Lymph node dissection was the key procedure of pancreatic surgery.The majority of guidelines indicated that extended lymph node dissection was helpless for improving survival rate.However,there were still quite a few researches which demonstrated that the extended dissection was a valuable procedure.It was still a controversial topic considering lymph node dissection.To review the shortcomings of previous randomized controlled trials (RCT),this article combined the experience of new techniques in pancreatic surgery,which are developing rapidly in recent years,and our theory and practice of radical resection of retroperitoneal lipo-lymphatic layer (RRRLLL).Therefore,the controversy and update of extended lymph node dissection for pancreatic head carcinoma were discussed,which could provide references for standardizing the treatment of extended lymph node dissection in clinical practice.

OBJECTIVETo investigate the synergistic effect of transforming growth factor-beta1 (TGF-beta1) and platelet-derived growth factor-BB (PDGF-BB) on the expression of integrin beta3, in periodontal membrane of rat orthodontic tooth.

METHODSAn orthodontic tooth movement model was established. Up to 32 experimental rats were randomly divided into four groups according to a random number table. The four groups were injected with 1% PBS, TGF-beta1 (5 ng), PDGF-BB (10 ng), and combined TGF-beta1 (5 ng) and PDGF-BB (10 ng) in the buccal submucosal, respectively. The volume injected in each group was 0.1 mL. The animals were then sacrificed on the 10th day. The left maxillary first molar and periodontal tissue were taken. Different expressions of integrin beta3 were detected in periodontal tissues through immunohistochemistry. Mean optical density (OD) values of the positive fields were examined. The data obtained were analyzed through ANOVA. The data followed normal distribution, and were compared via t-test.

RESULTSCompared with the control groups, the expression of integrin beta3 was higher in the experimental groupin tension sides (P < 0.01). Significant differences in tension sides between the single-injection groups and the combined group were observed (P < 0.01). Compared with the control groups, the expression of integrin beta3 was higher in the experimental group in compression sides (P < 0.05). In addition, there was no significant differences in compression sides between the single-injection groups and the combined group (P > 0.05).

CONCLUSIONIn terms of local regulatory factors, TGF-beta1 combined with PDGF-BB enhance the expression of integrin beta3 in the periodontal membrane and accelerate periodontal remodeling. The synergistic effect of the two growth factors is better than the single growth factor.

Animals ; Integrin beta3 ; Molar ; Periodontal Ligament ; Platelet-Derived Growth Factor ; Proto-Oncogene Proteins c-sis ; Rats ; Tooth Movement Techniques ; Transforming Growth Factor beta1

Objective:To study the effects of recombinant human platelet-derived growth factor-BB(rhPDGF-BB)combined with recombinant human transforming growth factor-β1 (rhTGF-β1 )on the expression of FAK mRNA of osteoclasts in the alveolar bone on the pressure side of orthodontic teeth in rats.Methods:Orthodontic tooth movement model was established in 160 male SD rats.The rats in experimental group were treated by injection of 10 ng rhPDGF-BB and 5 ng rhTGF-β1 in the buccal submucosal area of the mo-lar every other day from day 1 afterburner,while those in control group received equivalent volumes of PBS.The rats were sacrificed at 1,4,7,10 and 14 days(n=16)after appliance placement.Specimens were collected.Osteoclasts in the alveolar bone on the pres-sure side of the orthodontic teeth were observed by TRAP staining,the FAK mRNA expression was quantified by quantitative RT-PCR.Results:rhPDGF-BB combined with rhTGF-β1 significantly promoted an increasing number of osteoclasts on the compressing side(P<0.05),increased the expression of FAK mRNA at day 4 and 7(P<0.05),then decresed it to the control level(P>0.05) at day 14.Conclusion:Combination of rhPDGF-BB and rhTGF-β1 can increase the number of osteoclasts in the alveolar bone on compressing side,and promote FAK mRNA expression in osteoclasts.

AIM:Toinvestigatetheeffectofrhynchophylline(Rhy)onbloodpressure,cardiachypertrophy and myocardial fibrosis in spontaneously hypertensive rats ( SHR) .METHODS:Spontaneously hypertensive rats were ran-domly divided into model group , high dose (10 mg? kg-1? d-1 ) and low dose (2.5 mg? kg-1? d-1 ) group of rhyncho-phylline, captopril group (17.5 mg? kg -1? d-1).Wistar-Kyoto rats were used as normal control.Respectively, systolic blood pressure was measured by tail cuff every 2 weeks.After 10 weeks, heart weight index and left ventricular weight in-dex were calculated .The myocardial hydroxyproline and plasma angiotensin Ⅱwere detected .Moreover , basic myocardial histopathological changes and myocardial collagen fibres were observed by HE staining and Masson staining , respectively . The protein expression of TGF-β1 and Smad3 in the myocardium was measured by the methods of immunohistochemistry and Western blot .RESULTS:Compared with SHR model group , Rhy significantly reduced blood pressure ( P<0.05 ) , the levels of HYP in the myocardium (P<0.05) and the levels of AngⅡin the plasma (P<0.01).The pathological dama-ges of the myocardial tissues and collagen deposition were attenuated .The protein expression of TGF-β1 and Smad3 was sig-nificantly reduced by the treatment with Rhy (P<0.01).CONCLUSION:Rhynchophylline reduces blood pressure and adjusts to improve ventricular remodeling of SHR .The mechanism may be involved in the TGF-β1/Smad pathway and re-ducing AngⅡcontent.

Objective:To evaluate the value of radiomics in predicting the efficacy of non-operative treatment of esophageal cancer by meta-analysis.Methods:Search terms included "Esophageal Neoplasms", "Esophageal Neoplasms", "Neoplasm, Esophageal", "Esophagus Neoplasm", "Esophagus Neoplasm", "Neoplasm, Esophagus", "Neoplasms, Esophagus", "Neoplasms, Esophageal", "Cancer of Esophagus", "Cancer of the Esophagus", "Esophagus Cancer", "Cancer, Esophagus", "Cancers, Esophagus", "Esophagus Cancers", "Esophageal Cancer", "Cancer, Esophageal", "Cancers, Esophageal", "Esophageal Cancers" and "radiomics", "radiomics features", "radiomic", "texture", "texture analysis", "textural analysis", "histogram", "machine learning", "artificial intelligence", both in English and corresponding Chinese. The Chinese and English literatures related to radiomics prediction of the efficacy of non-surgical treatment of esophageal cancer published in PubMed, Web of Science, Embase, China National Knowledge Internet, Wanfang Medical Online and VIP Chinese Journal Service Platform from the establishment of the database to November 2022 were searched, and screening, quality evaluation and data extraction were carried out. Meta analysis was performed by using Stata 15.1, Meta-disc 1.4 and Review Manager 5.3 software.Results:Seventeen literatures of Chinese and English with 1389 patients with esophageal cancer who received non-surgical treatment were included. There was no significant threshold effect in predicting the effect of non-operative treatment of esophageal cancer by radiomics ( r=0.103, P=0.694), and there was high heterogeneity ( I2>50%). The combined sensitivity of all included literatures was 0.86 (95% CI: 0.81-0.89), specificity was 0.81 (95% CI: 0.76-0.85), positive likelihood ratio was 4.4 (95% CI: 3.5-5.6), and negative likelihood ratio was 0.18 (95% CI: 0.13-0.24). The diagnostic odds ratio was 25 (95% CI: 16-39) and the AUC was 0.90 (95% CI: 0.87-0.92). Conclusions:Radiomics can better predict the efficacy of non-surgical treatment of esophageal cancer, MRI and PET/CT radiomics has higher accuracy in predicting the efficacy of esophageal cancer, and machine learning can also improve the accuracy of prediction. It is helpful to make individualized treatment plan and improve the efficiency of treatment by effectively predicting the curative effect of patients with esophageal cancer before treatment.

OBJECTIVETo investigate the combined effects of platelet-derived growth factor-BB (PDGF-BB) and insulin-like growth factor-I (IGF-I) on the expression of integrin (beta3 protein in the periodontal tissues of the compressing side of orthodontic tooth in rats.

METHODSEstablishing orthodontic movement model in Sprague-Dawley rats, which were injected with 10 ng PDGF-BB, 200 ng IGF-I alone or in combination in the buccal submucosal area of the orthodontic tooth. The injection was applied every other day. The experiment continued for ten days and then the rats were sacrificed. The expression of integrin (beta3 protein in periodontal ligament tissues of the compressing side was detected by immunohistochemical techniques.

RESULTSThe expression of integrin (beta3 protein in periodontal ligament tissues of the compressing side of each experimental group was significantly increased compared with that of the control group (P<0.01). Meanwhile the maximum mean optical density value of integrin (beta3 protein expression was attained in the combination group which showed a significant increase compared with the PDGF-BB group (P<0.05) and the IGF-I group (P<0.01).

CONCLUSIONThe combination of exogenous PDGF-BB and IGF- I in orthodontic tooth movement may enhance the expression of integrin (beta3 protein in periodontal ligament cells and PDGF-BB and IGF-I may have a synergistic effect during orthodontic tooth movement.

Animals ; Cells, Cultured ; Fibroblasts ; Insulin-Like Growth Factor I ; Integrins ; Periodontal Ligament ; Platelet-Derived Growth Factor ; Proto-Oncogene Proteins c-sis ; Rats ; Rats, Sprague-Dawley ; Somatomedins ; Tooth Movement Techniques

Objective To analyze the application of multi‐slice spiral CT and 3D airway reconstruction technique on obstruc‐tive sleep apnea syndrome (OSAS) of pharyngeal soft tissue and upper airway stenosis .Methods Selected 92 patients with OSAS in our hospital as the observation group and another 92 healthy persons were selected as control group ,all patients achieved multi‐slice CT and 3D airway reconstruction technical inspections ,counted and compared their pharyngeal soft tissue and upper airway stenosis .Results Airway stenosis of tongue back ,and hypopharynx retro‐palatal of control group were more narrow compared with the control group(P<0 .05);the observation group′s pharyngeal soft tissue was more thick than the control group ,so as the length and width(P< 0 .05) .Conclusion Multi‐slice spiral CT and 3D airway reconstruction technique can effectively share pharyngeal soft tissue and upper airway stenosis of patients with OSAS .

Objective To evaluate the effects of different depths of sedation on postoperative cognitive function in elderly patients with mild cognitive impairment.Methods A total of 100 patients with mild cognitive impairment before surgery,aged 65-75 yr,weighing 55-75 kg,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,scheduled for elective gynecological surgery under general anesthesia,were divided into Ⅰ and Ⅱ groups (n =50 each) using a random number table method.Propofol was given by closed-loop target-controlled infusion,and the target plasma concentration was automatically regulated.The bispectral index value was maintained at 40-50 in group Ⅰ and at＞50-60 in group Ⅱ.Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were used to evaluate the cognitive function at 1 day before operation (T0) and 7 days after operation (T1),and the development of postoperative cognitive dysfunction (POCD) was recorded.Venous blood samples were collected at T0 and T1 for determination of the concentrations of serum interleukin-10 (IL-10) and tumor necrosis factor-alpha (TNF-α) by enzyme-linked immunosorbent assay.Results Compared with the baseline value at T0,MoCA and MMSE scores were significantly decreased at T1,and the serum concentrations of IL-10 and TNF-α were increased in both groups (P＜0.05).Compared with group Ⅰ,MoCA and MMSE scores were significantly decreased at T1,and the incidence of POCD was increased,the serum concentration of TNF-α was increased,and the serum concentration of IL-t0 was decreased in group Ⅱ (P ＜ 0.05).Conclusion Maintaining BIS value at 40-50 during operation can decrease the development of POCD in elderly patients with mild cognitive impairment,which may be related to reduced systemic inflammatory responses.

Objective: To examine mental health problems among adolescents in Taiyuan City and its relationship to chronotype, so as to give a scientific basis for supporting mental health of middle school students. Methods: From October to November 2021, a total of 2 621 pupils were enrolled from three junior high schools and two senior high schools in Taiyuan by using a multi stage stratified cluster random sampling method to investigate demographic characteristics, mental health status, and chronotype. Chi squared test, Spearman correlation analysis and Logistic regression were used to analyze the relationship between sleep patterns and mental health problems in middle school students. Results: The proportion of morning, intermediate and evening types of middle school students sleep were 17.9%, 65.6%, and 16.4%, respectively. The overall detection rate of mental health problems was 13.8 %, which was statistically significant among middle school students in different grades, self perceived family economic status, the number of friends and sleep patterns ( χ 2=42.69, 29.15, 46.02, 93.99, P <0.05). After adjusting for grade, self perceived family economic status and the number of friends, Logistic regression analysis revealed that mental health problems were positively associated with evening type ( OR =2.84) and negatively associated with morning type ( OR =0.61)( P ＜0.05). Conclusion Chronotype is associated with mental health problems among middle school students, with a higher risk for evening type and a lower risk for morning type. Mental health of middle school students can be enhanced by changing their chronotype.

Objective To explore the characters of lower urinary tract symptoms (LUTS) in patients with Parkinson's Disease (PD).Methods From Oct 2013 to Jun 2016,after evaluating of movement disorder by modified Hoehn-Yahr(H-Y) scale and LUTS by international prostate symptom score (IPSS),urodynamic study was performed in PD patients with LUTS.The incidence of every symptom of LUTS,the relationships between the IPSS categories and urodynamic study were analyzed.Results 64 patients (containing 26 male and 38 female) with 40-80 (62.7 ± 10.2) years old were included.2,4,30,19,12 and 6 patients were belonged to modified H-Y scale 1-4,respectively.Frequency (50 patients,78.1％) was the most common LUTS,while frequency all day (20 patients,31.3％) was the most common symptom for the most severe LUTS.IPSS was 1 7.5 ± 7.8 (4-35) and quality of life was 5.1 ± 0.6 (4-6) for the patients.There was no significant correlation between modified H-Y scale and IPSS (P ＞ 0.05).According to the criteria of IPSS,28 patients (43.8％) only had irritative symptoms,3 patients (4.7％) only had obstructive symptoms,while 26 patients (40.6％) had mixed symptoms and 7 patients (10.9％) belonged to no one.Urodynamic study showed 11 patients (39.3％) with only irritative symptoms had detrusor overactivity(DO),6 patients (23.1％) with mixed symptoms had DO + bladder outlet obstruction (BOO) or DO + detrusor underactivity,however,there was no one with BOO in the three patients with only obstructive symptoms.Conclusion Frequency was the most common LUTS,while frequency all day was the most common symptom for the most severe LUTS in PD patients.Irritative and mixed symptoms were common in PD patients with LUTS,but the urodynamic results were not consistent with the category of LUTS in most of the patients.LUTS severity was not correlated with movement disorders in PD patients.