Aim To investigate the effects and mecha-nism of nuclear factor-κ B inhibitor, PDTC, on global cerebral ischemia reperfusion ( GCIR ) rat hippocam-pus. Methods Forty-eight adult male Sprague-Daw-ley rats were randomly divided into one control group receiving sham operation and three experimental groups all receiving global cerebral ischemia for 20 min. In PDTC 100 mg·kg-1 group ( P100 ) and PDTC 200 mg ·kg-1 group ( P200 ) , PDTC 100 mg · kg-1 or PDTC 200 mg·kg-1 was injected ip one hour before ischemi-a respectively. Spatial learning and memory function of rats were tested using Morris water maze. HE staining was employed to observe pathological changes of hipp-ocampal neurons. Expression of COX2 was measured by Western blot, and the content of PGI2 and TXA2 in
rat hippocampus was detected by enzyme-linked immu-nosorbent assay. Results A significant increase of es-cape latency was observed in GCIR group compared to the sham operation group(P<0.05). PDTC 100 mg· kg-1 and PDTC 200 mg · kg-1 significantly reduced escape latency ( P <0.05 ) and histopathological injury in CA1 region of hippocampus. PDTC 100 mg · kg-1 and PDTC 200 mg · kg-1 also reduced COX2 expres-sion, PGI2 content, TXA2 content and PGI2/TXA2 . Conclusion Pretreatment with PDTC can protect hip-pocampus from GCIR injury through inhibition of COX2 expression and PGI2/TXA2 .

Objective To introduce a new minimally invasive lumbar positioning system and its positioning method as well as conduct a prospective control study on the differences in positioning time,positioning frequency and radiation exposure dose between the new positioning method and the traditional positioning method.Methods 121 patients with lumbar disc herniation combined with lumbar instability and patients with thoracolumbar vertebral fracture admitted in our hospital from May 2010 to February 2013 were randomized into two groups.68 patients in Group A had undergone the traditional positioning method before and during operation.Among the 68 patients,41 were with single-segment lesion and 27 were with two-segment lesion.53 patients in Group B had undergone the new minimally invasive lumbar positioning system before and during operation.Among the 53 patients,34 were with single-segment lesion and 19 were with two-segment lesion.There were no significant differences in gender,age,course of disease and other general information between the two groups.The positioning time,positioning frequency and radiation dose of the two groups before and during operation were compared and statistically analyzed.Results The positioning time of Group A and Group B were 8.26±3.44 min and 3.51±1.82 min respectively; the positioning frequencies were 3.57 and 1.22; the accuracy were 60.8％ and 96.2％.For the patients with single-segment lesion,the positioning time before implanting two percutaneous pedicle screws during operation were 15.12±4.69 min and 5.51±1.32 min respectively and the positioning frequency were 6.47 and 2.45.For the patients with two-segment lesion,the positioning time before implanting three percutaneous pedicle screws during operation were 24.91±7.43 min and 8.84±2.32 min respectively and the positioning frequency were 11.72 and 3.69.Moreover,the radiation dose detected at neck,chest and wrist of the surgical staff in Group A were 3.09±0.24 Gy,4.23±0.71 Gy and 5.17±0.62 Gy and that detected in Group B were 1.38±0.47 Gy,2.69±0.33 Gy and 3.21±1.05 Gy.There were significant differences in positioning time,positioning frequency and radiation dose between Group A and Group B.Conclusion The minimally invasive spine positioning system and positioning method can simplify the operative procedures and largely reduce radiation exposure,which is characterized by high positioning accuracy,short positioning time,low fluoroscopy frequency and X-ray radiation dose.

Objective To construct a prognostic model for cuprotosis-related genes (CRGs) in patients with hepatocellular carcinoma (HCC). Methods Differential expression of CRGs in HCC was analyzed on the basis of datasets from the TCGA database. The potential mechanisms of CRGs and their related genes in HCC were explored through GO and KEGG enrichment analyses. The prognostic value of the CRGs was evaluated through Kaplan-Meier survival analysis, and the relationship between CRG expression and immune cell infiltration was investigated. CRGs significantly correlated with prognosis in patients with HCC were identified. A prognostic model was established through univariate, Lasso regression, and multivariate Cox regression analyses. The patients were divided into two groups by risk score. ROC curve was used in evaluating the prognostic model. The relationship of risk score or clinical factors with prognosis was analyzed through univariate and multivariate Cox regression analyses. Results A total of 11 differentially expressed CRGs in HCC were obtained. The main enriched GO item of CRGs and their related genes was oxidoreductase activity, acting on the aldehyde or oxo group of donors, and the main enriched KEGG pathway was carbon metabolism. The expression of CRGs was significantly correlated with pDC, T helper cells and other immune cells (P < 0.05). Three CRGs (CDKN2A, DLAT, and LIPT1) were screened and a prognostic model was constructed. There was significant difference in overall survival between the high- and low-risk groups (P < 0.001). The risk score is an independent risk factor for poor prognosis (P < 0.001). Conclusion The prognostic model for CRGs in patients with HCC is constructed using TCGA database data. This model may be used in evaluating patient prognosis.

Objective To investigate the effect of ulinastatin on myocardial injury in rats with sepsis.Methods Thirty male SD rats were randomly (random number) divided into 3 groups:sham operation group (Sham group,n=10),sepsis group (sepsis group,n=10) and ulinastatin group (UTI group,n=10).The sepsis model of the rats was subjected to cecal ligation and puncture (CLP).Rats of UTI group were given 200 000 U/kg ulinastatin at 6 hour after modeling,and dosing was repeated every 12 h.Blood samples were collected from inferior vena cava at 6,12,24,36 h after modeling for determination of cardiac troponin-Ⅰ (cTnI) and the inflammatory factor by ELISA,then the rats were sacrificed and hearts were removed for myocardial tissue stained with hematoxylin eosin (HE) staining,the expression of Bax/Bcl-2 protein level and myocardial cell apoptosis were detected by TUNEL.The level of caspase-3 protein in myocardial tissue was detected by Western-blot.Results The level of cTnI (ng/mL) in serum in UTI group at 6,12,24 and 36 h after modeling were significantly lower compared with sepsis group(P＜0.05).The protein expression levels of TNF-α and IL-6 (ng/mL) in group UTI were higher than those in Sham group,but was significantly lower than those in Sepsis group (P＜0.05).HE staining showed that inflammatory cell infiltration present in myocardial cells,edema and vacuole formation were observed in sepsis group,while those were significantly attenuated in UTI group compared with sepsis group.UTI increased the level of myocardial Bcl-2 protein in the rats (P＜0.05),and reduced the level of myocardial Bax protein (P＜0.05).TUNEL and HE staining showed apoptosis cells in UTI group was significantly reduced compared with sepsis group [(32.2±4.8)％ vs.(58.4±5.6)％,P＜0.05];Western-blot method showed the level of Caspase-3 protein in UTI group was higher than that in group sham (0.32±0.048) vs.(0.12±0.03),P＜0.05],but significantly lower than that of Sepsis group [(0.32±0.048) vs.(0.55±0.052),P＜0.05].Conclusions Ulinastatin can reduce proinflammatory mediators release in the blood of sepsis rats,and inhibit the apoptosis of myocardial cells protecting myocardial cells through the regulation of the Caspase-3 pathway during sepsis.

Objective To investigate the anti-inflammatory effect of penehyclidine hydrochloride on oleic acid-induced acute respiratory distress syndrome (ARDS) in rats.Methods According to randomize number table method, 30 adult male Sprague-Dawley (SD) rats were divided into control group, model group and treatment group. Catheters were placed in femoral vein in each group. The control group was injected with 1.1 mL/kg physiological saline; the model group was injected with 0.1 mL/kg oleic acid and then injected with 1.0 mL/kg normal saline to establish ARDS model; the treatment group was injected with 0.1 mL/kg oleic acid and then injected with 1.0 mL/kg penehyclidine hydrochloride. At 3 hours after the model was established, blood gas analysis was carried out in each group, oxygenation index (PaO2/FiO2) was calculated, and the levels of serum interleukins (IL-1, IL-6) were measured by enzyme linked immunosorbent assay (ELISA). Rats were sacrificed to harvest lung tissue, and the lung wet/dry ratio (W/D) was calculated; the morphological changes of lung tissue was observed under microscope; the superoxide dismutase (SOD) activity and malondialdehyde (MDA) levels were detected by colorimetry; the expression of tumor necrosis factor-α(TNF-α) in lung tissue was detected by immunohistochemical method. The correlations between lung W/D ratio and various indicators were analyzed using Pearson correlation test.Results Compared with the control group, PaO2/FiO2 in model group was significantly decreased, lung W/D ratio was significantly increased, serum IL-1, IL-6 levels and lung tissue MDA content were significantly increased, lung tissue SOD activity was significantly decreased; the alveolar space was filled with exudate, neutrophils and red blood cells, and there were obvious edema and broadening in pulmonary interstitial and alveolar under light microscope; the type Ⅱ alveolar epithelial cells were partly destroyed, accompanied by lamellar body degeneration and emptying phenomenon under electron microscope; and immunohistochemistry showed that the positive expression of TNF-α in lung tissue was significantly increased. Compared with the model group, PaO2/FiO2 in the treatment group was significantly improved [mmHg (1 mmHg = 0.133 kPa): 204.42±31.61 vs. 113.91±47.78,P < 0.05], the lung W/D ratio was significantly decreased (5.80±0.44 vs. 6.82±0.59,P < 0.01), serum IL-1, IL-6 levels and lung tissue MDA content were significantly decreased [IL-1 (μg/L): 18.38±0.28 vs. 20.04±0.39, IL-6 (μg/L): 12.64±0.67 vs. 14.28±1.33, MDA (nmol/mg): 3.95±0.28 vs. 5.17±0.29, allP < 0.05], the activity of SOD in lung tissue was significantly increased (U/mg: 48.75±2.41 vs. 45.09±1.69,P < 0.01), histological and pathological changes were significantly reduced, and the positive expression of TNF-α in lung tissue was significantly reduced [positive cell rate: (25.80±3.44)％ vs. (38.82±3.59)％,P < 0.01].Conclusion Penehyclidine hydrochloride can effectively improve the oxygenation, alleviate lung injury and reduce pulmonary edema in oleic acid induced ARDS rat by decreasing lung W/D ratio, inhibiting oxidative stress and inflammatory response.

OBJECTIVE: To report the prospective efficacy of 45 patients intracranial germinoma treated by radiotherapy and discuss its treatment. METHODS: From February 1998 to October 2007, a total of 45 intracranial germinoma patients were performed radiotherapy, including 15 combined chemotherapy in the Department of Oncology. Of them 23 were pathologically diagnosed while 22 cases were clinical diagnosed. Life table method showed the 5-year and 10-year survival rate. RESULTS: Forty patients were followed-up. Most symptoms of the patients were significantly reduced or disappeared completely. The 5-year and 10-year survival rate of all patients were 84% and 74%. CONCLUSION Radiotherapy is the main treatment for intracranial germinoma. Craniospinal irradiation, whole brain irradiation and partial brain irradiation are the main treatments. Radiotherapy combined with chemotherapy, which can reduce the radiation range and dose will be the trend.
Adolescent ; Adult ; Antineoplastic Agents ; therapeutic use ; Brain Neoplasms ; drug therapy ; mortality ; radiotherapy ; Child ; Female ; Follow-Up Studies ; Germinoma ; drug therapy ; radiotherapy ; Humans ; Male ; Young Adult

Objective:To analyze the application value of negative pressure closed drainage in tuberculous surgery infected wounds and its effect on wound healing and Th1/Th2 expression.Methods:A prospective study was conducted on 120 patients with tuberculous surgery infected wounds admitted to Hebei Provincial Chest Hospital from January 2019 to June 2021. The patients were divided into observation group and control group according to the random envelope method, with 60 cases in each group. The control group received conventional suture drainage tube intervention, while the observation group received negative pressure closed drainage intervention. The survival rate of skin grafting at 2 weeks after operation, the wound healing rate at 8 weeks after operation, and the pain situation during the first 3 dressing changes were observed. The levels of interferon γ (IFN-γ), interleukin 2 (IL-2), tumor necrosis factor α (TNF-α), IL-6, alkaline phosphatase (ALP), phosphorus (P), calcium (Ca), Th1 and Th2 in serum were detected before treatment and 14 days after treatment.Results:The survival rate of skin grafting at 2 weeks and the wound healing rate at 8 weeks in the observation group were significantly higher than those in the control group, with statistically significant differences (all P<0.05). The Visual Analog Scale (VAS) scores of the observation group were significantly lower than those of the control group during the second and third dressing changes (all P<0.05). At 14 days after treatment, the serum levels of Th1 and Th2 in the observation group were significantly higher than those in the control group, while the levels of IFN-γ, IL-2, TNF-α, IL-6, ALP, P, Ca, Th1/Th2 in serum were significantly lower than those in the control group (all P<0.05). Conclusions:Using negative pressure closed drainage technology can effectively promote wound healing in patients with tuberculous surgery infected wounds and improve the balance of Th1/Th2 in blood.

Objective:To investigate the involvement of ferroptosis mediated by glutathione peroxidase 4(Gpx4)in acute lung injury in rats with sepsis,as well as the intervention mechanism of curcumin(Cur).Methods:Twenty-four rats were randomly divided into three groups,with 8 rats in each group:Sham group,Sepsis group and Cur group.The rat model of acute lung injury in sepsis was established by cecal ligation and puncture(CLP).The Sham group only underwent laparotomy and closure.Both Sepsis group and Cur group underwent CLP,Cur group was injected with curcumin(200 mg/kg)intraperitoneally 1 hour after modeling,and the administra-tion was repeated 24 hours later.The lung tissues of the rats were sampled 48 hours after surgery,and the wet/dry weight of lung tissue ratio(W/D)of lung tissues in each group was measured.Morphological changes of lung tissues were observed by HE staining.The con-tents of GSH,MDA,and Fe2+and the levels of inflammatory factors including TNF-α,IL-6,and IL-1β in the lung tissues were mea-sured using test kits.Western blot was used to detect the expressions of nuclear factor E2-related factor 2(Nrf2)and the key regulatory protein of ferroptosis Gpx4.Apoptosis of alveolar epithelial cells was detected by TUNEL method.Ultrastructural changes of alveolar epithelial cells were observed by transmission electron microscopy.Results:Compared with the Sham group,lung tissues in the Sepsis group showed an increased W/D(P<0.05),significantly higher levels of inflammatory factors TNF-α,IL-6,and IL-1β and contents of MDA and Fe2+(P<0.05),decreased content of GSH,up-regulated expression of Nrf2,and down-regulated expression of Gpx4(P<0.05),the type Ⅱ alveolar epithelial cells were seen to be edematous,congested,and infiltrated with inflammatory cells via light microscopy,and ferroptosis signs such as mitochondrial crinkling,thickened bilayer membrane density,and reduced or broken cristae were seen via transmission electron microscopy.Compared with Sepsis group,lung tissues in the Cur group showed decreased W/D(P<0.05),lower levels of TNF-α,IL-6 and IL-1β,lower contents of MDA and Fe2+,increased content of GSH,down-regulated expression of Nrf2,and up-regulated expression of Gpx4(P<0.05),the pathological changes of lung tissues were significantly reduced.Conclusion:Curcumin reduces sepsis-induced acute lung injury in rats,and the mechanism is related to inhibiting inflamma-tory response and GPX4-mediated ferroptosis.

OBJECTIVE：To provide reference for safe and rational use of Sodium tanshinone ⅡA sulfonate（STS）injection in the clinic. METHODS ：The information of the patients who received STS injection from Jan. 2016 to Dec. 2017 were collected from a Grade 3 hospital. According to relevant suggestions in drug package inserts ，drug utilization rationality was evaluated ，and single-factor and multi-factor analysis on the risk and influential factors for ADR/ADE were performed by group design and individual matching to examine their correlation. RESULTS ：Totally 3 283 patients were included in the study. The drug use frequency were less than 1.5，and the drug utilization indexes were less than 1.0，suggesting that the hospital using STS injection was basically reasonable. Irrational use of drugs mainly included that inappropriate indications （46.48％），unreasonable solvent selection（15.84％），and excessive concentration （2.71％）. Patients with renal insufficiency received STS injection ，and then the risk of ADR/ADE increased by correlation analysis （P＜0.05）. CONCLUSIONS ：Irrational use of STS injection in clinics existed ， mainly like off-label drug use ，excessive concentration ，irrational solvent selection. Drug use evaluation and monitoring should be strengthened. For patients with renal insufficiency ，it is necessary to prevent the occurrence of ADR/ADE ．

Objective To investigate the value of a nomogram model based on contrast-enhanced CT radiomics in predicting the histological type of thymoma.Methods A total of 154 patients(101 in low-risk group and 53 in high-risk group)with thymoma confirmed by pathology were retrospectively selected.The cases were randomly divided into training set(n=107)and validation set(n=47)at a ratio of 7∶3.The three-dimensional volume of interest(VOI)of the whole lesion on the image from the arterial phase of contrast-enhanced CT was manually delineated,and the radiomics features were extracted.Based on the selected radiomics features,the radiomics model was constructed and the model Radiomics score(Radscore)was calculated.Clinical risk factors were screened to construct a clinical model,and a nomogram model was constructed by fusing Radscore and clinical risk factors.The receiver operating characteristic(ROC)curve,area under the curve(AUC),accuracy,sensitivity and specificity were compared to analyze the predictive efficacy and difference of different models for high-risk and low-risk thymoma.The decision curve and calibration curve were drawn to evaluate the clinical value and fitting performance of the nomogram model.Results Eleven radiomics features were selected to construct the radiomics model,and five clinical risk factors[myasthenia gravis(MG),morphology,border,surrounding tissue invasion and CT value in arterial phase]were used to construct the clinical model.In the training set,the AUC of the nomogram model(0.88)was higher than that of the radiomics model(0.80)and the clinical model(0.79),and the difference was statistically significant(Z=2.233,2.713,P=0.026,0.007,respectively).In the validation set,the AUC of the nomogram model was higher than that of the radiomics and clinical models,but the difference was not statistically significant.The calibration curve showed that the nomogram model had good fitting performance,and the decision curve showed that the nomogram model had high clinical benefit.Conclusion The nomogram model based on contrast-enhanced CT can effectively predict high-risk and low-risk thymoma,which is helpful to guide clinicians to make relevant decisions.