Objective:To explore the hemodynamic effect of the modified Z Trendelenburg position in patients undergoing laparoscopic radical surgery of endometrial carcinoma, to provide a reference for the selection of the operative position of patients.Methods:A total of 80 patients who undergoing laparoscopic radical surgery of endometrial carcinoma from April 2017 to April 2019 in the Central Hospital of Xiangyang were recruited and assigned to experiment group and control group by random digits table method with 40 cases in each group. Patients in the experiment group were positioned in modified Z Trendelenburg position, while the patients in the control group were placed in conventional Trendelenburg position. The data of heart rate, mean arterial pressure, central venous pressure, systemic circulation resistance, cardiac output were recorded at 10 minutes before pneumoperitoneum (T 0), pneumoperitoneum immediately (T 1) and 5 minutes (T 2), 10 minutes (T 3), 30 minutes (T 4), 60 minutes (T 5) after pneumoperitoneum and 1 minute after recover horizontal position (T 6). Followed up investigation at 24 h after surgery, the degree of pain in the shoulder and the lower limbs were also recorded by Visual Analogue Scale(VAS). Results:The differences of heart rate, mean arterial pressure, systemic circulation resistance and cardiac output between the two groups had no statistical significance at T 0 to T 6 (all P>0.05). The central venous pressure were (9.86±1.95), (10.94±1.53), (11.33±2.24), (11.14±1.54),(7.75±1.59) cmH 2O(1 cmH 2O=0.098 kPa) respectively from T 2 to T 6 in the experiment group, lower than that of control group (18.83±2.82), (16.81±2.93), (16.27±3.56), (15.76±2.33), (8.92±1.68) cmH 2O at the same time, the differences were statically significant ( t values were 3.057-15.736, all P<0.05). The VAS scores of shoulder pain and low leg pain in experiment group were (3.48±1.10), (2.35±0.66) points, lower than that of control group (4.16±1.32), (2.99±1.02) points, the differences were statically significant ( t values were 2.404, 3.228, P<0.05). Conclusions:Modified Z Trendelenburg position can maintain the circulatory system hemodynamic stability, reduce the degree of shoulder pain and low leg pain after surgery in the laparoscopic radical resection for endometrial carcinoma patients.

Objective:To investigate the reasonable approach and surgical indication for acute necrotizing pancreatitis(ANP)by analyzing the factors that affecting the mortality of ANP.Methods:One hundred and twelve patients with ANP were retrospectively divided into two groups-the dead and the survivors.Some parameters were analyzed statistically to reveal what's the reason for death.Results:The average age,sex ratio and onset of illness were similar between two groups.And the ratio of early shock,early adult respiratory distress syndrome (ARDS),high temperature,leukocytosis and high blood glucose between two groups were also similar between two groups(P＞0.05,respectively).The important factors that affecting the mortality were:①severity of pancreatic necrosis,②improper surgical approach,③incorrect surgical indication.Conclusion:The patiets with mild or moderate ANP should mainly receive conservative treatment for 48～72 hours.The early shock and ARDS should be redressed before surgical intervention.If the operation is unavoidable,the swelling pancreas should be dissected fully,which will provide sufficient drainage after operation,and duodenostomy should be performed during operation.

BACKGROUND:As the main function cel of intervertebral disc, nucleus pulposus cel s are the focus of studying the degenerative mechanism;thereby, it is crucial to maintaining the physiological function of nucleus pulposus cel s in vitro and the stability of the cel phenotype.
OBJECTIVE:To study the excel ence of differential velocity adherent procedure in primary culture of nucleus pulposus cel s of rat intervertebral disc through comparison.
METHODS:Twenty male Wistar rats aged 4 weeks were enrol ed, and then nucleus pulposus cel s of intervertebral disc were isolated and cultured in vitro;cel passage culture was performed in different groups when the primary cel s were merged to 90%. Differential velocity adherent group cel s adhered for 30 minutes, and non-adherent cel s were aspirated and transferred to new culture dish after readjusting the concentration;the controls received no intervention. Passages 1 and 2 cel s in the differential velocity adherent group were isolated and purified by the same procedure. The morphology of three generations of cel s in the two groups was compared, the purity of the identification was detected by immunohistochemistry, the cel viability was detected by cel counting kit-8 and the cel growth curve was drawn.
RESULTS AND CONCLUSION:Inverted phase contrast microscope and hematoxylin-eosin staining revealed that the cel homogeneity of the differential velocity adherent group was significantly higher than that of the control group, and there were more kinds of fibroblast-like cel s in nucleus pulposus cel s in the control group. Identification and purity analysis of col agen type II showed that the cytoplasm of two groups were both stained brown, indicating that they were the nucleus pulposus chrondrocytes. The positive rate of differential velocity adherent group was significantly higher than that of the control group (P<0.05). The cel growth curve of cel counting kit-8 showed cel s in the two groups al passed by the latency phase within 2 days, then to the logarithmic phase of 3 days, and entered the lag phase, while the growth rate of the control group was more rapid during the latency and the early logarithmic phases. These findings suggest that differential velocity adherence method is a practical and effective procedure for the isolation and purification of primary cultured rat nucleus pulposus cel s. Through the primary culture, twice differential velocity adherence procedure, the passage 3 rat nucleus pulposus cel s are metabolic exuberant, consistent with the phenotype, the cel purity is higher, and the logarithmic growth phase can be used as the optimal time for studying the mechanism of intervertebral disc cel s.

Objective To investigate the role of substance P (SP) and its neurokinin-1 receptor (NK-1R) in the pathophysiologic process of Crohn′s disease. Methods In 23 surgical patients of Crohn′s disease and 24 healthy controls, reverse transcription polymerase chain reaction (RT-PCR) was used to determine the mRNA expression of NK-1R, Western blot analysis was used to determine NK-1R protein expression levels, and immunohistochemistry was used to localize expression of NK-1R. Results Compared with normal gut NK-1R mRNA and NK-1R protein in Crohn′s disease were overexpressed. In Crohn′s disease moderate to strong intestinal NK-1R immunoreactivity was found in the lamina propria mononuclear cells, lymphoid follicles, and the surface and crypt epithelium, lymphoid follicles, submucosal vessels, smooth muscle and myoenteric plexus neurones. Conclusions In cases of Crohn′s disease, overexpression of NK-1R may disturb neuropeptides loop balance, and may be involved in the pathophysiological change in this disease.

AIM: To study the expression and the role of neurokinin-1 receptor(NK-1R) and neurokinin-2 receptor (NK-2R) in distal ileum during acute necrotizing pancreatitis(ANP).METHODS: 130 adult Sprague-Dawley rats were divided into 2 groups: the rats in ANP group( n=80 ) were induced by the retrograde intraductal infusion of 5% sodium taurocholate. The rats in sham operation control group ( n=50 ) received laparotomy only. Reverse transcription polymerase chain reaction (RT-PCR) was used to determine the mRNA expression of NK-1R and NK-2R, Western blot was used to investigate expression level of NK-1R.RESULTS: NK-1R and NK-2R mRNA levels were enhanced in the distal ileum of ANP rats compared with controls. Western blot revealed stronger NK-1R immunoreactivity exited in intestinal mucosa in ANP rats. The overexpression of NK-1R was associated with mucosal pathological score( r=0.77,P

AIM: To investigate the expression of neurok inin-2 receptor (NK-2R) in normal pancreas and chronic pancreatitis (CP) tissues. The relation of expres sion of NK-2R with pain in CP was also evaluated. METHODS: CP tis sues were ob tained from 18 men and 7 women undergoing pancreatic head resection as a result of CP. Normal human pancreatic tissues were obtained from 20 patients (11 males/ 9 females). Real-time quantitative reverse transcription polymerase chain reacti on was used to determine the mRNA expression of NK-2R, Western blot analysis was used to determine its protein expression level, and immunohistochemistry was us ed to localize expression site of NK-2R protein. NK-2R mRNA level and pain were also analysed whether correlation exists. RESULTS: NK-2R mRNA and p rotein level were enhanced expressed in CP tissue samples compared with normal pancreas. Ove rexpression of NK-2R was related to the intensity ( r=0 59, P

Objective:To explore the clinical effect of forced-air-warming blanket covering the macroangiopathy of lower limb on hypothemia of patients with radical breast cancer.Methods:A total of 106 radical breast cancer patients from May 2018 to May 2019 in the Central Hospital of Xiangyang City, Hugei Province, were divided into experiment group and control group with 53 cases each, in accordance with the random number table. Forced-air-warming blanket rely on the lower half body, cover a wide range from biliateral iliac spines to feet in the control group, while those cover range from biliateral iliac spines to knee in the experiment group. The nasopharyngeal temperature, heart rate, mean arterial pressure was recorded after the patients into the operation room (T 0), 30 min (T 1), 60 min (T 2), 90 min (T 3), 120 min (T 4) and at when operation was over (T 5). Meanwhile, the changes of coagulation index were compared between groups before and after operation. Results:There was no significant difference in nasopharynx temperature between groups at T 0 and T 1 ( P>0.05). From T 2 to T 5, the nasopharynx temperature was (36.41±0.61), (36.37±0.76), (36.20±0.94), (36.15±1.05) ℃ in the experiment group, and (36.05±0.73), (35.84±0.76), (35.60±0.59), (35.57±0.53) ℃ in the control group, the differences were statistically significant ( t values were 2.762-3.970, P<0.01). However, the level of heart rate, mean arterial pressure was no significant difference between groups at different operation time ( P>0.05). After operation, the thrombin time, activated partial thromboplastin time, prothrombin time, fibrinogen, platelet count was (9.43±1.51) s, (32.49±3.69) s, (13.33±2.23) s, (3.58±0.83) g/L, (199.11±20.31)×10 9/L in the experiment group, and (10.48±1.81) s, (34.36±4.14) s, (15.38±2.43) s, (3.25±0.43) g/L, (176.45±16.41)×10 9/L in the control group, the differences were statistically significant ( t values were 2.445-6.319, P<0.05 or 0.01). Inaddition, blood loss in surgery, the incidence of hypothemia, shivering were (279.56±46.03) ml, 5.66%(3/53), 16.33%(8/53) in the experiment group, and (318.66±74.47) ml, 18.87%(10/53), 33.96%(18/53) in the control group, the differences were statistically significant ( t value was 3.251, χ2 values were 4.296, 4.169, P<0.01 or 0.05). Conclusions:Forced-air-warming blanket covering the macroangiopathy of lower limb can prevent hypothemia and reduce blood loss of patients with radical breast cancer.

Objective To evaluate the treatment efficacy,toxicities and prognostic factors of nasopharyngeal carcinoma ( NPC ) treated with intensity modulated radiation oncology ( IMRT ).Methods Between January 2006 and August 2008,300 patients with pathologically diagnosed NPC from 6 center received IMRT.The number of patients with stage Ⅰ,Ⅱ,Ⅲ and Ⅳa+b disease (UICC/AJCC 2002 staging system) were 6,45,141 and 108,respectively.The prescription doses were as follows:70-74 Gy/30f toplanning target volume of primary nasopharynx tumor ( PTVRλ),68-70 Gy/30f to planning target volume of positive lymphnode (ptvnd),60-64 Gy/30f to higher risk region (PTV1),50-54 Gy/30f to lower risk region (PTV2).Patients with stage Ⅲ and Ⅳa+b disease also received cisplatin-based chemotherapy.Cox method was used for Multivariate analysis.ResultsThe follow-up rate was 99.7％.The 4-year rate of local control,regional control,metastasis-free survival (DMFS),disease-free survival (DFS) and overall survival (OS) was 94.0％,95.5％,87.4％,80.8％,86.1％,respectively.Mucositis was the most severe acute toxicity,with 18.0％grade 1,48.7％grade 2,33.3％grade 3.No patient suffered from grade 4mucositis.Xerostomia was the most common late toxicity,with 12.0％ grade 0,75.7％ grade 1,12.3％grade 2.No grade 3-4 xerostomia was observed.There were 18,15 and 42 patients failed in local,regional and distant metastasis,respectively.Multivariate analysis showed that N stage was the only prognostic factor for OS (x2 =5.17,P=0.023),DMFS (x2 =6.91,P=0.009) and DFS (x2 =8.15,P=0.004) in these patients.ConclusionsIMRT can improve the treatment efficacy of NPC.The acute and late toxicities were tolerated.Distant metastasis becomes the main treatment failure.N stage is a significant prognostic factors.

Objective:To assess the clinical effectiveness and safety of Runing granule for hyperplasia of mammary gland.Methods:The databases such as the CNKI, Wanfang Data, VIP, CBM, Cochrane Library, Embase, PubMed and Web of Science are searched from the date of their establishment to June 2020. The main outcome measures were effective rate and incidence of adverse events. All randomized control trial (RCT) about the clinical effectiveness and safety of Runing granule single (single group) or combined with other treatment (combined group)/ other treatment (control group) for hyperplasia of mammary gland were included. Endnote software was used to manage literature, Excel software was used to extract data, quality assessment was conducted according to the methods of Cochrane Reviewers′ Handbook 5.1 recommend by the Cochrane Collaboration and Revman 5.3 software was used to perform Meta-analysis.Results:Twelve RCT were included with total 2 447 patients. In terms of efficiency, Meta-analysis showed single group was better than control group ( RR=1.17, 95% CI: 1.00-1.36, P=0.04), combined group was better than control group ( RR=1.35, 95% CI: 1.10-1.67, P=0.005). In terms of adverse event rate, single group was lower than control group ( RR=0.18, 95% CI: 0.09-0.34, P<0.01), combined group was better than control group( RR=0.33, 95% CI: 0.20-0.56, P<0.01). Conclusion:The usage of Runing granule single or combined with other treatment in the treatment of hyperplasia of mammary gland is more effective and the adverse reaction is lower.

Genetic and epigenetic alterations accumulate in the process of hepatocellular carcinogenesis, but the role of genomic spatial organization in HCC is still unknown. Here, we performed in situ Hi-C in HCC cell line PLC/PRF/5 compared with normal liver cell line L02, together with RNA-seq and ChIP-seq of SMC3/CTCF/H3K27ac. The results indicate that there were significant compartment switching, TAD shifting and loop pattern altering in PLC/PRF/5. These spatial changes are correlated with abnormal gene expression and more opening promoter regions of the HCC cell line. Thus, the 3D genome organization alterations in PLC/PRF/5 are important in epigenetic mechanisms of HCC tumorigenesis.
Carcinoma, Hepatocellular/genetics* ; Cell Line ; Cell Line, Tumor ; Genomics ; Humans ; Liver Neoplasms/genetics*