Objective:To investigate the short-term efficacy of thoracoscopic radical surgery in the treatment of esophageal cancer and its influence on the expression of trigger receptor-1 (TRE-1) and tumor necrosis factor receptor-associated protein 1 (TRAP1).Methods:A total of 68 patients with esophageal cancer who were admitted to First People′s Hospital of Ningyang from June 2016 to June 2019 were selected and divided into thoracoscope radical surgery group and raditional surgery group by stratified sampling method, with 34 cases in each group. The thoracoscopic radical surgery group was treated with thoracoscopic radical surgery, and the traditional surgery group was treated with traditional open radical esophageal cancer surgery with neck, chest, and abdominal incisions. The levels of inflammatory factors, immune function, lung function indexes, TREM-1, TRAP1 expression and complications of the two groups were observed and compared.Results:Before operation, the levels of inflammatory factors tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-10 in two groups had no significant differences ( P>0.05). At 2 d after operation, the levels of TNF-α, IL-6, IL-10 in two groups were increased and the levels of above index in the thoracoscopic radical surgery group were lower than those in the traditional surgery group: (23.21 ± 0.32) mg/L vs. (29.69 ± 0.48) mg/L, (232.15 ± 23.64) ng/L vs. (246.73 ± 25.89) ng/L, (0.64 ± 0.19) ng/L vs. (0.89 ± 0.21) ng/L, and there were statistical differences ( P<0.05). Before operation, the levels of CD 3+, CD 4+, CD 8+, and CD 4+/CD 8+ in two groups had no significant differences ( P>0.05). At 2 d after operation, the levels of CD 3+, CD 4+, CD 8+ decreased and the level of CD 4+/CD 8+ increased, and the levels of CD 3+, CD 4+, CD 8+, CD 4+/CD 8+ in the thoracoscopic radical surgery group were higher than those in the traditional surgery group: (46.78 ± 1a2.43)% vs. (41.32 ± 9.36)%, (46.12 ± 9.68)% vs. (41.59 ± 7.98)%, (27.42 ± 4.27)% vs. (21.38 ± 3.16)%, 1.47 ± 0.46 vs. 1.25 ± 0.27, and there were statistical differences ( P<0.05). Before operation, the levels of forced expiratory volume in one second (FEV 1), forced vital capacity (FVC), FEV 1/FVC in two groups had no significant differences ( P>0.05). At 2 day after operation, the levels of FEV 1, FVC, FEV 1/FVC in two groups decreased, and the levels of FEV 1, FVC, FEV 1/FVC in the thoracoscopic radical surgery group were higher than those in the traditional surgery group: (2.37 ± 0.72) L vs. (1.82 ± 0.53) L, (3.34 ± 1.06) L vs. (2.43 ± 0.82) L, (62.47 ± 15.26)% vs. (53.67 ± 12.28)%, and there were statistical differences ( P<0.05).Before operation, the expression of TREM-1 and TRAP1 in two groups had no significant differences ( P>0.05). At 2 d after operation, the expression of TREM-1in the thoracoscopic radical surgery group was higher than that of traditional surgery group: (141.56 ± 34.69 vs. 121.54 ± 22.75); the expression of TRAP1 was lower than that of the traditional surgery group: (1.63 ± 0.51 vs. 2.11 ± 0.64), and there were statistical differences ( P<0.05). The postoperative complication rate of the thoracoscopic radical surgery group was lower than that of the traditional surgery group:5.88%(2/34) vs. 23.53%(8/34), and there was statistical difference ( χ2=4.221, P=0.040). Conclusions:The short-term efficacy of thoracoscopic radical surgery in the treatment of esophageal cancer is better than that of the traditional surgery group, which can increase the expression of TREM-1, reduce the expression of TRAP1, and reduce the inflammatory response and the impact on the immune function.

Objective To compare the long-term outcomes in patients with newly diagnosed stage T1G3 bladder cancer treated with bladder preserving approach and intravesical instillation or im-mediate cystectomy.Methods of 113 patients with a median age of 64 years (range 27 to 88) diag-nosed with T1G3 bladder cancer from January 1993 to February 2007,81 cases were treated by tran-sureteral resection with additional intravesieal instillation and 32 were treated with immediate cystecto-my.Differences between the 2 groups in 5-year overall survival and tumor specific survival were calcu-lated using the Kaplan-Meier survival function and analyzed by the log rank test.Results of 81 pa-tients treated with organ preserving approach and postoperative intravesical instillation,53 patients developed local recurrence and 21 patients underwent deferred cysteetomy in a median 64 (range 6-140) months follow-up.The overall and tumor specific survival at 5 years was 64.2% (52/81) and 77.8%(63/81),and in those who had deferred cystectomy it was 61.9% (13/21) and 76.2% (16/21),respectively.Of the 32 patients treated with immediate cystectomy,the 5-year overall and tumor specific survival was 59.4%(19/32) and 75.0%(24/32) within a median follow-up of 62(range 4-141)months.There was no statistical difference of the 5-year overall and tumor specific survival be-tween patients treated with bladder preserving approach or immediate cystectomy.Conclusion Blad-der preserving approach and immediate eystectomy might have similar 5-year overall and tumor specific survival for primary T1G3 bladder cancers.

OBJECTIVETo evaluate the structural characteristics and biocompatibility of a novel nano-Ta-Ti alloy rod for its potential application in internal fixation.

METHODSTa coating of a Ti alloy rod with nano-Ta (tantalum) powder was performed using laser melting with symmetrical grooves repleted with nano-Ta powder along the whole length. The microstructure of the cross section of Ta-Ti alloy rod, pore diameter and components of the coating were analyzed using scanning electron microscopy. The influence of this nano-Ta-Ti alloy on proliferation and differentiation of MC3T3-E1 cells was evaluated by MTT cytotoxicity test and ALP activity test.

RESULTSUnder scanning electron microscope, the Ta-coating surface presented with a gross porous (200-300 µm) structure with dense fusion between Ta particles, and no new element was produced after laser melting. Biocompatibility evaluation showed that Ti alloys with and without Ta coating both promoted the proliferation of MC3T3-E1 cells, but the coated alloy showed better performance and obviously promoted the differentiation of the osteoblasts.

CONCLUSIONAlloying between Ta and Ti can be accomplished successfully by laser melting technique, and the alloy obtained has ideal surface structure and good biocompatibility.

3T3 Cells ; Alloys ; Animals ; Biocompatible Materials ; Cell Differentiation ; Cell Proliferation ; Materials Testing ; Mice ; Microscopy, Electron, Scanning ; Osteoblasts ; cytology ; Porosity ; Tantalum ; Titanium

Objective To evaluate the structural characteristics and biocompatibility of a novel nano-Ta-Ti alloy rod for its potential application in internal fixation. Methods Ta coating of a Ti alloy rod with nano-Ta (tantalum) powder was performed using laser melting with symmetrical grooves repleted with nano-Ta powder along the whole length. The microstructure of the cross section of Ta-Ti alloy rod, pore diameter and components of the coating were analyzed using scanning electron microscopy. The influence of this nano-Ta-Ti alloy on proliferation and differentiation of MC3T3-E1 cells was evaluated by MTT cytotoxicity test and ALP activity test. Results Under scanning electron microscope, the Ta-coating surface presented with a gross porous (200-300μm) structure with dense fusion between Ta particles, and no new element was produced after laser melting. Biocompatibility evaluation showed that Ti alloys with and without Ta coating both promoted the proliferation of MC3T3-E1 cells, but the coated alloy showed better performance and obviously promoted the differentiation of the osteoblasts. Conclusion Alloying between Ta and Ti can be accomplished successfully by laser melting technique, and the alloy obtained has ideal surface structure and good biocompatibility.

Objective To investigate the anesthetic effects and adverse effects of cypropofol and propofol combined with alfentanil,respectively,for gastroenteroscopy.Methods A total of 162 patients who underwent elective gastroenteroscopy at the Gastrointestinal Endoscopy Center of the First Hospital of Lanzhou University from January to February 2024 were enrolled,including 86 males and 76 females,at an age of 18～65 years old,with a BMI value of 18～30 kg/m2,and ASA grade ≤ Ⅱ.They were randomly divided into propofol group(Group P)and cypropofol group(Group C),with 81 cases in each group.All patients were sedated with 0.7 μg/kg alfentanil,and in 30 s later,2 mg/kg propofol and 0.4 mg/kg cypropofol was intravenously dripped into Group P and Group C,respectively.When the modified alertness/sedation score(MOAA/S)≤1,a gastroscope was started to insert.The related indicators,including total procedure time,successful cases of sedation,induction time and awakening time,heart rate,blood pressure,and pulse oximetry saturation were recorded,occurrence of adverse reactions such as hypotension,respiratory depression,injection pain,intraoperative body movement,nausea and vomiting were observed,and the satisfaction of endoscopists and of patients to anesthesia were recorded and compared between the 2 groups.Results There were no statistical differences in the success rate of sedation,induction time and awakening time between the 2 groups.The patients of the Group C had more stable intraoperative vital signs,statistically lower incidences of injection pain,respiratory depression and hypotension(P＜0.05),and increased satisfaction for anesthesia(P＜0.05)when compared with those in Group P.No obvious difference were observed in the satisfaction of endoscopist to anesthesia between the 2 groups.Conclusion In combination with small-dose alfentanil,0.4 mg/kg cypropofol shows similar sedation effect as 2 mg/kg propofol in gastroenteroscopy,with comparable induction and awakening time.Cypropofol has more advantages in stable intraoperative vital signs,less adverse effects such as low blood pressure,respiratory depression and injection pain,higher the patient satisfaction,which is worthy of clinical promotion.

Objective To evaluate the structural characteristics and biocompatibility of a novel nano-Ta-Ti alloy rod for its potential application in internal fixation. Methods Ta coating of a Ti alloy rod with nano-Ta (tantalum) powder was performed using laser melting with symmetrical grooves repleted with nano-Ta powder along the whole length. The microstructure of the cross section of Ta-Ti alloy rod, pore diameter and components of the coating were analyzed using scanning electron microscopy. The influence of this nano-Ta-Ti alloy on proliferation and differentiation of MC3T3-E1 cells was evaluated by MTT cytotoxicity test and ALP activity test. Results Under scanning electron microscope, the Ta-coating surface presented with a gross porous (200-300μm) structure with dense fusion between Ta particles, and no new element was produced after laser melting. Biocompatibility evaluation showed that Ti alloys with and without Ta coating both promoted the proliferation of MC3T3-E1 cells, but the coated alloy showed better performance and obviously promoted the differentiation of the osteoblasts. Conclusion Alloying between Ta and Ti can be accomplished successfully by laser melting technique, and the alloy obtained has ideal surface structure and good biocompatibility.

Objective To analyze the feasibility and safety in application of resectoscope combined with laparoscopy in the operation treatment of paraganglioma of urinary bladder.Methods 7 cases patients with paraganglioma of urinary bladder treated in our hospital from November 2014 to August 2018 were analyzed retrospectively.There were 5 males and 2 females,average age of 31.1 years (22-37 years),average body mass index was 22.3 kg/m2 (18.3-22.5 kg/m2).All the 7 cases patients complained of dizziness and palpitation after urination,average basal systolic blood pressure was 111.8 mmHg (97-124 mmHg),the average fluctuation of systolic blood pressure before and after urination was 64.9 mmHg(28-91 mmHg),the CT and cystoscopy prompt bladder tumor,the average diameter was 2.7 cm(2.1-3.5 cm).The average of plasma norepinephrine was 706.3 pg/ml(330-997 pg/ml);the average of plasma dopamine was 101.1 pg/ml(44-145 pg/ml);the average of 24h urinary vanilmandelic acid was 13.4 mg/24h (10.3-16.1 mg/24h).All the patients has controlled the blood pressure and dilate the blood vessels with phenoxybenzamine hydrochloride,accepted the operation of resectoscope combined with laparoscopy partial cystectomy and bladder sutura per abdomen after ample dilatancy.The patients had lithotomy position with trendelenburg,preparation of gas peritoneal cavity by transabdominal,inside the resectoscope by transurethral at the same time,mutilated bladder mucosa beside 1cm at the edge of the tumor,and cut full thickness bladder wall,take the extraperitional fat as the standard procedure;we could see the cutting edge clear at this time by laparoscopy,cut off the pelvic peritoneum,extraperitional fat and the tumor.The sample placed in bladder,close the bladder with absorbable or barbed wires,take out the sample by resectoscope.Results All the 7 cases patients operation was successfully completed,no cases has been transfered to open.The average time of operation is 85.3 min(65-100 min),the average amount of bleeding is 27.9 ml(10-50 ml).The average fluctuation of systolic blood pressure is 8.7 mmHg(6-15 mmHg).Bladder washout was stopped 24h after operation,catheter was removed 1 weeks after operation.There is no obvious complications occurred.The average hospital stay is 3.7 days (3-5 days).The average pain score of 4 cases 4h after operation is 3.8 (2-5),reevaluation 24h after operation is 2.3 (1-4).The average follow-up time is 7.9 months(2-15 months).All the 7 cases patients clinical symptoms disappeared,there is no fluctuation of systolic blood pressure before and after urination,there is no recurrence of the tumor.Conclusions To the paraganglioma of urinary bladder in fundus of bladder or anterior wall of bladder,we can accurate resection tumor by resectoscope combined with laparoscopy,reduce blood pressure fluctuations,reduce the surgical trauma and the distress of patients.It is a safety and effective minimally invasive surgery.

IgG4-related diseases have a low incidence and are easily misdiagnosed as tumors in clinical treatments. A 26-year-old male patient was admitted to the hospital because of a left adrenal tumor found in health examination for more than 5 months. The tumor in the left adrenal region could be seen from abdominal CT, and the retroperitoneal laparoscopic resection of the left adrenal tumor was performed. Postoperative pathology was consistent with IgG4-related diseases, and serum IgG4 was abnormally high. After 2 months’ follow-up, serum IgG4 returned to normal, and no special discomfort.

Major depressive disorder(MDD)is a common mental illness.Currently,nearly 16%of the global population is affected by depression-related symptoms,while the diagnosis and treatment rate of MDD patients in China is only 9.5%.MDD is characterised by high morbidity and low recovery rate,and how to effectively improve its therapeutic effect has been a hot research topic in recent years.Antidepressants,as the main treatment for MDD,have the disadvantages of many adverse effects and slow onset of action,prompting people to pay attention to the non-pharmacological treatments of MDD.Dietary intervention is a kind of non-pharmacological treatment by changing dietary structures and rhythms;the current application of dietary intervention to psychiatry is very extensive,and it has been proved to be effective in the treatment of depression.Recent research suggests that dietary interventions can treat and ameliorate depressive symptoms by influencing brain-gut axis-related eating mechanisms.This article reviews the multidimensional exploration of dietary interventions in the treatment of depression:dietary structure interventions,dietary rhythm interventions,and the role of intestinal flora.It details the modalities of dietary interventions and the related mechanisms involved,and provides reference for dietary interventions in the treatment of depression-related symptoms.

ObjectiveTo investigate the mechanism of astragaloside-Ⅳ （AS-Ⅳ） in regulating pyroptosis to alleviate intestinal ischemia-reperfusion injury （IRI） by combining network pharmacology and in vivo experiments. MethodFirstly， the corresponding target genes of AS-Ⅳ were obtained from TraditionalChineseMedicineSystemsPharmacology（TCMSP） database and Swiss Target Prediction database， and the target genes related to intestinal IRI and Pyroptosis were obtained from GeneCards database， and the common target genes of the three were obtained by drawing Venn diagrams through unspiralized website. Protein-protein interaction （PPI） network was constructed by STRING database and Cytoscape software to screen common target genes and imported into Cytoscape software to obtain core target genes. Microbiotics platform was used for gene ontology（GO） and Kyoto encyclopedia of genes and genomes（KEGG） enrichment analysis and prediction of the mechanism of action of AS-Ⅳ in regulating Pyroptosis to alleviate intestinal IRI. Then C57/BL6J mice were randomly divided into 5 groups normal group， model group（IR）， drug administration group （IR+AS-Ⅳ）， nucleotide-binding oligomerization structural domain-like receptor protein 3 （NLRP3） agonist NSS group （IR+AS-Ⅳ+NSS）， and NLRP3 inhibitor MCC950 group （IR+AS-Ⅳ+MCC950） by using a randomized numerical table method. The intestinal IRI model was established by clamping the superior mesenteric artery for 45 min and resuming perfusion for 2 h in the model group， the drug administration group， the NLRP3 agonist NSS group， and the NLRP3 inhibitor MCC950 group， and the normal group was only separated from the vessels without clamping. The administration group， the NLRP3 agonist NSS group， and the NLRP3 inhibitor MCC950 group were gavaged with astragaloside dissolved in 0.1% dimethylsulfoxide （50 mg·kg^-1） for 3 consecutive days before modeling， with the last gavage 2 h before modeling， and the remaining two groups were gavaged with equal amounts of saline. The NLRP3 agonist NSS group was injected intraperitoneally with 4 mg·kg^-1 of NSS 1 h before modeling， and the NLRP3 inhibitor MCC950 group was injected intraperitoneally with 10 mg·kg^-1 of MCC950 1 h before modeling.The mice were put to death by reperfusion for 2 h， and intestinal tissues were obtained. The levels of IL-18 and IL-1β were detected by enzyme linked immunosorbent assay（ELISA）， and the protein expression of thioredoxin-binding protein （TXNIP）， NLRP3， Caspase-1 and pyrocatechin D （GSDMD） were detected by Western blot， and the pathological changes of intestinal tissues were evaluated by Chiu's score. ResultNetwork pharmacological analysis showed that there were 1599 targets of intestinal IRI， 199 targets of AS-Ⅳ action， 197 targets of pyroptosis， and 20 targets common to all three. There were 10 core targets， including NLRP3， TXNIP， silencing information regulator 1 （SIRT1）， high mobility group protein 1 （HMGB1）， interleukin-18 （IL-18）， GSDMD， and metallo matrix protease-9 （MMP-9），et al. The results of in vivo experiments showed that compared with the normal group， Chiu's score was elevated in the model group， the levels of IL-18，IL-1β inflammatory factors in mouse intestinal tissues were elevated （P<0.05）， and the protein expression levels of TXNIP， NLRP3， Caspase-1， and GSDMD were elevated （P<0.05）. Compared with the model group，Chiu's score was decreased in the administered group and NLRP3 inhibitor MCC950 group，the level of IL-18，IL-1β inflammatory factors in the intestinal tissue of mice was decreased（P<0.05）， and the level of TXNIP，NLRP3，Caspase-1，GSDMD protein expression was decreased（P<0.05）. Compared with the administered group， Chiu's score was elevated in the NLRP3 agonist NSS group， the levels of IL-18， IL-1β inflammatory factors in mouse intestinal tissues were elevated （P<0.05）， and the protein expression levels of NLRP3， Caspase-1， and GSDMD were elevated （P<0.05）. Compared with the NLRP3 inhibitor MCC950 group， the NLRP3 agonist NSS group had elevated Chiu's scores， elevated levels of IL-18，IL-1β inflammatory factors in mouse intestinal tissues （P<0.05）， and elevated levels of TXNIP，NLRP3， Caspase-1， and GSDMD protein expression （P<0.05）. ConclusionNetwork pharmacological predictions were consistent with the results of in vivo experiments， and astragaloside attenuated intestinal ischemia-reperfusion injury by inhibiting cellular pyroptosis through the TXNIP-NLRP3 signaling pathway.