Humans ; Liver Cirrhosis ; Portal Vein ; Venous Thrombosis

[Objective] To evaluate the biomechanical stability of lumbar intact specimen,anterior lumbar interbody fixation(ALIF)specimen,ALIF specimen fixed with pedicle screw and ALIF specimen fixed with translaminar facets screw.[Method]Each of eight adult fresh cadaver specimen of lumbarsacral segmcnts was analyzed in four states(groups):intact,L5S1 ALIF,L5S1 ALIF fixed with pedicle screw or fixed with translaminar facets screw,test and compare its range of motion(ROM)in flexion,extension,lateral bending and axial rotation.[Result]The ROM of ALIF specimen in extension was larger than that of intact specimen(P

Objective To study the relationship between the neovascula rization of carotid atherosclerotic plaques with real-time contrast-enhanced ultrasonography(CEUS),plasma myeloperoxidase (MPO)concentration and cerebral infarction.Methods Seventy-three cases with eighty-nine carotid atherosclerotic plaques were examined with real-time CEUS.According to the imaging features,the seventythree cases were divided into three groups:soft plaques group,hard plaques group and mixed plaques group.The differences of the incidence rate of cerebral infarction events,plasma MPO concentration and contrast media persistent enhancement time with real-time CEUS in plaques among the three groups were analyzed.The cerebral infarction events were diagnosed by CT or MRI routinely.Results The incidence rate of cerebral infarction events,plasma MPO concentration and contrast media persistent enhancement time of soft plaques group were significantly higher than that in hard plaques group and mixed plaques group.The risk of cerebral infarction was higher in the patients with elevated level of MPO.It showed positive correlation between the contrast media persistent enhancement time and plasma MPO concentration,and the correlation coefficient was 0.838. Conclusions The type of the plaque is correlated with the neovascularization of plaques and plasma MPO concentration.The study of relationships among them can help to evaluate the plaques,stability thoroughly and guide the clinician to prevent the incidence of cerebral infarction events.

Objective To study the inhibitory effects of δ-opioid receptor activation in serumdeprivation induced apoptosis of human liver cells and the proposed protein kinase C(PKC)pathway mechanism.Methods MTT assay was used to detect the survival rate of human liver cells in vitro and Annexin V-FITC/PI double staining was used to detect the cell apoptosis rate.Flow cytometry was used to analyze cell cycle,RT PCR used to analyze the PKC mRNA and Western Blot analysis was used for detecting the protein expression of PKC and Caspase-3.Results After serum-deprivation for 48h of cultured human liver cells in vitro,significant liver cell apoptosis occurred.The apoptosis was suppressed by δ-opioid receptor activation,which manifested as a slower rate of apoptosis,decreased expression of Caspase-3and increased expression of PKC.After GF109203X was added,the inhibitory effects of DADLE decreased markedly.Conclusion Activation of δ-opioid receptor on the membrane of human liver cells has inhibitory effects on serum-deprivation induced apoptosis of liver cells.The underlying mechanism may be associated with PKC pathway activation.

Objective To observe the effect of progressive resistance exercise combined with alendronate sodium on bone mineral density(BMD)of lumbar spine in patients with postmenopausal osteoporosis.Methods 20 patients with postmenopausal osteoporosis were randomly divided into the A and B group with 10 cases in each group.The cases of the group A were treated with progressive resistance exercises combined with alendronate sodium.Those of the group B only took alendronate sodium orally.The course of two groups was 3 months.BMD of lumbar spine was measured by dual-energy X-ray absorptiometry before and 3 months after treatment.Results Before treatment,BMD of two groups was not different.After 3 months treatment,BMD of lumbar spine were significantly improved in group A(raised 4.520±0.68%)than group B(raised 0.100±0.01%),there was a significant difference between two groups(P<0.01).Conclusion Progressive resistance exercises combined with alendronate is more efficacious than alendronate alone in restoring lumbar spine BMD in patients with postmenopausal osteoporosis.

Objective To construct recombinant adeno-associated virus and lentivirus carrying siRNA of TIMP-1 and to investigate the efficiency of infection and short-term inhibitory effect of TIMP-1 gene expres-sion on rat hepatic stellate cells. Methods One pair of siRNA which could effectively inhibit expression of the TIMP-1 gene in HSC-T6 was screened and cloned into AAV vector and lentiviral vector to construct the recombinant AAV/siRNA-TIMP-1/GFP and Lenti/siRNA-TIMP-1/GFP. AAV/GFP and Lenti/GFP as neg-ative control were also obtained. Experiments were assigned to five groups: AAV/siRNA-TIMP-1/GFP, AAV/GFP, Lenti/siRNA-TIMP-1/GFP, Lenti/GFP group and mock group. Rat HSC-T6 cells were infected by these recombinant viruses at a concentration of MOI by 10. To monitor the efficiency of infection, fluores-cence microscope and flow cytometer were used. After 7 d post-infection, Western blot was used to detect the TIMP-1 protein expression. Results HSC-T6 had no significant changes after infection. The efficiency of infection in AAV/GFP and Lenti/GFP group were 72.7% and 70.0%, AAV/siRNA-TIMP-1/GFP and Lenti/siRNA-TIMP-1/GFP group were 64.58% and 61.86%. The protein expression levels of TIMP-1 in HSC-T6 cells at 7 d post-infection by the recombinant AAV and Lentivirus were decreased 40.0% compared with those in mock control and normal HSC-T6 (P<0.05). Conclusion Recombinant AAV/siRNA-TIMP-1/GFP and Lenti/siRNA-TIMP-1/GFP could effectively infect HSC-T6 with similar efficiency and suppress the expression of TIMP-1 in rat HSC-T6 remarkably.

Objective:To explore the mediating effect of social support on social avoidance and distress and reproductive concerns in young breast cancer patients undergoing chemotherapy.Methods:This is a cross-sectional study. From February 2020 to December 2021, a total of 180 young breast cancer patients undergoing chemotherapy in Shandong Cancer Hospital were selected as the research objects using the convenient sampling method. General Data questionnaire, Social Support Rating Scale, Reproductive Concerns After Cancer Scale (RCAC) and Social Avoidance and Distress Scale (SADS) were used to investigate patients. Pearson correlation analysis was used to investigate the correlation among social support, social avoidance, distress and reproductive concerns in young breast cancer patients undergoing chemotherapy. Structural equation models was used to explore the mediating effect of social support between social avoidance and distress and reproductive concerns. A total of 180 questionnaires were distributed in this study, and 172 were effectively received, with an effective recovery of 95.56% (172/180) .Results:The total score of SADS of young breast cancer patients undergoing chemotherapy was (18.98±3.15), the total score of RCAC was (59.85±5.03), and total score of Social Support Rating Scale was (33.53±4.25). Pearson correlation analysis results showed that social avoidance, distress was positively correlated with reproductive concerns ( r=0.810, P<0.01), and social support was negatively correlated with reproductive concerns and social avoidance and distress ( r=-0.570, -0.612; P<0.01). Structural equation model results showed that social support played a partial mediating role between social avoidance and distress and reproductive concerns. Conclusions:Social support plays a mediating effect between social avoidance and distress and reproductive concerns in young breast cancer patients undergoing chemotherapy. Medical and nursing staff should provide more social support for young breast cancer patients undergoing chemotherapy, reduce reproductive concerns and improve quality of life.

Objective To explore the surgical feasibility and clinical efficacy of one-stage anterior-posterior approaches in treatment of severe fracture and dislocation of lower cervical spine in "beach chair position".Methods Sixteen male cases of severe fracture and dislocation of lower cervical spine and with a mean age of 49.8 years (range,36-78 years) treated surgically from May 2012 to May 2016 were analyzed retrospectively by using case series study.The segment of injury was C4-5 in 4 cases,C5-6 in 7 and C6-7 in 5.The degree of spinal cord injury according to the American Spine injury Association (ASIA) score was Grade A in 4 cases,Grade B in 7 and Grade C in 5.Sub-axial injury classification (SLIC) score was 8 points in 9 cases and 9 points in 7.After a general anesthesia,a ring with a hole was hanged on patient's head before the operation.Then,under the protection of hole traction,the upper of operating bed was swung up slowly,so that the patient was restricted in vertical "beach chair position" with traction on the halo in order to immobilize the head and partially reduce the kyphotic deformity.Routine cervical anterior-posterior approach was done with the exposure of damaged section of the front and rear structure.Pedicle screw system or lateral mass screw displacement was conducted.Anterior intervertebral discectomy or fracture vertebral was performed,using collaborative reset prying method before and after the road.In the front of intervertebral cage or titanium net support bone graft,rear pedicle screws or lateral mass screws fixation and bone graft fusion were implemented.The operation time and blood loss were recorded.The healing of the wound was observed.The recovery of neurological function was evaluated according to the ASIA grade.Postoperative review X-ray,CT and MRI were done to evaluate the reset and bone graft in position and fusion.Results All the surgeries were done well without aeroembolism and other related complications.The mean operative time was 153 minutes (range,150-180 minutes),and the mean amount of blood loss was 543 ml (range,400-800 ml).Sixteen cases were followed-up from 6 to 24 months (mean 13.7 months).All the incision were healed at Ⅰ stage.Spinal cord function did not aggravate.The ASIA grade was improved with an average of one to two Grades 6 months after surgery.Postoperative X-ray and CT confirmed that graft object position was favorable and cervical sequence was recovered well.The Cobb angle decreased from (23.6 ± 5.3) ° preoperatively to (4.0 ± 0.4)°postoperatively,and the translational displacement of vertebral body was restored into (2.7 ±0.4) mm (P ＜ 0.01) from (10.9 ± 1.6) mm before operation.The cervical spinal canal was not obstructed and the cervical spinal cord was relieved,showed by MRI.Conclusions One-stage anterior-posterior approaches for severe fracture and dislocation of lower cervical spine circumferential reconstruction in "beach chair position" is a beneficial and effective method,without the need of changing positions in a collaborative reduction and fixation.The method can reduce the interference of spinal cord,shorten the operation time and save anterior extra fixation.

Objective:To identify the risk factors of non-sentinel lymph node (nSLN) metastasis in breast cancer patients with 1~2 positive axillary sentinel lymph node (SLN) and construct an accurate prediction model.Methods:Retrospective chart review was performed in 917 breast cancer patients who underwent surgery treatment between 2002 and 2017 and pathologically confirmed 1-2 positive SLNs. According to the date of surgery, patients were divided into training group (497 cases) and validation group (420 cases). A nomogram was built to predict nSLN metastasis and the accuracy of the model was validated.Results:Among the 917 patients, 251 (27.4%) had nSLN metastasis. Univariate analysis showed tumor grade, lymphovascular invasion (LVI), extra-capsular extension (ECE), the number of positive and negative SLN and macro-metastasis of SLN were associated with nSLN metastasis (all P<0.05). Multivariate Logistic regression analysis showed the numbers of positive SLN, negative SLN and macro-metastasis of SLN were independent predictors of nSLN metastasis (all P<0.05). A nomogram was constructed based on the 6 factors. The area under the receiver operating characteristic curve was 0.718 for the training group and 0.742 for the validation group. Conclusion:We have developed a nomogram that uses 6 risk factors commonly available to accurately estimate the likelihood of nSLN metastasis for individual patient, which might be helpful for radiation oncologists to make a decision on regional nodal irradiation.