Objective To discuss the causes and clinical significance of conversion to laparotomy during laparoscopic surgery.Method Three thousand two hundred and three cases who underwent laparoscopic surgery during the past five years were analyzed retrospectively.Results Three thousand one hundred and eighty cases underwent laparoscopic surgery,in which 23 cases were converted to laparotomy due to factors including severe pelvic adhesions(6 cases),complex disease with difficulties in laparoscopy (7 cases),massive haemorrhage(3 cases),bladder trauma(1 case),gastric trauma(1 case),intestinal trauma(1 case),as well as unexpected malignant genitalia neoplasm(4 cases).Conclusion The major causes for the conversion to laparotomy during gynecology laparoscopic surgery are severe pelvic adhesion and complex disease with difficulties in laparoscopy.Careful evaluation before surgery and conversion to laparotomy at the right moment can decrease the complication.

Abstract: Due to the continued emergence of multiple variants of SARS-CoV-2, the ongoing pandemic has resulted in severe mortality over the past two years. After the Alpha, Beta, Gamma and Delta variants, the most recent new variant of concern (VOC) strain to emerge is Omicron (B.1.1.529), which evolved as a result of the accumulation of a large number of mutations. The Omicron variant, which has a much higher transmission rate than the Delta variant, soon replaced the Delta variant and others, is now the dominant variant worldwide. The emergence of Omicron poses new challenges for the prevention and control of COVID-19 and has raised a number of concerns worldwide. Recently, cases of Omicron infection have been reported in several parts of China, and therefore this paper provides a comprehensive analysis and summary of the epidemiology and immune escape mechanisms of the Omicron variant. We also suggest some therapeutic strategies against the Omicron variant, including rapid diagnosis, genome analysis of emerging variants, ramping up of vaccination drives and receiving booster doses, updating the available vaccines, designing of multivalent vaccines able to generate hybrid immunity, up-gradation of medical facilities and strict implementation of adequate prevention and control measures need to be given high priority to handle the on-going COVID-19 pandemic successfully.

Objective To research the curative effect of chondroitin sulfate and glucosamine on Kashin-Beck disease(KBD). Methods According to Diagnosis for Kashin-Beck disease,80 patients of adult KBD were detected from Guanghui village Shangzhi city Heilongjiang province in July,2007,and they divided into treatment group and control group according to their condition,age and sex,40 person in each group. Treatment group was given chondroitin sulfate and glucosamine sulfate,and control group was given placebo(equivalent amount of starch). Bilateral knees X-ray films were shot before and after treatment (8th month),scale division magnifying glass was used to measure the width of joint space on X-ray films. Results The width of joint space respectively was (4.30±2.14) and (4.10±2.07)mm in control group before and after treatment,and treatment group respectively was (4.17±2.15),(4.16±2.11)mm. Medicine had no obviously role on joint space (F = 0.50,P > 0.05),Time and both of time and medicine had obvious role on joint space(F= 67.66,46.74,all P< 0.05). Joint space of treat group was thinner than control group(P < 0.05) before treatment,but thicker after treatment(P < 0.05). To compare with the width of before treatment,joint space width of control group became obviously narrow(P < 0.05). Conclusions Experimental group taking chondroitin sulfate and glucosamine sulfate alleviated knee joint space narrowing process of adults KBD patients compared with control group. It plays a protection role in articular cartilage and provides evidences for choosing drug and evaluating effect in the treatment of adults KBD.

Background:Recent studies show that microRNA-145 (miRNA-145) might be an attractive tumor biomarker of considerable prognostic value,but little is known about their relationship with acute myocardial infarction (AMI).This study investigated the correlation between the level ofmiR-145 and AMI.Methods:One-hundred patients were divided into three groups:no coronary artery disease (CAD) group,non-ST segment elevation myocardial infarction group,and ST segment elevation myocardial infarction group.The plasma levels of miR-145 were quantified using real-time quantitative polymerase chain reaction.Logarithmic transformation of miRNA-145 levels (Ln_miRNA-145) was used for statistical analysis due to the skewed data distribution.Results:Plasma levels of miR-145 were significantly lower in patients with AMI compared to patients in the non-CAD group (-6.38 ± 0.11 vs.-4.47 ± 0.17,P ＜ 0.0001).Compared to those without heart failure,the levels of miR-145 were significantly lower in patients with heart failure (-6.91 ± 0.20 vs.-5.35 ± 0.13,P ＜ 0.0001).We also found that the lower plasma levels of miRNA-145 significantly correlated with increased serum levels of B-type natriuretic peptide (Spearman p =-0.60,P ＜ 0.0001),troponin T (Spearman p =-0.62,P ＜ 0.0001),and decreased ejection fraction (Spearman p =0.65,P ＜ 0.0001).In a multivariable linear regression analysis,AMI and heart failure were independently associated with lower Ln_miRNA-145 (estimate-0.99,standard error [SE] 0.28;P =0.001 and estimate-0.62,SE 0.21;P=0.004).Conclusions:Our results suggest that decreased plasma levels of miR-145 are associated with AMI.Circulating miR-145 may be useful in prognosticating cardiac function and the risk of developing heart failure.

AIMTo explore new agents of quinolone derivatives with high activity against Gram-positive organisms.

METHODSdl-7-(4,4-Dimethyl-3- aminomethylpyrrolidinyl)-quinolones were designed and synthesized, and their activity against Gram-positive organisms was tested in vitro.

RESULTSTen target compounds were obtained. The structures of these compounds were confirmed by 1H NMR, MS. The target compounds with dl-4,4-dimethyl-3-( methyl) aminomethylpyrrolidine side chains had high activity against Gram-positive organisms. Especially the MIC values of compound 22 for 4 strains of Gram-positive resistant bacteria (two strains of MRSA and two of MRSE) were 0.015 -0.5 mg x L(-), which exhibited more potent activities than gatifloxacin (4 - 128 times). Its MIC value for Pseudomonas aeruginosa 03-5 (0.008 mg x L(-1)) was 4 times as that of gatifloxacin (0.03 mg x L(-1)).

CONCLUSIONThe compound 22 showed high activity against Gram-positive organisms in vitro and it is worth of more investigation.

Anti-Bacterial Agents ; chemical synthesis ; pharmacology ; Gram-Negative Aerobic Bacteria ; drug effects ; Gram-Positive Bacteria ; drug effects ; Microbial Sensitivity Tests ; Molecular Structure ; Pseudomonas aeruginosa ; drug effects ; Quinolones ; chemical synthesis ; pharmacology ; Staphylococcus epidermidis ; drug effects

The aim of the present study was to evaluate the active and passive mechanical properties and wall collagen and elastin contents of mesenteric small arteries (MSAs) isolated from rats of 28-day simulated microgravity (SUS), countermeasure [S + D: SUS plus 1 h/d -G(x) to simulate intermittent artificial gravity (IAG)] and control (CON) groups. Three mechanical parameters were calculated: the overall stiffness (β), circumferential stress (σ(θ))-strain (ε(θ)) relationship and pressure-dependent incremental elastic modulus (E(inc,p)). Vessel wall collagen and elastin percentage were quantified by electron microscopy. The results demonstrate that the active mechanical behavior of MSAs differs noticeably among the three groups: the active stress-strain curve of SUS vessels is very close to the passive curve, whereas the active σ(θ)-ε(θ) curves of CON and S + D vessels are shifted leftward and display a parabolic shape, indicating that for MSAs isolated from S + D, but not those from SUS rats, the pressure-induced myogenic constriction can effectively stiffen the vessel wall as the CON vessels. The passive mechanical behavior of MSAs does not show significant differences among the three groups. However, the percentage of collagen is decreased in the wall of SUS and S + D compared with CON vessels in the following order: SUS < S + D < CON. Thus, the relationship between passive mechanical behavior and compositional changes may be complex and yet depends on factors other than the quantity of collagen and elastin. These findings have provided biomechanical data for the understanding of the mechanism of postflight orthostatic intolerance and its gravity-based countermeasure.
Animals ; Biomechanical Phenomena ; Collagen ; metabolism ; Elasticity ; Hindlimb Suspension ; physiology ; Male ; Mesenteric Arteries ; physiology ; ultrastructure ; Muscle, Smooth, Vascular ; physiology ; ultrastructure ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Stress, Mechanical ; Vasoconstriction ; physiology ; Weightlessness Simulation

Objective To investigate the relationship between drinking-water type of endemic arsenicosis and adult carotid artery atherosclerosis. Methods In 2009, 285 participants aged over 40 from drinking-water type of endemic arsenism areas and 293 residents aged over 40 from control areas were investigated in Yingxian county,Shanxi province. Portable-type B mode color ultrasound was used to examine the carotid artery of all participants.The carotid atherosclerosis were diagnosed and graded through the ultrasonograms. Content of water arsenic and hair arsenic of 10 people randomly selected in every villages were detected. Results A total of 5 villages with drinkingwater type of endemic arsenicosis as observation group and 5 villages without drinking-water type of endemic arsenicosis as control group were investigated. The prevalence rates of adult carotid atherosclerosis within observation group were 35.09%(20/57), 55.74%(34/61), 38.46%(20/52), 36.51%(23/63) and 46.15%(24/52), respectively,and standardized prevalence rates were 32.5%, 33.8%, 34.9%, 46.2% and 47.3%, respectively and the prevalence rates of adult carotid atherosclerosis within control group were 18.18%(10/55), 30.77%(16/52), 20.00%(10/50),18.67% (14/75) and 21.31% ( 13/61 ), respectively; the standardize prevalence rates were 22.4%, 17.7%, 10.7%,24.6%, 18.9%, respectively. The standardize prevalence rates were higher in observation group [39.50%(113/285) ]than that in control group[39.50%(113/285), T = 26, P ＜ 0.01 ]. The severity of adult carotid atherosclerosis (composition of 4 - 7 scores ) was compared between observation group [ 17.70%(20/113 )] and control group [ 14.06% (9/64) ], and the difference was insignificant(x2 = 0.26, P ＞ 0.05). Conclusions The prevalence rate of carotid atherosclerosis in drinking-water type of endemic arsenicosis areas is higher than that of the control areas.The study provides evidence that arsenic poisoning can cause atherosclerosis.

Objective To evaluate the treatment time and the anterior and posterior teeth movement pattern as closing extraction space for the Class Ⅲ surgical patients facilitated by accelerated osteogenic orthodontic treatment.Methods There were 10 skeletal Class Ⅲ patients in accelerated osteogenic orthodontic group (AOO) and 10 patients in control group.Upper first premolars were extracted in all patients.After leveling and alignment(T2),corticotomy was performed in the area of maxillary anterior teeth to accelerate space closing.Study models of upper dentition were taken before orthodontic treatment(T1) and after space closing(T3).All the casts were laser scanned,and the distances of the movement of incisors and molars were digitally measured.The distances of tooth movement in two groups were recorded and analyzed.Results The alignment time between two groups was not statistically significant.The treatment time in AOO group from T2 to T3 was less than that in the control group (less than 9.1 ± 4.1 months).The treatment time in AOO group from T1 to T3 was less than that in the control group (less than 6.3 ± 4.8 months),and the differences were significant(P ＜ 0.01).Average distances of upper incisor movement (D1) in AOO group and control group were (2.89 1.48) and (3.10 ±0.95) mm,respectively.Average distances of upper first molar movement(D2) in AOO group and control group were (2.17 ± 1.13) and (2.45 ± 1.04) mm,respectively.No statistically significant difference was found between the two groups (P ＞ 0.05).Conclusions Accelerated osteogenic orthodontic treatment could accelerate space closing in Class Ⅲ surgical patients and shorten preoperative orthodontic time.There were no influence on the movement pattern of anterior aud posterior teeth during pre-surgical orthodontic treatment.

The present study was designed to test the hypothesis that a medium-term simulated microgravity can induce region-specific remodeling in large elastic arteries with their innermost smooth muscle (SM) layers being most profoundly affected. The second purpose was to examine whether these changes can be prevented by a simulated intermittent artificial gravity (IAG). The third purpose was to elucidate whether vascular local renin-angiotensin system (L-RAS) plays an important role in the regional vascular remodeling and its prevention by the gravity-based countermeasure. This study consisted of two interconnected series of in-vivo and ex-vivo experiments. In the in-vivo experiments, the tail-suspended, hindlimb unloaded rat model was used to simulate microgravity-induced cardiovascular deconditioning for 28 days (SUS group); and during the simulation period, another group was subjected to daily 1-hour dorso-ventral (-G(x)) gravitation provided by restoring to normal standing posture (S + D group). The activity of vascular L-RAS was evaluated by examining the gene and protein expression of angiotensinogen (Ao) and angiotensin II receptor type 1 (AT1R) in the arterial wall tissue. The results showed that SUS induced an increase in the media thickness of the common carotid artery due to hypertrophy of the four SM layers and a decrease in the total cross-sectional area of the nine SM layers of the abdominal aorta without significant change in its media thickness. And for both arteries, the most prominent changes were in the innermost SM layers. Immunohistochemistry and in situ hybridization revealed that SUS induced an up- and down-regulation of Ao and AT1R expression in the vessel wall of common carotid artery and abdominal aorta, respectively, which was further confirmed by Western blot analysis and real time PCR analysis. Daily 1-hour restoring to normal standing posture over 28 days fully prevented these remodeling and L-RAS changes in the large elastic arteries that might occur due to SUS alone. In the ex-vivo experiments, to elucidate the important role of transmural pressure in vascular regional remodeling and differential regulation of L-RAS activity, we established an organ culture system in which rat common carotid artery, held at in-vivo length, can be perfused and pressurized at varied flow and pressure for 7 days. In arteries perfused at a flow rate of 7.9 mL/min and pressurized at 150 mmHg, but not at 0 or 80 mmHg, for 3 days led to an augmentation of c-fibronectin (c-FN) expression, which was also more markedly expressed in the innermost SM layers, and an increase in Ang II production detected in the perfusion fluid. However, the enhanced c-FN expression and increased Ang II production that might occur due to a sustained high perfusion pressure alone were fully prevented by daily restoration to 0 or 80 mmHg for a short duration. These findings from in-vivo and ex-vivo experiments have provided evidence supporting our hypothesis that redistribution of transmural pressures might be the primary factor that initiates region-specific remodeling of arteries during microgravity and the mechanism of IAG is associated with an intermittent restoration of the transmural pressures to their normal distribution. And they also provide support to the hypothesis that L-RAS plays an important role in vascular adaptation to microgravity and its prevention by the IAG countermeasure.
Angiotensinogen ; genetics ; metabolism ; Animals ; Aorta, Abdominal ; pathology ; physiopathology ; Carotid Artery, Common ; pathology ; physiopathology ; Hindlimb Suspension ; Male ; Muscle, Smooth, Vascular ; metabolism ; pathology ; RNA, Messenger ; genetics ; metabolism ; Rats ; Rats, Sprague-Dawley ; Receptor, Angiotensin, Type 1 ; genetics ; metabolism ; Renin-Angiotensin System ; physiology ; Weightlessness Simulation

The aim of the present study was to further elucidate the mechanisms of vascular adaptation to microgravity and its gravity-based countermeasure by a biomechanical approach. Active (the dissected vessel segment was superfused with PPS) and passive (while it was superfused with Ca(2+)-free PPS) biomechanical properties of mesenteric third-order small arteries and middle cerebral arteries isolated from 3-day simulated microgravity (SUS), countermeasure (STD, daily 1 h of -G(x) gravitation), and control (CON) groups of rats were studied. The following mechanical parameters were calculated: the overall stiffness parameter of passive vessels (beta), circumferential stress (sigma(theta))-strain (epsilon(theta)) relationship, and pressure-dependent incremental elastic modulus (E(inc,p)) of both active and passive vessels, and vascular smooth muscle (VSM) activity-dependent incremental modulus (E(inc,a)). Results from the analysis of active biomechanical properties revealed the contribution of vascular smooth muscle (VSM) tone during the early adaptation to microgravity: (1) For mesenteric small arteries, active circumferential sigma(theta) -epsilon(theta) curve of SUS group was comparable with that of the passive vessels, indicating that the function of VSM to restore the normal stress distribution is compromised; however, this mal-adaptation was fully prevented by the countermeasure of daily 1 h of -G(x) gravitation; (2) For the middle cerebral arteries, active circumferential sigma(theta) -epsilon(theta) relation of SUS group was shifted to the left side of the passive curve and epsilon(theta) was kept at a nearly constant level with the corresponding sigma(theta) being at its normal range; furthermore, the enhanced myogenic tone responsiveness was not prevented by daily short-duration -G(x). Analysis of the passive biomechanical properties has suggested remodeling changes in matrix components of different types of vessels, which might be significant if the exposure duration was further prolonged. In brief, studies of vascular biomechanics are of particular importance in elucidating the mechanisms underlying vascular adaptation to microgravity and its gravity-based countermeasure.
Animals ; Biomechanical Phenomena ; Mesenteric Arteries ; physiology ; Middle Cerebral Artery ; physiology ; Muscle, Smooth, Vascular ; physiology ; Pressure ; Rats ; Weightlessness Simulation