 (ACSL4) in the Control cells and TRCs; WB assay was performed to determine the effects on the expressions of ferroptosis-related proteins GPX4 and ACSL4. Results: Colorectal TRCs with high stemness were cultured and screened out from soft fibrin gels. After irradiation with different doses (2, 4, 6, 8 Gy) of X-rays, the viability rate, the clone sizeand the number of clones in the control group were significantly lower than those in the TRC group (all P<0.05). After the cells in the control group were irradiated with different doses of X-rays (4, 8 Gy) and treated with Erastin, the lipid peroxidation level of the cells in the X-ray treated group was significantly higher than that in the untreated group (P<0.05). The lipid peroxidation level of the cells in the Erastin-treated group was significantly higher than that in the DMSO-treated group (P<0.05). There was no statistical difference among all treatment subgroups in the TRC group (all P>0.05). The mechanism study indicated that compared with those in control cells, GPX4 and ACSL4 in TRCs under ferroptosis-inducing conditions (X-ray radiation and Erastin treatment) presented expressions that contributed more to radiation resistance, i.e., continued upregulation of GPX4 and downregulation of ACSL4 and their expressions were dependent on the doses of Erastin. Conclusion: Colorectal TRCs may resist ferroptosis through a high expression of GPX4 and a low expression of ACSL4, which in turn induces radiation resistance.

Objective:To analyze the fail mode of neoadjuvant therapy combined with surgery for locally advanced esophageal squamous cell carcinoma (ESCC) after long-term follow-up.Methods:Clinical data of consecutive 238 patients with locally advanced resectable ESCC who underwent neoadjuvant therapy combined with surgery in Zhejiang Cancer Hospital from September 2012 to October 2019 were retrospectively analyzed. The failure mode in the whole cohort was analyzed after long-term follow-up. The overall survival (OS) and disease free survival (DFS) rates were analyzed by Kaplan-Meier method. Survival differences were determined by log-rank test.Results:The pathological complete response (pCR) rate was 42.0% in 238 patients. After a median follow-up of 46.1 months, tumor progression occurred in 96 patients (40.3%), including 25 patients (10.5%) with local recurrence, 61 patients (25.6%) with distant metastases, and 10 patients (4.2%) with simultaneous local recurrence and distant metastases. The median OS and DFS were 64.7 months and 49.9 months. And the 3-, 5-, and 7-year OS and DFS rates were 70.0%, 52.8%, 36.4% and 63.5%, 42.5%, and 30.0%, respectively. The 3-, 5-, and 7-year locoregional recurrence-free survival rates and distant metastasis-free survival rates were 86.0%, 71.4%, 61.2% and 70.6%, 55.9%, 43.0%. Compared with non-pCR patients, the overall progression rate and distant metastasis rate of pCR patients were lower (26.0% vs. 50.7%, 16.0% vs. 32.6%, both P<0.05). And the 3-, 5-, and 7-year OS (83.0% vs. 60.2%, 69.7% vs. 41.7%, 50.4% vs. 27.7%, all P<0.001) and DFS rates (80.4% vs. 51.4%, 63.9% vs. 31.2%, 45.9% vs. 20.3%, all P<0.001) were significantly better in pCR patients. Conclusions:Distant metastasis is the main failure mode of patients with locally advanced ESCC after neoadjuvant therapy. Patients with postoperative pCR can achieve better long-term survival.