The clival region refers to the skull base between dorsum sellae and anterior border of foramen magnum. It is located in central area of skull base and is in close proximity to pons, medulla oblongata, basilar artery and other crucial intracranial structures. Although there are various microsurgical approaches using craniotomy to reach this region, there are still a lot of difficulty in exposure of clivus. With the increasing development in extended endoscopic endonasal approach, a new route to clivus, as well as meticulous endoscopic anatomy studies is emerging. This article reviewed related researches progress of the detailed anatomical studies from endoscopic perspective.
Cranial Fossa, Posterior ; anatomy & histology ; Craniotomy ; Endoscopy ; methods ; Humans ; Nasal Surgical Procedures ; methods ; Nose ; anatomy & histology ; Skull Base ; anatomy & histology

Objective To investigate the role and mechanism of TMPRSS4 in radiation induced metastasis of hepatocellular carcinoma (HCC).Methods Metastatic model of human HCC was established by orthotopic implantation of histologically intact human HCC tissue into the liver of nude mice.Mice bearing xenografts in liver were killed after radiation and the residual tumors were resected and reimplanted into the liver of normal nude mice.At the end of sixth week,the mice were killed and the histopathological features,tumor volume,intrahepatic and lung metastasis were evaluated.Expression of epithelial-mesenchymal transition (EMT) related genes including N-cadherin,Vimentin,SIP1 and TMPRSS4 were measured by Western blotting and RT-PCR.Results The tumor volume and frequency of lung metastasis of control group was 2.25±0.52 cm3 and 66.7％,respectively.Compared to control group,tumor diameter (1.61±0.51 cm3,P＜0.05) and lung metastasis (12.5％,P＜0.05) were significantly inhibited 2 days after radiation.Whereas,30 days after radiation,tumor growth recovered (2.60±0.61 cm3,P＞0.05) and lung metastasis was enhanced (100％,P＜0.05).There were no intrahepatic metastasis in the control group and in the group of reimplantation of HCC 2 days after radiation,while the tumors from those 30 days after radiation showed enhanced intrahepatic metastasis (18 ± 8.05,P＜ 0.01 ),with overexpression of SIP1,N-cadherin,Vimentin and TMPRSS4,and reduced expression of E-cadherin.Conclusion The metastasis potential of residual HCC after radiation was first inhibited and then promoted.Overexpression of TMPRSS4 plays a critical role in radiation induced long-term metastasis of HCC by facilitating EMT.

Objective To optimize the volatile oil extraction and inclusion process of Wenweiyang capsules. Methods An orthogonal test was adopted in this study. The extraction technology was optimized for the yield of volatile oil regarding the amount of water loaded, grain size of medicinal material, and decoction time as factors. The inclusion technology was optimized for the inclusion yield and volatile oil inclusion rate using the ratio ofβ-CD:oil, amount of water and grinding time as factors. Results The optimized extraction parameters were as follows:breaking medicinal material through 10 mesh screen, adding 6 fold volume of water and extracting for 5 h. The optimized inclusion progress was grinding at theβ-CD:oil ratio of 81, loading equivalent amount of water and grinding for 30 minutes. The average yield of volatile oil is 1. 72%, the average inclusion rate is 93. 01% and the average volatile oil inclusion rate is 74. 82%. Conclusion The extraction and inclusion technology is simple, reliable, which can effectively retain the volatile oil and provide evidence for the preparation of Wenweiyang capsules.

Objective To study the effects of Androsace umbellata extract on bone wound healing in rats.Methods A total of 32 rats were selected,and the rat femur bone trauma model was established.The Androsace umbellata was administrated to rats in treatment groups (including high-dose Androsace umbellata group and low-dose Androsace umbellata group,8 rats in each group)continuously for 10 days,while rats in the fake operation control group (8 rats)and bone trauma model group (8 rats) were treated with corresponding volume of solvent by body weight.The growth of body weight and wound healing of rats were recorded.The serum levels of calcium and phosphorus,activity of alkaline phosphatase (ALP),bone density and bone biomechanics were examined.The X-ray photograph was carried out to observe the effects of Androsace umbellata on bone wound healing,Results Compared with the bone trauma model group,serum levels of calcium and phosphorus,calcium-phosphorus product and activity of ALP were significantly increased in treatment groups,there were statistically significant differences (P＜0.05).Compared with the bone trauma model group,bone density of trauma place in the high-dose Androsace umbellata group was significantly decreased (P＜0.05),bending energy in the low-dose Androsace umbellata group was increased (P＜0.05),while no statistically significant difference was found in the other skeletal biomechanical properties (P＞0.05).The results of X-ray films indicated that the treatment groups shown better effects on bone wound healing compared with the bone trauma model group.Conclusion Androsace umbellata extract could effectively promote bone wound healing in rats.

OBJECTIVETo evaluate the time course of granulocyte-colony-stimulating-factor (G-CSF), estrogen and various doses of atorvastatin on endothelial progenitor cells (EPCs) mobilization.

METHODA total of 48 male New Zealand White rabbits were treated with placebo, estrogen (0.25 mg.k(-1).d(-1)), Atorvastatin (2.5, 5, or 10 mg) and G-CSF (50 microg/rabbit/d), respectively. Peripheral EPCs number was surveyed weekly for 4 weeks by FACS analysis (double-positive for PE-CD34/FITC-CD133) and under fluorescent microscope (double-positive for FITC-UEA-1/Dil-acLDL). Serum nitric oxide (NO) and lipids were also measured at the third week.

RESULTSPeripheral EPCs was significantly increased in G-CSF treated animals and remained constant for 4 weeks compared to placebo treated animals. Atorvastatin increased peripheral EPCs dose-dependently from 2.5 to 5 mg and peaked at the third week while peripheral EPCs number was not affected by 10 mg.k(-1).d(-1) atorvastatin during the first 3 weeks and was significantly higher only in the fourth week compared to placebo group. Estrogen also significantly increased peripheral EPCs at the third and fourth week compared to placebo group. At the third week, serum NO was similar in G-CSF group, significantly higher in atorvastatin 5 mg.k(-1).d(-1) and estrogen groups while significantly lower in atorvastatin 10 mg.k(-1).d(-1) group compared to placebo group. Serum lipids were similar among various groups.

CONCLUSIONAtorvastatin, estrogen and G-CSF could mobilize EPCs. The mobilization efficacy is as follows: G-CSF > atorvastatin 5 mg.k(-1).d(-1) > estrogen > atorvastatin 2.5 mg.k(-1).d(-1) > atorvastatin 10 mg.k(-1).d(-1). NO might partly contribute to the mobilizing effect of estrogen and atorvastatin.

Animals ; Atorvastatin Calcium ; Endothelial Cells ; cytology ; drug effects ; Estrogens ; pharmacology ; Granulocyte Colony-Stimulating Factor ; pharmacology ; Heptanoic Acids ; pharmacology ; Hypolipidemic Agents ; pharmacology ; Lipids ; blood ; Male ; Nitric Oxide ; blood ; Pyrroles ; pharmacology ; Rabbits ; Recombinant Proteins ; Stem Cells ; drug effects

Objective To explore the characteristic of fractional amplitude of low frequency fluctuation (fALFF) and the relationship with the severity of depression, suicidal ideation and suicide risk in depression patients with suicidal ideation with resting-state functional magnetic resonance imaging (rs-fMRI). Methods Resting state functional magnetic resonance imaging maps were conducted using fractional amplitude of low frequency fluctuation (fALFF) in 52 depression patients (30 with suicidal ideation and 22 without) and 21 healthy controls (HCs). The severity of depression was evaluat-ed by using Hamilton Depression scale(HAMD). The suicidal ideation, the suicide risk in depression patients with sui-cidal ideation were both assessed by the Beck Scale for Suicide Ideation. The correlation between the fALFF value and the score of HAMD and the Beck Scale for Suicide Ideation was analyzed. Results MRI revealed significant differences in fALFF in the left superior/middle occipital gyrus and the right middle/inferior occipital gyrus (P<0.05, AlphaSim cor-rected)between depression patients with suicidal ideation and the HCs. Compared to the HCs, depression patients with-out suicidal ideation showed a higher fALFF in the left middle occipital gyrus (P<0.05, AlphaSim corrected). MRI re-vealed significant differences in fALFF in the left middle occipital gyrus (P<0.01, AlphaSim corrected)and the right mid-dle occipital gyrus (P<0.01, AlphaSim corrected) between depression patients with suicidal ideation and without. The fALFF of left middle occipital gyrus (r=0.366, P=0.046) and right middle occipital gyrus (r=0.513, P=0.004) were posi-tively correlated with the scores of HAMD, respectively whereas were not correlated with suicidal ideation and suicide risk. Conclusions Depression patients with suicidal ideation have an abnormal spontaneous activity in their left and right middle occipital gyrus. The increased activity in these brain areas are probably associated with the severity of de-pression whereas are not associated with suicidal ideation or suicide risk.

Objective: To study the current status, hotspots and frontiers in the field of occupational health and safety (OHS) research among medical staff. Methods: A comprehensive search on OHS of domestic and international literature on medical staff was conducted using the China National Knowledge Infrastructure and Web of Science databases from 2002 to 2022. The collected literature was subjected to bibliometric analysis and visualized using CiteSpace 6.1.R6 software. Results: A total of 5 858 articles related to medical personnel OHS comprising 2 144 Chinese articles and 3 714 English articles, were included. The publication of Chinese articles showed an initial increase followed by a decline, while English articles exhibited a sustained increase followed by a sudden decline. Domestic research mainly focused on hospitals and academic institutions, with few collaboration between institutions and regions in China. Research abroad demonstrated strong collaboration and exchange between countries and institutions. The OHS related research hotspots were occupational exposure, occupational health, and occupational safety of medical personnel at home and abroad. The key department of interest was operating rooms, and the key group personnel was nurses. Advanced research in foreign countries has extended to fields such as personal protective equipment and medical personnel sleep issues. Conclusion: There is still a gap on OHS research among medical staff between China and foreign countries. Domestic scholars need to grasp the academic frontiers, strengthen collaboration and exchange among domestic institutions, regions, and international counterparts, enlarge the research scope and content to ensure the OHS of medical personnel.

OBJECTIVETo investigate the effects of Ginkgo leaf extract (GLE) on function of dendritic cells (DC) and Th1/Th2 cytokines in patients with unstable angina pectoris (UAP).

METHODSFifty-four patients with UAP were equally assigned into two groups, the treated group and the control group, both treated with conventional Western medicine, but with GLE given additionally to the treated group. Blood of all patients was taken before and 4 weeks after treatment to prepare the peripheral mononuclear cells, then which were incubated in the completed medium containing granulocyte-macrophage colony stimulatory factor (GM-CSF) and interleukin-4 (IL-4) to induce mature DC. The expression of co-stimulating factor CD86 (B7-2) on the surface of DC was detected by flow cytometry, and the stimulating capacity of DC was determined by mixed lymphocyte reaction (MLR). The blood levels of cytokines, interferon-gamma (IFN-gamma), and IL-4, were analyzed by ELISA, and blood C-reactive protein (CRP) level by turbidimetry. Moreover, the direct effect of Ginkgolide B on CD86 expression on DC were also tested in vitro.

RESULTSAfter treatment, CD86 expression on DC, the stimulating capacity of DC as well as levels of IFN-gamma and CRP were lowered in both groups (P < 0.05 or P < 0.01), but the changes were much more significant in the treated group than those in the control group. Ginkgolide B showed a direct inhibitory effect on the CD86 expression on DC.

CONCLUSIONThe inhibition of GLE on DC and thereby the suppression on inflammatory reaction may be one of the mechanisms of GLE in treating patients with UAP.

Adult ; Aged ; Angina, Unstable ; immunology ; B7-2 Antigen ; analysis ; C-Reactive Protein ; analysis ; Cells, Cultured ; Dendritic Cells ; cytology ; drug effects ; immunology ; Diterpenes ; pharmacology ; Female ; Ginkgolides ; Humans ; Interferon-gamma ; analysis ; Interleukin-4 ; analysis ; Lactones ; pharmacology ; Male ; Middle Aged

The study was purposed to investigate the immune regulatory effects of human bone marrow mesenchymal stem cells (hMSCs) on Foxp3 expressing CD4(+)CD25(+) regulatory T cells and to explore the mechanism of immune modulation by hMSCs. Human MSCs were isolated and expanded from bone marrow cells, and identified with cell morphology, and the phenotypes were assessed by immunohistochemistry. Human peripheral blood mononuclear cells (hPBMNCs) were prepared by centrifugation on a Ficoll Hypaque density gradient. The hMSCs (1 x 10(3), 1 x 10(4), 1 x 10(5)) were added into wells containing hPBMNCs (1 x 10(6)) from an unrelated donor in the presence of rhIL-2. After 5 days of co-culture, the percentage of CD4(+)CD25(+) T cells was detected by flow cytometry. T cell proliferation was assessed by [(3)H] thymidine incorporation using a liquid scintillation counter. The expression of Foxp3 in CD4(+)CD25(+) T cells was detected by reverse transcription polymerase chain reaction (RT-PCR). Cytokines (TGF-beta, IL-12, IFN-gamma, IL-10) concertrations of cultured supernatants were measured with ELISA. The results indicated that in all the experiments, the presence of hMSCs with hPBMNCs resulted in a statistically significant decrease in T cell proliferation, in dose-dependent manner. The increase of percentage of CD4(+)CD25(+) T cells in the peripheral CD4(+) T cell was observed after coculturing lymphocytes with hMSCs (p < 0.01). The expression of Foxp3-mRNA (Foxp3/beta-actin) in hMSCs groups was significantly higher than that in the control and was negatively associated with the value of CPM representing T proliferation. The levels of TGF-beta and IL-10 were higher in hMSCs groups than that in the control, and the levels of TGF-beta and IL-10 correlated positively with Foxp3-mRNA expression and the percentage of CD4(+)CD25(+) T cells. However, the secretion of IL-12 and IFN-gamma was significantly attenuated by hMSCs coculture, and there was no correlation with Foxp3-mRNA expression and the percentage of CD4(+)CD25(+) T cells. It is concluded that the Foxp3 expressing regulatory T cells may play an important role in the immune regulatory by hMSCs. Its mechanism is related to that the hMSCs-mediated TGF-beta and IL-10 convert CD4(+)CD25(-) T cells into CD4(+)CD25(+) T regulatory T cells, which specifically inhibits the proliferation of T cells.
Bone Marrow Cells ; cytology ; Cell Proliferation ; Cells, Cultured ; Coculture Techniques ; Forkhead Transcription Factors ; metabolism ; Humans ; Immunization ; Interleukin-10 ; biosynthesis ; Interleukin-2 Receptor alpha Subunit ; immunology ; metabolism ; Mesenchymal Stromal Cells ; cytology ; T-Lymphocytes, Regulatory ; immunology ; metabolism ; Transforming Growth Factor beta ; biosynthesis

AIMTo study the mechanism of the therapeutic angiogenesis effect of bone marrow stromal cells (BMSCs) implantation on rat acute myocardial infarction models.

METHODSThe rat acute myocardial infarction models were made by coronary artery ligation and divided into 2 groups at random. In the experiment group, twice passaged BMSCs were labeled with BrdU and then implanted into the infarction region of the recipients in 4 weeks. The control group was the model rats received only DMEM injection. In control group, the hearts were harvested on the day 3, 7, 14, 28, 42 and 56. The infarction regions were examined to identify the angiogenesis and the expression of the VEGF and bFGF. In experiment group, the hearts were examined on the day 42 and 56 after AMI (the day 14 and 28 after cells implantation).

RESULTSViable cells labeled with BrdU could be identified in host hearts. Histologic examination found most donor cells within the infarction region expressed fibroblastic and endothelial phenotype. The transplantation regions had a greater capillary density than the control regions did (14 +/- 4.7/HPF vs 6 +/- 2.4/HPF, P < 0.05). In the control group, the expression of VEGF and bFGF within the infarction regions peaked on day 7, and then decreased over time. In the experiment groups, the expression of bFGF and VEGF on the day 42 and 56 had a higher level than the control group did.

CONCLUSIONThe expression of VEGF and bFGF is significantly increased after cells therapy during the late phase of AMI. It indicates that BMSCs implantation promoted the angiogenesis is mediated by its differentiation into endothelium and the increased release of VEGF and bFGF.

Animals ; Bone Marrow Cells ; cytology ; Bone Marrow Transplantation ; Female ; Fibroblast Growth Factor 2 ; metabolism ; Myocardial Infarction ; surgery ; Neovascularization, Physiologic ; physiology ; Rats ; Rats, Wistar ; Stromal Cells ; transplantation ; Vascular Endothelial Growth Factor A ; metabolism