Objective To observe the effect of hyperglycemia on intracranial pressure (ICP) and neurological outcome following severe brain injury. Methods A retrospective review was done on 79 cases with severe traumatic brain injury (with no history of diabetes or important extracranial complications) who underwent craniotomy for evacuation of intracranial hematoma and were divided into two groups based on Glasgow outcome scales (GOS) score, ie, favorable group with GOS of 5 or 4 and unfavorable group with GOS less than 3. Statistical analysis of data was accomplished by using SPSS 11.5 software. The outcome was assessed at the 6th month after injury. Results A significant correlation was found between ICP levels and admission or postoperative glucose values. The unfavorable group had significantly higher glucose levels both on admission and after operation compared with the favorable group, with statistical difference (P

Objective:To analyze the effect of anticoagulant or antiplatelet drugs on bleeding and cardio-cerebral vascular events in perioperative period of catherization for peritoneal dialysis.Methods:The clinical data of patients undergoing peritoneal dialysis catheterization in Peking University Third Hospital from July 1, 2010 to December 31, 2020 were collected and analyzed retrospectively. The patients were divided into drugs discontinuation group and drugs continuation group according to whether the anticoagulant drugs or antiplatelet drugs were discontinued or not. Baseline clinical data and bleeding and cardio-cerebral events after surgery were compared between the two groups. Multivariate logistic regression model was used to analyze the influencing factors for bleeding and cardio-cerebral events.Results:A total of 57 patients were included in the study, with 34 males and 23 females. The age was (67.37±13.93) years old (range from 27 to 97 years old). There were 37 patients in drugs discontinuation group and 20 patients in drugs continuation group. The proportions of acute myocardial infarction events in drugs continuation group were higher than those in drugs discontinuation group in 3 months and 6 months before surgery (10/20 vs 3/37, χ2=10.671, P=0.001; 11/20 vs 3/37, χ2=12.980, P<0.001 respectively). The median drugs discontinuation time was 5.0(2.0, 14.0) d (range from 1 to 30 d) before surgery, and median restore medication time was 4.0(3.0, 7.0) d (range from 1 to 14 d) after surgery in drugs discontinuation group. There was no significant difference in the proportion of bleeding (10/37 vs 8/20, χ2=1.011, P=0.315) and cardio-cerebral events (4/37 vs 0/20, χ2=0.964, P=0.326) between drugs discontinuation group and drugs continuation group within 2 weeks after surgery. The results of multivariate logistic regression analysis showed that drugs discontinuation before surgery was not an independent influencing factor for bleeding events ( OR=0.656, 95% CI 0.195-2.206, P=0.496), however combination of aspirin and clopidogrel before surgery was an independent influencing factor for bleeding events ( OR=4.038, 95% CI 1.044-15.626, P=0.043). All cardio-cerebral events (4 cases) happened in drugs discontinuation group, and myocardial angina in 6 months before surgery ( OR=9.764, 95% CI 0.928-102.682, P=0.058) and increased serum calcium concentration ( OR=1.491, 95% CI 0.976-2.278, P=0.065) were related with an elevated trend for cardio-cerebral events. Conclusions:Whether anticoagulant or antiplatelet drugs are discontinued before catherization surgery for peritoneal dialysis is not an independent influencing factor for bleeding events after surgery. The risk of postoperative bleeding in patients using combination of aspirin and clopidogrel should be paid attention. Myocardial angina in 6 months before surgery and higher serum calcium are related with an elevated trend for cardio-cerebral events after drugs discontinuation.

Objective: To compare the safety and efficacy of the retrograde and the antegrade techniques in laparoscopic left hemihepatectomy. Methods: Of the 65 patients who underwent laparoscopic left hemihepatectomy between January 2016 to June 2018 at the Ningbo Li Huili Hospital of Medical Center, retrograde left hemihepatectomy was carried out in 31 patients, and antegrade left hemihepatectomy in 34 patients. The perioperative data, duration of operation, intraoperative blood loss, postoperative complications (including major bleeding, abdominal abscess and bile leakage), and post-operative hospital stay were retrospectively compared between the two groups. Results: There were no significant differences in the perioperative general status between the two groups (P>0.05). Both the duration of operation [(121.5±22.1) min vs. (190.9±48.9) min, P<0.05] and the amount of blood loss [(118.9±84.1) ml vs. (195.2±85.4) ml, P<0.05] were significantly less in the retrograde than the antegrade group. There were no statistical differences in the incidences of major complications such as post-hepatectomy hemorrhage, abdominal abscess, or bile leakage, and in the postoperative hospital stay [(10.0±2.8) d vs. (12.2±3.4) d, P>0.05]. Conclusions Occlusion of hepatic vascular inflow and outflow combined with retrograde left hemihepatectomy was safe and feasibly. The retrograde approach was superior to the antegrade approach in laparoscopic left hemihepatectomy.

In this paper, experiments were designed for inducing neutral, terrified, excited, annoying emotions, and also low, middle, high, three levels of tension emotions of stress state, respectively. Based on the multi physiological signals generated by the subjects in emotions, such as heart rate and respiration rate and so on, we extracted features from these data which had been eliminated the baseline. Then the Particle Swarm Optimization method was adopted to optimize the features selection from the features of multi physiological signals, and combined with k-Nearest Neighbor algorithm, different emotions and varying degree tensions were classified. The result shows that the classification accuracy of the kNN method with SPO and baseline eliminated is better than the traditional kNN method.
Algorithms ; Behavioral Research ; instrumentation ; methods ; Emotions ; Humans ; Stress, Psychological

Objective To observe the expression level of PRMT5 in gastric cancer cells, and explore the effect of knocking down the expression level of PRMT5 on the biological behavior of gastric cancer cells. Methods Western blot was used to detect the expression of PRMT5 protein in gastric cancer cell lines MGC803, SGC7901, MKN45 and human gastric epithelial cells GES-1. siRNA1 and siRNA2 plasmids were transfected to knock down the expression of PRMT5. Cell proliferation and apoptosis assay, transwell assay were used to detect cell proliferation, apoptosis and invasion abilities, respectively. The protein expression levels of β-catenin, cyclin D1 and Bax were detected. Results Compared with GES-1 cells, PRMT5 protein expression levels increased in MGC803, SGC7901 and MKN45 cells (P < 0.001). After knocking down the expression of PRMT5, the cell proliferation and invasion abilities were weakened, the apoptosis rate increased (P < 0.05), the expression of β-catenin and Cyclin D1 protein decreased, and the expression of Bax protein increased (P < 0.001). Conclusion The expression level of PRMT5 is increased in gastric cancer cells. Knockdown of PRMT5 expression level could inhibit cell proliferation, invasion and promote cell apoptosis via reducing Wnt/β-catenin signaling pathway.

Background::Sirtuin-3 (Sirt3) has been documented to protect against mitochondrial dysfunction and apoptosis. Honokiol (HKL) is a Sirt3 pharmacological activator with reported neuroprotective effects in multiple neurological disorders. The present study aimed to explore the neuroprotective effects of HKL and the role of Sirt3 following intracerebral hemorrhage (ICH).Methods::An in vivo ICH model in rats was established by injecting autologous blood into the right basal ganglia. PC12 cells were stimulated with hemin. For the in vivo investigation, the modified Neurological Severity Scores and the Morris water maze test were performed to assess neurological deficits. Hematoxylin-Eosin and Terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling staining were employed to evaluate the histopathology and apoptosis. Immunohistochemical staining was used to investigate the expression of Sirt3. Adenosine triphosphate (ATP) levels were quantified to assess mitochondrial dysfunction. Cell counting kit-8, lactate dehydrogenase assay, and flow cytometry were used to analyze cell vitality and apoptosis in vitro. Immunofluorescence staining was performed to observe mitochondrial morphology and dynamin-related protein 1 (Drp1) localization to mitochondria. Western blot was applied to quantify the expression of Sirt3, Bax, Bcl-2, cleaved-caspase-3, Drp1, phosphorylation of Drp1 at serine-616, and phosphorylation of Drp1 at serine-637 in vivo and in vitro.Results::HKL treatment alleviated neurological deficits, attenuated the histopathological damage and cell apoptosis, and restored the decreased ATP levels in ICH rats. HKL improved cell survival rate, reduced cell apoptosis, and inhibited mitochondrial fission in PC12 cells. Moreover, both in vivo and in vitro models showed increased phosphorylation of Drp1 at Ser616, and reduced phosphorylation of Drp1 at Ser637. Meanwhile, immunofluorescence co-localization analysis revealed that hemin increased the overlap of Drp1 and mitochondria in PC12 cells. The phosphorylation and mitochondrial translocation of Drp1 were effectively reversed by HKL treatment. Importantly, the selective Sirt3 inhibitor 3-(1H-1,2,3-triazol-4-yl) pyridine suppressed these effects. Conclusion::Our findings demonstrated that HKL ameliorated ICH-induced apoptosis and mitochondrial fission by Sirt3, suggesting that HKL has immense prospects for the treatment of ICH.

Objective:To analyze the feasibility and advantages of gastric triangle suspension technique in laparoscopic radical anterograde modular pancreatiplenectomy (L-RAMPS) for patients of pancreatic body and tail malignant tumor.Methods:The clinical data of 29 patients with L-RAMPS in Li Huili Hospital of Ningbo Medical Center from January 2019 to October 2023 were retrospectively analyzed, including 14 males and 15 females, aged (67.6±7.5) years. According to whether gastric triangle suspension was used during operation, 29 patients were divided into suspension group ( n=14) and control group ( n=15). The two groups were compared with several indexes of body mass index, tumor length, postoperative pathological type, operation time, intraoperative blood loss, intraoperative incision margin, intraoperative blood transfusion, pancreatic fistula, postoperative massive bleeding, postoperative gastroparesis, length of hospital stay and so on. Results:There were no significant differences in age, sex, body mass index, tumor length and pathological type between the two groups (all P>0.05). Postoperative pathologic findings of the 29 patients included 21 cases of pancreatic adenocarcinoma (72.4%), 2 cases of intraductal papillary mucinous tumors (6.9%), 2 cases of pancreatic neuroendocrine tumors (6.9%), 1 case of pancreatic adenosquamous carcinoma (3.4%), and 3 cases of mucinous cystadenocarcinoma (10.3%). There was no significant difference in the proportion of positive first incision margin, intraoperative blood transfusion, postoperative B/C pancreatic fistula, postoperative massive hemorrhage and postoperative gastroparesis between the two groups (all P>0.05). The operative time and intraoperative blood loss in the suspension group were (200.3±13.5) min and (148.6±42.2) ml respectively, less than that in the control group (223.5±36.3) min and (205.3±63.3) ml, and the hospital stay in the suspension group was 14 (12, 17) d, shorter than that in the control group 26 (17, 32) d. The differences were statistically significant (all P<0.05). Conclusion:Gastric triangle suspension in L-RAMPS for patients of pancreatic body and tail malignant tumor can reduce the amount of intraoperative bleeding, shorten the operation time and hospital stay, is a reliable and simple suspension method.

Objective:To compare the early and mid-term results of hybrid coronary revascularization (HCR) and minimally invasive multivessel coronary artery bypass grafting (MICS-CABG) in coronary artery disease patients with low left ventricular ejection fraction and non diabetes mellitus, and to explore the indication of HCR and MICS-CABG.Methods:A retrospective cohort analysis of HCR and MICS-CABG cases with preoperative left ventricular ejection fraction less than 0.40, and without diabetes mellitus were conducted in Xijing Hospital from January 2015 to December 2019. 36 cases in HCR group and 17 cases in MICS group were included in this study. For HCR procedure, minimally invasive left internal mammary artery(LIMA) to the left anterior descending artery (LAD) bypass surgery were performed, and followed by percutaneous coronary intervention (PCI) to treat non LAD lesion 1 to 4 weeks later. MICS-CABG procedure was performed through left anterior small thoracotomy minimally invasive direct coronary artery bypass grafting for multiple diseased vessels.Results:The preoperative SYNTAX score in MICS group was significantly higher than that in HCR group ( P<0.05). There was no perioperative death in both groups. Troponin I, postoperative drainage volume, blood transfusion volume and ventilator ventilation time in MICS group were significantly higher than those in HCR group ( P<0.05). After 12 months follow-up, no patient died in both groups. Furthermore, all LIMA grafts were patency. The stenosis rate of drug-eluting stents in HCR group was similar to that of great saphenous vein grafts in MICS group. LVEF and left ventricular end diastolic diameter of both groups were significantly improved 12 months after operation ( P<0.05). Conclusion:HCR and MICS-CABG are minimally invasive and safe treatment for multivessel coronary artery disease patients with low ejection fraction and non diabetese mellitus. The early and mid-term therapeutic effects are satisfactory. If coronary artery lesions other than LAD are suitable for PCI, HCR should be the preferred treatment.

Objective:To explore the effect of the situational doctor-patient communication skills training course based on chest pain center.Methods:The "5+3" integrated students of clinical medicine were selected to take the doctor-patient communication skills training course. The typical cases of chest pain center were written as module units, and were divided into 3 modules according to the disease types and the training contents of doctor-patient communication. The effect evaluation was performed before the course and after each module course, including the Liverpool doctor communication skills assessment scale, the college student empathy ability scale and emotional intelligence evaluation scale.Results:The students' communication ability, empathy ability, and emotional intelligence were significantly improved by three modules of practical training courses (all P<0.05). Among them, the communication ability of medical students was improved after each lecture in module 1, module 2 and module 3 (all P<0.05), which was 84% higher than that before the course [(28.2±2.7) vs. (15.3±3.9)]. After each lecture in module 1 and module 2, the empathy ability of medical students was improved (both P<0.05), which was 34% higher than that before teaching [(132.7±12.5) vs. (99.0±17.4)]. After each lecture in module 2 and module 3, the emotional intelligence of medical students was improved by 34% [(138.5±13.0) vs. (103.0±16.6)] (both P<0.05). Conclusion:The situational doctor-patient communication skills training course based on chest pain center, as a practical course of doctor-patient communication for medical students at the undergraduate stage, can effectively improve students' doctor-patient communication ability, empathy ability and emotional intelligence.