Objective To evaluate the key points of anesthetic management for retroperitoneoscopic nephrectomy combined with inferior vena cava ( IVC ) tumor thrombectomy. Methods Perioperative clinical data of 3 patients undergoing retroperitoneoscopic nephrectomy combined with IVC tumor thrombectomy from December 2010 to June 2014 were retrospectively analyzed.There were 2 cases of level Ⅰthrombus and 1 case of level Ⅱthrombus.All the patients were given general anesthesia with intubation.Brief inferior vena cava occlusion was performed in the patient with level Ⅱ thrombus. Results The operation was completed smoothly in all the cases without conversions to open surgery. The operating time was 244, 333, and 289 min, respectively. The total IVC control time for level Ⅱ thrombus was 10 min.No intraoperative pulmonary embolism and other severe anesthetic complications occurred. One patient with level ⅠIVC thrombus was extubated and sent back to surgical ward after surgery, and the remaining 2 patients underwent intensive care monitoring overnight and were extubated and discharged to surgical ward on the next day. Conclusions Retroperitoneoscopic nephrectomy and IVC thrombectomy is a brand-new, difficult but feasible procedure. Anesthesiologist should have a full recognition of surgical procedures and make perfect anesthetic plan to ensure close collaboration. Furthermore, circulatory swing during IVC clamping and perioperative severe complications such as pulmonary embolization and massive hemorrhage cannot be neglected.

[Summary] Regional cerebral oxygen saturation ( rSO2 ) can be used to monitor the changes of cerebral oxygen demand and supply, and postoperative cognitive dysfunction ( POCD ) is a relatively common adverse effect following cardiac surgery. The intraoperative rSO2 decrease may associate with the incidence of POCD. Real-time intraoperative monitoring of rSO2 and necessary interventions performed to correct cerebral rSO2 desaturation may reduce the incidence of POCD of cardiac surgery.

Forty-eight patients with subclinical Cushing's syndrome(SCS)were evaluated.Eleven of them underwent adrenalectomy(Group 1)and the other 37 cases did not(Group 2).Serum and urine corticosol, plasma ACTH and parameters related to metabolic syndrome(such as waist circumference,blood pressure,blood lipids and fasting plasma glucose)were measured.The data at diagnosis were compared with those during the survey.The results indicated that patients with SCS had a significantly high prevalence of metabolic syndrome.The symptoms and signs of metabolic syndrome could be improved after removing the tumor.Otherwise there is no improvement,some patients will even develop into overt Cushing's syndrome.

Erythromelalgia ; complications ; Female ; Humans ; Mercury Poisoning ; complications ; Middle Aged

Objective To study the effect of chitosan-pCrmA nanoparticles on the apoptosis of chondrocytes induced by interleukin-1 beta (IL-1β).Methods Chitosan-pDNA nanoparticles were prepared and characterized.The transfection efficiency of chitosan-mediated pIRES2-EGFP was evaluated using fluorescence microscope.The cytotoxicity of chitosan-pIRES2-EGFP nanoparticles in primary rabbit chondrocytes was analyzed by MTT assay.The expression of chitosan-mediated pCrmA in primary rabbit chondrocytes was verified by Western blotting.The effect of chitosan-mediated CrmA on chondrocytes apoptosis induced by IL-1β were analyzed by TUNEL assay.One-way ANOVA was used to analysis.Results The size of chitosan-pDNA nanoparticles was 50 nm.The pDNA release of chitosan-pDNA nanoparticles appeared as biphasic release at pH 2.0 and pH 7.4 buffer.The expression of CrmA in rabbit primary chondrocytes mediated by chitosan could be detected.The chitosan-pIRES2-EGFP nanoparticles had no cytotoxicity.The apoptosis rate of chondrocytes in the chitosan-pCrmA nanoparticles treated group was significantly lower than that of the chitosan treated group (P＜0.05) and PBS group (P＜0.01).Conclsion Chitosan is an effective non-viral gene transfer vector.The CrmA mediated by chitosan can significantly inhibit chondrocytes apoptosis induced by IL-1β,suggesting that chitosan-pCrmA nanoparticles may be the treatment of osteoarthrifis.

Background Familial vitreous amyloidosis is a rare ocular regional amyloidosis,and it is a kind of autosomal dominant inheritance disease.Familial vitreous amyloidosis demonstrates a variable penetrance due to the mutation in the plasma thyroid hormone-binding protein transtheretin (TTR) gene.Many studies have reported over 100 types of TTR genetic mutation in Switzerland,Portugal and Japan,but rare in China.Objective This survey aimed to investigate the clinical and genetic mutation characteristics in familial vitreous amyloidosis.Methods Physical and eye examinations were performed on 52 family members of this vitreous amyloidosis family.Peripheral blood samples from 52 members were collected for TTR gene test by DNA extract,PCR amplification,clone,bolting and sequencing.Pars plana vitrectomy was firstly performed prior to the pathological examination of vitreous sample on 13 eyes of 8 members.Informed consent was obtained from each individual before any medical procedure.Results Seventeen members suffered from vitreous amyloidosis in this family without nervous system,heart,kidney and liver disease.Vitreous opacity was found in 34 eyes of the 17 members,and retinal vasculopathy was seen in 28 eyes of 15 members.In addition,cataract appeared in 16 eyes of 10 members.None of the members had glaucoma or ocular motility disorders.Congo red test of vitreous specimens showed a positive result in 13 eyes of 8 patients who received vitrectomy.Point mutation was verified on the 83th amine acid location of exon 3 (Gly83Arg) in TTR gene by gene sequencing.Conclusions Clinical characteristics of familial vitreous amyloidosis induced by TTR gene Arg-83 mutation is rate retinal vasculopathy without glaucoma,other ocular regional disease and systemic diseases.

The coronavirus disease 2019 (COVID-19) is an acute infectious disease caused by the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, which has led to serious worldwide economic burden. Due to the continuous emergence of variants, vaccines and monoclonal antibodies are only partial effective against infections caused by distinct strains of SARS-CoV-2. Therefore, it is still of great importance to call for the development of broad-spectrum and effective small molecule drugs to combat both current and future outbreaks triggered by SARS-CoV-2. Cathepsin L (CatL) cleaves the spike glycoprotein (S) of SARS-CoV-2, playing an indispensable role in enhancing virus entry into host cells. Therefore CatL is one of the ideal targets for the development of pan-coronavirus inhibitor-based drugs. In this study, a CatL enzyme inhibitor screening model was established based on fluorescein labeled substrate. Two CatL inhibitors IMB 6290 and IMB 8014 with low cytotoxicity were obtained through high-throughput screening, the half inhibition concentrations (IC₅₀) of which were 11.53 ± 0.68 and 1.56 ± 1.10 μmol·L^-1, respectively. SDS-PAGE and cell-cell fusion experiments confirmed that the compounds inhibited the hydrolysis of S protein by CatL in a concentration-dependent manner. Surface plasmon resonance (SPR) detection showed that both compounds exhibited moderate binding affinity with CatL. Molecular docking revealed the binding mode between the compound and the CatL active pocket. The pseudovirus experiment further confirmed the inhibitory effects of IMB 8014 on the S protein mediated entry process. In vitro pharmacokinetic evaluation indicated that the compounds had relatively good drug-likeness properties. Our research suggested that these two compounds have the potential to be further developed as antiviral drugs for COVID-19 treatment.

Adolescent ; Adult ; Endoscopy ; methods ; Female ; Humans ; Male ; Middle Aged ; Parotid Neoplasms ; surgery ; Salivary Glands ; surgery ; Young Adult

Adolescent ; Adult ; Child ; Cholesteatoma, Middle Ear ; surgery ; Ear, Middle ; Female ; Humans ; Male ; Middle Aged ; Young Adult

Adult ; Cochlear Implantation ; Female ; Hearing Loss, Sensorineural ; etiology ; surgery ; Humans ; Meniere Disease ; complications ; surgery