Objective:To investigate the expression of MMP-1 and PTEN protein in basal cell papilloma (BCP), as well as their correlation with skin photoaging. Methods:Immunohistochemistry technique via Elivison method was employed to measure the expres-sion of MMP-1 and PTEN protein in lesions from 50 cases of BCP on exposed areas, 50 cases on non-exposed areas, and 30 normal controls. We compared the differences among the three groups and analyzed the result. A total of 90 BCP cases on exposed areas were randomly divided into three groups. Titanium dioxide cream and placebo were respectively applied in the trial groups twice daily for 12 weeks, whereas the control group was non-administered. After 12 weeks, the MMP-1 in the lesions of the three groups was measured and compared. Results:The expression scores of MMP-1 on exposed areas were significantly higher than those in the control group (P<0.01). No significant difference was found between non-exposed areas and the control group (P>0.05). The expression scores of PTEN protein on exposed areas and on non-exposed areas were significantly lower than that in control group (P<0.01). The expression scores of MMP-1 in the group that used titanium dioxide were evidently lower than those in control group after 12 weeks (P<0.05). Conclu-sion:MMP-1 is overexpressed in BCP on exposed areas. PTEN protein is underexpressed in BCP of exposed areas and non-exposed ar-eas. Skin photoaging is a possible cause of BCP on exposed areas.

The MEMS-based micro surgical tools are a kind of new devices applied in the minimally-invasive surgery. This paper introduces their application background and basic technology first, and then lays emphasis on the typical research accomplishments in the world. Finally, the research activities in China and some of the difficulties about the work are discussed.
Biosensing Techniques ; Endoscopes ; Equipment Design ; Microsurgery ; instrumentation ; Minimally Invasive Surgical Procedures ; instrumentation ; Surgical Equipment

Objective To evaluate the capability of three tests used alone or in combination for identification of Staphylococcus aureus.Methods Identification of Staphylococcus aureus by the detection of spa gene with PCR and the Vitek-2 system were selected as the reference methods.Comparison of three phenotypic tests including DNase,mannitol fermentation and tube coagulase test was carried out to analyze the sensitivity,specificity,positive/negative predictive value,positive/negative likelihood ratio and Youden index.The consistency,cost and related indexes of the assays were analyzed between the combined phenotypic tests and the reference methods.Results In the present study,324 isolates of Staphylococci,including 293 Staphylococcus aureus and 31 non-Staphylococcus aureus,were collected.Single biochemical test could not identify Staphylococcus aureus efficiently.Comparison between the reference methods and the combined three biochemical tests by Kappa statistic analysis indicated that an overall Kappa value was 0.9441,and the algorithm of combined test was less costly.The sensitivity and specificity of this algorithm were 100％ and 90.3％,respectively.Conclusion The cost-effective algorithm of combined DNase,mannitol fermentation and tube coagulase test could efficiently distinguish Staphylococcus aureus from other Staphylococcus species.

Objective We aimed to recent experience at our hospital in the diagnosis and treatment of pericardial effusion after cardiac surgery and to identify risk factors for its development.Methods We searched our hospital for patient who had cardiac surgery with cardiopulmonary bypass from January 2002 through December 2010.For patient with pericardial effusion,medical records were reviewed to evaluate its manifestations and management.To identify risk factors for effusion,patients with effusions were compared with patients without effusions.All patients had routine postoperative echocardiographic examination.Results Of 22462 patients identified,509 (2.3％) had pericardial effusion.Compared with patients without pericardial effusion,ages,sex,cardiac function and so on were no significant( P ＞ 0.05 ).Body,valve cardiac diseases,and cardiopulmonary bypass time and so on were significant ( P ＜ 0.05 ).Among 509 patients with pericardial effusion,262 patients (51.4％) of whom had specific symptoms.Clinical features of tamponade were documented in 51 patients( 10.1％ ).Pericardial effusions were evacuated by echocardilgraphy-guided pericardiocentesis ( n =27,10.3％ ) or surgical drainage ( n =15,5.7％ ).Pericardial effusion resolved after left thoracocentesis for pleural effusion in 5 patients ( 1.9％ ) ; The Other patients with pericardial effusion were treated conservatively.Indeperdent risk factors for pericardial effusion were large body,valve cardiac operations,and prolonged cardiopulmonsry bypass.Conclusion In our study,pericardial effusion occurred in 2.3％ of patients,and symptoms were nonspecific.Several factors,mainly related to preoperative characteristics and type of operation,predispose patients to effusion,echocardiography-guided pericardiocentesis is effective and safe in these patients with pericardial effusion.

Objective To identify the risk factors of major bleeding in patients undergoing off-pump coronary artery by-pass grafting( OPCAB) .Methods Data on coronary artery disease patients who underwent off-pump CABG between December 2009 and December 2014 were reviewed.Baseline characteristics were compared between patients with clopidogrel discontinua-tion ≥5 days and <5 days.Univariate and multivariate logistic regression analyses were performed to investigate the risk fac-tors of perioperative major bleeding.Major bleeding was defined as the Universal Definition of Perioperative Bleeding(UDPB) class 3 -4.Results A total of 3988 patients who underwent OPCAB were included in this study.Major bleeding rate was 9.23%(n=368).Multivariable regression analysis showed that female sex(OR=1.99, 95%CI:1.57-2.52), age(OR=1. 02, 95%CI:1.00-1.03), lower BMI(BMI≤25 kg/m2)(OR=1.40,95%CI:1.12-1.75), decreased GRF(GFR<60 ml/min)(OR=1.43,95%CI:1.01-2.02), decreased preoperative Hct(Hct <0.40)(OR =1.57, 95%CI: 1.23-1.99) and clopidogrel discontinuation <5 days(OR=1.97, 95%CI:1.58-2.44) conferred a higher risk of perioperative major bleeding during OPCABG.Conclusion Female, advanced age, lower BMI, decreased GRF, decreased preoperative Hct and clopi-dogrel discontinuation<5 days are independent risk factors of perioperatice major bleeding in patients undergoing OPCAB .Pre-dicting risk of major bleeding can help sugeons to optimize perioperative management .

Objective:To investigate the preoperative ascending aorta diameter in patients with acute type A aortic dissection in the Chinese population, compares and analyze the differences in preoperative blood biomarkers, and evaluate the impact of the preoperative ascending aorta diameter in this part of patients on the short-term prognosis of patients.Methods:A collection of 641 patients with acute type A aortic dissection who were enrolled in the " Acute Aortic Syndrome High-Risk Early Warning and Intervention Study" project from January 2018 to January 2020 were collected. Divide the patients into two groups (group Ⅰ<55 mm, group Ⅱ≥55 mm) according to the preventive intervention value of ascending aorta diameter recommended by the guideline for studying preoperative ascending aorta diameter difference in blood biomarkers and the influence of ascending aorta diameter on the short-term prognosis of patients. All patients had CT scans to assess the diameter of the ascending aorta before operation.Results:In this study, all patients with acute type A aortic dissection had a mean preoperative ascending aorta diameter of (46.9±9.7)mm. The preoperative ascending aorta diameter of all patients was less than 55 mm, accounted for 84.1%. Male patients were more likely to have aortic dissection than females; most patients' age was less than 60 years old. The preoperative blood inflammatory index counts were higher in the ascending aorta diameter ≥55 mm group. However, the long-term prognosis of patients with different ascending aorta diameters before surgery was not apparent in this study. The preoperative survival rate and short-term survival rate of patients with ascending aorta diameter <55 mm were higher than those of other groups, but the difference was not statistically significant.Conclusion:In patients with acute type A aortic dissection, the diameter of the ascending aorta is usually less than 55 mm. Moreover, the blood inflammatory index counts are high in the preoperative ascending aorta diameter ≥55 mm group. Meanwhile, patients with smaller ascending aorta diameter have better survival rate and short-term prognosis.

Objective: To investigate the effects of sIL-13Rα2 on the apoptosis of goblet cell in nasal mucosa of allergic rhinitis rats. Methods: Forty healthy male Wistar rats were randomly divided into 4 groups (10 rats per group): control group (group A), AR group (group B), sIL-13Rα2 group (group C) and triamcinolone acetonide group (group D). Ovalbumin (OVA) and aluminum hydroxide were used to establish the AR rat model. After the establishment of AR rat models, 50 μl PBS, 100 μg/50 μl IL-13Rα2 and 3.5 μg/50 μl triamcinolone acetonide were respectively dropped into each nasal cavity of every rat two times a week from 4 to 10 week in group B, group C and group D. Group A was operated with saline instead of OVA. The nasal mucosa tissues were collected at 24 h after the final administration. AB-PAS staining method was used to detect the quantity and secretion of goblet cells in the nasal mucosa tissue of all groups. Immunohistochemistry method was used to detect the expression of Bax proteins.Apoptosis was detected by TUNEL method.ANOVA analysis was used to compare multiple groups, and LSD-t test was used to compare the two groups.Pearson correlation analysis was used to analyze the correlation between the Bax positive cell rate of goblet cells and the rate of apoptotic cells. The difference was statistically significant with P<0.05. Results: Compared with group A, there were more goblet cells and hypersecretion of mucus in the nasal mucosa tissue of rats in group B while fewer in group C. The goblet cells in group C and group D were significantly fewer than that in group B (0.639 00±0.831 vs 0.956 7±0.980, 0.661 90±0.657 vs 0.956 7±0.980, t value was 2.748, 2.767, respectively, all P<0.05). The immunohistochemistry results showed that the positive expression rates of Bax protein in goblet cells of group C and group D were significantly higher than that in group B (0.880 2±0.125 vs 0.568 7±0.953, 0.938 4±0.200 vs 0.568 7±0.953, t value was -2.292, -2.685, respectively, all P<0.05). The apoptosis rates of goblet cell in nasal mucosa of group C and group D were also significantly higher than that in group B (0.516 0±0.079 vs 0.274 0±0.056, 0.535 4±0.829 vs 0.274 0±0.056, t value was -17.671, -2.225, respectively, all P<0.05). The expression of Bax protein and apoptosis of goblet cells were positively correlated (r=0.859, P<0.01). Conclusion sIL-13Rα2 can induce apoptosis of the goblet cells in nasal mucosa of allergic rhinitis rats, by inhibiting IL-13 and up regulating Bax.

Objective    To evaluate the preoperative risk factors for acute Stanford type A aortic dissection (ASTAAD) patients in our country by collecting multi-center data. Methods    We consecutively enrolled 700 patients who underwent surgery for ASTAAD in the multi-center hospital database from January 2018 to January 2020. According to the ascending aorta size (AAS), the patients were divided into two groups: a group AAS≥55 mm and a group AAS< 55 mm. Univariate and multivariate logistic regression analyses were used to investigate the related preoperative risk factors for the onset of ASTAAD. Results    According to the exclusion criteria, a total of 621 patients were finally enrolled, including 453 males and 168 females with an average age of 48.24±11.51 years, and 509 (81.94%) patients had AAS< 55 mm. Univariate and multivariate statistical analyses showed that smoking, hypertension, preoperative cardiac troponin I, and left ventricular ejection fraction were related to the occurrence of ASTAAD. The mortality rate of the patient during hospitalization was 13.04% (81 patients). Conclusion    In clinical practice, various preoperative risk factors affect ASTAAD patients, which should be paid attention to. Comprehensive evaluation and an individualized analysis of patients and timely prevention and intervention improve patients' survival rate.