Objective To study the protective effect of lycopene on vascular endothelial cell injury by cigarette smoke extract ( CSE) . Methods CSE was prepared and the human umbilical vein endothelial cells ( HUVECs) were assigned into four groups, cells in control were untreated, and cells in other three groups were treated by 10%CSE, 10%CSE+1. 0 μmol·L-1 lycopene and 1. 0 μmol·L-1 lycopene, respectively. Cell viability was evaluated using MTT assay. The intracelluar reactive oxygen species ( ROS) level was detected by ROS assay kits. Cell cycle and apoptosis were analyzed by flow cytometry. SIRT1 expression was detected by real-time fluorescence quantification PCR ( qRT-PCR) and Western blot. Results Cell viability in 10%CSE group, 10%CSE+1. 0 μmol·L-1 lycopene or 1. 0 μmol·L-1 lycopene group was (56. 7±5. 1)%,(75. 6±7. 1)% and (95. 5± 9. 7)%, respectively. ROS assay showed that the relative fluorescence intensity in the control was 25. 3±3. 9, however, in 10%CSE group, 10%CSE+1. 0 μmol·L-1 lycopene group or 1. 0 μmol·L-1 lycopene group were 67. 3±4. 6, 45. 3±3. 9 and 20. 8±2. 9, respectively. 10%CSE could induce G2 arrested and which could be antagonized by 1. 0 μmol·L-1 lycopene. The apoptosis rate in the control, 10%CSE group, 10%CSE+1. 0 μmol·L-1 lycopene group or 1. 0 μmol·L-1 lycopene group was (6. 2±0. 5)%,
(30.8±4.3)%, (18. 3±1. 9)% and (7. 6±0. 4)%, respectively. As shown in qRT-PCT testing, compared with the control, mRNA of SIRT1 in 10%CSE group, 10%CSE+1. 0 μmol·L-1 lycopene group and 1. 0 μmol·L-1 lycopene group was (0. 51± 0. 03) fold, (0. 84±0. 05) fold, and (1. 31±0. 08) fold compared to the control, the data from western blot were consistent with qRT-PCR results. Conclusion Lycopene can prevent HUVECs from injury induced by CSE by upregulation of SIRT1.

Breast cancer is a major disease which threatens the health of women around the world.Breast cancer patients have acquired resistance to existing treatment methods become the current clinical problems.MicroRNA(miRNA) is an endogenous non-coding RNA that participates in the regulation of a variety of biological processes,including cell proliferation,invasion,metastasis,epithelial interstitial transformation and drug resistance.Acquired resistance includes a variety of complex mechanisms that can affect the expression of cell-associated proteins through the abnormal expression of specific microRNAs,the binding of antineoplastic agents to the corresponding target,and the pathways associated with apoptosis.This article will focus on the expression of abnormal microRNA in acquired drug resistance which was caused by endocrine therapy,chemotherapy and molecular targeted therapy of breast cancer.miRNAs are considered as promising biomarkers and targets for diagnosis,treatments for acquired drug resistance of breast cancer.

Objective To investigate the clinical value of ventricular intracranial pressure monitoring in treatment of severe craniocerebral trauma with high intracranial pressure.Methods A retrospective analysis was conducted on forty cases of severe craniocerebral trauma with GCS score of 3-5 undergone bilateral decompressive craniectomy from October 2010 to January 2012.The patients were divided into three groups:Group A (12 cases received craniotomy after the placement of ventricular intracranial pressure probe) ; Group B (15 cases had craniotomy ahead of the probe placement) ; control group (13 cases had probe placement alone).Intracranial pressure control,dose and duration of administration of dehydrator and prognosis were compared among groups.Results Groups A and B showed a better result in aspects of controlling intracranial pressure within 15 mm Hg,dose and duration of mannitol treatment,and prognosis,as compared with control group (P ＜ 0.05).Furthermore,Group A had seven cases of severe disability or in vegetable state,but only three cases in Group B (P ＜ 0.05).Conclusion Ventricular intracranial pressure monitoring can effectively reduce intracranial pressure,raise treatment success rate and decline the use of mannitol in management of severe craniocerebral trauma.

OBJECTIVE: To invstigate the influence of femoral neck area on larger anteversion angle of lag screw guide pin initial placement in proximal femoral intertrochanteric fracture treated with intramedullary nail. METHODS: From June 2014 to June 2016, 60 patients with femoral intertrochanteric fractures were treated with intramedullary nail, including 27 males and 33 females with an average age of 75 years old ranging from 49 to 88 years old. The lateral images of femoral neck were divided into areas during operation. The anteversion angle of lag screw guide pin of proximal femoral nail was observed at the time of initial insertion. The incidence of normal and larger was counted and the angle index of influencing factors was recorded. RESULTS: Among 60 patients, the screw guide pins of 23 cases were in the central region of the femoral neck and the anteversion angle was normal;screw guide pins of 37 cases were in the front area of the femoral neck, leading to larger anteversion angle. The single factor analysis showed that the independent variables influence factors of larger anteversion were internal collection of the affected limb, internal rotation of the affected limb, hip elevation and screw guide pin level(<0.05). The multi-factor regression analysis showed that the anteversion angle larger was significantly related to the internal rotation of the affected limb and screw guide pin level, and the screw guide pin level was the most relevant(=0.030). CONCLUSIONS The internal rotation of the affected limb and screw guide pin level may affect the anteversion angle of femoral neck when lag screw guide pin initial insertion, cause it to be too large and the screw guide pin level is the main influencing factor.
Aged ; Aged, 80 and over ; Bone Nails ; Bone Screws ; Female ; Femoral Fractures ; surgery ; Femur ; Femur Neck ; Fracture Fixation, Intramedullary ; Humans ; Male ; Middle Aged ; Treatment Outcome

Objective To investigate the application of Critical Care Chest Ultrasonic Examination (CCUE)-plus (CCUE-plus) in the etiological diagnosis in patieuts with dyspnea and/or hemodynamic instability caused by abdominal abnormalities.Methods Patients who suffered from dyspnea and/or hemodynamic instability in the Department of Critical Care Medicine,Xiangya Hospital,Central South University from September 2013 to September 2016 were recruited in this study.A total of 255 consecutive patients completed CCUE within 2hrs of admission.If the diaphragm could not be seen in the routine phrenic points according to Bedside Lung Ultrasound Evaluation (BLUE) protocol,it would be found along midaxillary line and defined m-point.The 59 patients with altered diaphragmatic position (m-point was more than 2 cm higher than phrenic point) received sequential abdominal ultrasonography.The latter ultrasonographic findings were compared with CT results.Results There were 42 (71.19％) cases with positive findings of abdominal ultrasonography,including 18 cases of seroperitoneum,16 cases of intestinal obstruction and 8 cases combined.Compared with 56 patients who applied with CT exam,the abdominal ultrasonography revealed a sensitivity of 76.7％ and a specificity of 100.0％ to diagnose seroperitoneum (AUCRoc 0.917);whereas the sensitivity was 75.0％ and the specificity was 90.9％ (AUCRoc 0.778) to diagnose intestinal obstruction.Moreover,there were 44 (74.58％) patients with normal left ventricular systolic function;more than three quarters (46/59,77.97％) patients had pulmonary consolidation.Conclusion In patients with dyspnea and/or hemodynamic instability caused by abdominal abnormalities and altered diaphragmatic position in BLUE protocol,CCUE-plus protocol has a high positive predictive value of more than 90％ in abdominal abnormality.The findings of abdominal ultrasonography may change therapeutic target from cardio-pulmonary optimization to relief of intestinal obstruction or drainage of seroperitoneum.

We report a fetus with ectopic connection of venous catheter into the dilated coronary sinus, right-sided aortic arch, left-sided ductal arch, and aberrant left subclavian artery detected by routine prenatal ultrasound screening at 23 +2 gestational weeks. The baby was born vaginally at 38 +2 gestational weeks with an Apgar score of 10 at both 1 and 5 min. The reexamination of neonatal echocardiography on the second day after birth showed dilation of the internal diameter of the coronary sinus, right-sided aortic arch, and aberrant left subclavian artery. Follow-up at 90 days after birth found no abnormal growth and development.

Objective:To understand the views of various relevant personnel on the standardized training mode of resident doctors after the implementation of Beijing′s medical education synergy policy, so as to provide references for further improvement of China′s medical education synergy policy.Methods:From January to May 2019, a semi-structured interview method was used to investigate the resident training students, clinical teachers(professional postgraduate tutors and resident training trainees′ guiding doctors)as well as resident training managers in 35 resident training bases in Beijing. The original data of the interviews were sorted out, coded and analyzed by taking root theory and main frame method descriptive analysis.Results:A total of 687 valid interview results were received, of which 71.86% of the resident training managers thought that the mode was more reasonable and the advantages outweighed the disadvantages; 38.07% of the resident training students and 45.45% of the graduate supervisors mentioned that the mode effectively shortened the training time of clinical talents; however, 31.98% of the resident training students and 22.92% of the resident training students′ guiding physicians mentioned it was difficult to balance courses, scientific research and clinical work under this mode, 61.62% of graduate supervisors pointed out that the students were lack of time and energy to engage in scientific research.Conclusions:The training mode of the integration of the standardized training of resident doctors and the postgraduate training of master′s degree in clinical medicine, given its necessity and institutional advantages, is found with room of improvement in its mode setting, arrangement of scientific research courses and clinical rotation, supervision and assessment of the process.

Background:With the improvement of national health awareness and the popularization of a series of screening methods,the number of early colorectal cancer is gradually increasing,accurate prediction of lymph node metastasis of T1 colorectal cancer is the key to determine the optimal therapeutic solutions.Aims:To investigate the relationship between preoperative inflammatory markers,fibrinogen,apolipoprotein B and lymph node metastasis in patients with early colorectal cancer.Methods:The clinical data of 102 patients with early colorectal cancer who received surgical treatment in the Department of General Surgery,Affiliated Hospital of Jiangsu University from January 2014 to December 2022 were retrospectively analyzed.The patients were divided into positive lymph node group and negative lymph node group according to postoperative pathological results.Univariate and multivariate Logistic regression analysis were employed to explore the correlation between lymph node metastasis and clinical test parameters in early colorectal cancer.Results:A total of 102 patients in T1 colorectal cancer were enrolled in this study,including 53 males and 49 females,and the mean age was(64±10)years.Postoperative pathological diagnosis of lymph node metastasis was 13 cases and no lymph node metastasis was 89 cases.The univariate analysis showed that age,fibrinogen and apolipoprotein B-monocyte ratio(AMR)were related to lymph node metastasis in early colorectal cancer(P<0.05).The multivariate Logistic regression analysis showed that age,fibrinogen and AMR were independent predictors of lymph node metastasis.Conclusions:The age,fibrinogen and AMR may play an important role in predicting lymph node metastasis in early colorectal cancer.They can be combined with pathological factors to further create a new prediction model,so as to provide some reference for patients in colorectal cancer to choose the therapeutic regimen.

This article reported a case of fetal congenital pyriform sinus fistula (CPSF) diagnosed by prenatal ultrasound. An oval cystic mass in the left side of the fetal neck was detected during routine prenatal ultrasonography at 17 +2 weeks of gestation, which was also found in the systemic ultrasound screening at 23 weeks. Besides, a narrow fistula between the cyst and pharynx was observed in the coronal view of the neck, raising the suspicion of CPSF. On day 21 after birth, the cystic mass bulged out of the neck and the neonate started choking and coughing during feeding alongside wheezing respiration. Ultrasound examination showed a strong gas echo in the cystic mass, which was also confirmed by CT scan on day 25. On day 26, cystectomy, ligation of high fistula, and fistulectomy were performed, and the diagnosis of CPSF was confirmed. The baby recovered after the operation and was healthy during follow-up till three months.

Objective:To investigate the clinical characteristics and prognosis of patients with left ventricular assist device (LVAD) implantation during the perioperative period.Methods:This retrospective study included 14 patients with end-stage heart failure who underwent LVAD implantation in the department of intensive care medicine of Nanjing Hospital Affiliated to Nanjing Medical University from February 2022 to March 2023, including 12 males and 2 females patients, the mean age was (57.6±9.8)years old. All patients were implanted with Corheart 6 implantable left ventricular assist system, did not use other mechanical assisted circulatory devices. The clinical data of enrolled patients were collected, and the clinical characteristics and prognosis during ICU treatment were analyzed.Results:Dilated cardiomyopathy (DCM) was the most common primary cause of heart failure. The results of transthoracic echocardiography showed that the left ventricular ejection fraction (0.297±0.074 vs. 0.238±0.064, P=0.031) of patients was significantly increased, while the left ventricular end diastolic diameter[69.0(65.8, 74.3)mm vs. 76.5(72.8, 83.0)mm, P=0.003]and systolic end systolic diameter[61.5(53.7, 65.3)mm vs. 68.3(63.8, 71.9)mm, P=0.005]were significantly decreased post LVAD implantation as compared to before LVAD implantation. Within one week after implantation, there was no significant difference in LVAD rotational speed, flow rate, and pulsation index ( P>0.05). During ICU treatment, dobutamine (13 cases) was the most commonly used vasoactive agent. 9 patients used phosphodiesterase Ⅲ inhibitors for perioperative pulmonary hypertension. Targeted management of volume and pressure indicators was conducted for enrolled patients to prevent postoperative right heart failure and to reduce right heart burden. Within 72 hours after LVAD implantation, the average pulmonary artery pressure of patients was 24 (22, 26) mmHg to 26 (21, 28)mmHg (1 mmHg=0.133 kPa), while the fluid balance was(-581±778)ml to(-1 209±1 134)ml. All enrolled patients survived to 28 days after LVAD implantation. The length of stay in the ICU was (8.0±1.8) days and the total length of hospital stay was 33 (29, 41)days, while the time of mechanical ventilation was 8 (5, 28)h. Conclusion:LVAD implantation can help improve left ventricular systolic function, prolong survival time so as to serve as an important means of terminal treatment or bridging therapy for heart transplantation of patients with end-stage heart failure. To strengthen the perioperative hemodynamic regulation and maintain the cardiac function of patients with LVAD implantation is the important purposes of ICU postoperative management.