Objective: To evaluate the long-term efifciency of percutaneous transluminal septal myocardial ablation (PTSMA) for treating the patients with hypertrophic obstructive cardiomyopathy (HOCM).
Methods: A total of 66/94 (70.2%) HOCM patients received PTSMA in Shenyang PLA general hospital from 2001-10 to 2012-10 were retrospectively studied. The left ventricular out lfow gradient (LVOFG) was measured at before and after the operation, ECG and echocardiography were examined at 1 month, 6 months and 1 year after operation, and then examined once per year for (63.8±28.5) months.
Results: There were 26 patients lost contact during follow-up period, 40 returned to routine clinical check-up and 2 patients died thereafter, 1 because of sudden death and 1 because of cerebral bleeding. The pre-operative average LVOTG was (102.7 ± 47.5) mmHg, compared with the values at 6 months post-operation and long term (>6 months) after operation (33.9 ± 30.2) mmHg and (29.7 ± 25.4) mmHg,P<0.001. The pre-operative average inter ventricular septal (IVS) was (20.1 ± 3.6) mm, compared with the values at 6 months post-operation and long term after operation (17.5 ± 2.9) mm and (16.4 ± 3.6) mm, P=0.028 andP<0.001. There were 7 patients with NYHA class at II-III and having occasional chest suppression and short of breath. There were no heart transplantation, frequent premature ventricular contraction, tachycardia and other malignant arrhythmia occurred in 38 survivors.
Conclusion: PTSMA may reduce LVOTG, IVS thickness and improve the clinical symptoms in HOCM patients, the long-term efifcacy is reliable.

BACKGROUND: How to promote the regeneration after peripheral nerve injury, especially after large defects, is a difficulty to be solved.OBJECTIVE: To review the mechanism of Wallerian degeneration and the development of nerve conduits.METHODS: PubMed database was searched for the literatures addressing the modular mechanism of Wallerian degeneration and nerve repair using the English keywords peripheral nerve regeneration, Wallerian degeneration, nerve guidance conduits. A total of 74 eligible literatures were included based on the exclusion criteria.RESULTS AND CONCLUSION: Rat SARM1 and fruit fly dSARM have been found to be highly implicated in Wallerian degeneration, indicating that the changes of nicotinamide adenine nucleotide/nicotinamide adenine dinucleotide may be related to the activated SARM1. Whether delaying Wallerian degeneration is good or bad is still in dispute. The future study should focus on the early inhibition of Wallerian degeneration and promotion of neuroregeneration following peripheral nerve injury.

Objective To assess the evidence-based support of short-term efficacy of sleeve gastrectomy and Roux-en-Y gastric bypass in obesity with metabolic syndrome by laparoscopy.Methods Electronic literature search was performed on PubMed,EMBASE,Cochrane Library,CNKI database for the efficacy of sleeve gostrectomy and Roux-en-Y gastric bypass in the treatment of obese patients with metabolic syndrome from Jan.2011 to Jun.2016.The inclusion and exclusion criteria were selected for quality evaluation,data extraction.Review Manager 5.3 software was used to conduct the statistical analysis.Results Thirteen articles were included in the Meta-analysis,including 5 randomized controlled trails,eight case-control studies with 18,850 cases,including 2,559 cases in the sleeve gastrectomy group and 16,291 cases in the Roux-en-Y gastric bypass group.The results of the Meta-analysis showed that there was no significant difference in the remission rate of type 2 diabetes rnellietus between sleeve gastrectomy and Roux-en-Y gastric bypass group (78.7％ vs 83.0％;RR =0.94,95％ CI:0.81 ～ 1.09,P ＞0.05),the reduction of body mass index was significantly higher in Roux-en-Y gastric bypass group than sleeve gastrectomy group from the short-term follow-up (MD =-2.03,95％ CI:-3.25 ～ 0.81,P ＜ 0.05).Both two surgeries can reduce the incidence of high blood lipids and hypertension,but there was no significant difference between them as well as type 2 diabetes mellitus remission.Conclusion Both sleeve gastrectomy and Roux-en-Y gastric bypass are effective in treating obesity complicated with metabolic syndrome,and can reduce the incidence of type 2 diabetes mellitus,hypertension and hyperlipidemia and reduce the body weight.Roux-en-Y gastric bypass is superior to sleeve gastrectomy in the treatment of obesity.

Objective:To solve the problems in intensity-modulated radiation therapy (IMRT) planning, such as large labor cost and high dependence on the experience of physicists and great inconsistency in the quality of plan, and to discuss an unsupervised automatic treatment planning procedure of IMRT.Methods:The eclipse scripting application programming interface (ESAPI) within the Eclipse treatment planning system (TPS) 15.6 and optimization parameters tree search algorithm (OPTSA) were used to emulate and realize the whole planning process. Interacted with the TPS through ESAPI, relevant dosimetric parameters were input and output. The OPTSA evaluated the plan qualities based on dosimetric parameters of the targets and organs at risk (OARs) and iteratively adjusted the optimization objective parameters to achieve a progressively improving IMRT plan. In order to verify the effectiveness of the automatic planning, twenty historical rectum cancer cases were selected from the clinical database, and the dose distribution and specific dosimetric parameters were compared between the plans generated by the OPTSA and the manual plans under the same constraints.Results:All the auto plans have met clinical requirements. Furthermore, 90% and 10% of the auto plans were deemed as clinically improved and equally compared with the manual plans, respectively. The average CI for the PTV was 0.88 and 0.80 for the auto and manual plans respectively. Compared with the manual plans, the mean doses of all the OARs in the auto plans were reduced by 11% in average. The average elapsed time of automatic planning and manual planning was (28.15±3.61) and (36.7±4.6) min, respectively.Conclusions:The plans created by the proposed algorithm have been shown to be at least as good as the manual plans. In addition, this method can shorten the labor time in plan designing while ensuring the plan quality and consistency of the plan.

Objective:To investigate the performance of W2 plastic scintillator in megavolt photon and electron beams.Methods:The photon and electron beam energy provided by linear accelerator was used to collect data of the W2 scintillator. The parameters include the electrometer reading stability, W2 dose and dose rate linearity, and angular response. And the dose uncertainty of the W2 correction factors was also investigated.Results:The standard deviation of the electrometer reading stability was between 0.03 and 0.47. The linear regression factors of W2 dose were all 1.0; the maximum deviation of the dose rates was 0.61%. The Cerenkov light radiation correction factor(CLR) for 6 and 10 MV were 0.741 and 0.746, respectively, and the CLR for 6, 9, 12 and 15 MeV were 0.750, 0.753, 0.757 and 0.757, respectively. The maximum deviation of dose uncertainty for 15 MeV was 3.15%.Conclusions:The signal obtained by the blue and green channel was no angular dependence, the same as the high-energy electron beam, which verified that the Cerenkov radiation correction factor has good linearity. W2 plastic scintillator can be applied to non-coplanar radiotherapy dosimetry.

Objective To investigate the effect of citric acid and ambroxol on clearing insoluble particles of depleted uranium in rat lungs by establishing a tracheal perfusion model.Methods One hundred and fifty male Wistar rats were randomly divided into model exposure group, normal control group(NC group), depleted uranium exposure group(DU), citric acid treatment group( CA) , ambroxol treatment group( AM) and citric acid+ambroxol treatment group( CA+AM) . The rats were sacrificed on 7, 15 and 30 days.Uranium content in the lungs was detected by microwave digestion method, pathological changes in the lungs were observed, and inflammatory factors of lung homogenates were detected.Results Compared to DU control group, the intrapulmonary uranium deposit amount in experimental groups was significantly reduced on 7 and 15 days (P<0.05).HE stained lung tissue showed that the pathological changes in treatment groups were less significant than in DU control group.The level of IL-1α,IL-1β,and IL-2 was significantly lower than in DU control, but the level of MCP-1 and MIP-1 was observably higher.Conclusion Citric acid and ambroxol can evidently improve the clear-ance of lung uranium and reduce damnification of lung tissues.Drug treatment can reduce the level of pulmonary inflamma-tory cytokines alleviate the chronic inflammation in the lungs, and enhance the capacity of macrophage to recruitment.

Excess fat mass accumulation can lead to a wide range of metabolic and cardiovascular complications.It includes immune cell infiltration and altered secretion of anti-and proinflammatory mediators,which contribute to systemic,low-grade inflammation.Bariatric surgery may reverse the altered secretory profile observed in the adipose tissue of severe obesity patients.This article will review available literature documenting the impact of surgeryinduced weight loss on tissue expression or circulating levels of a broad spectrum of inflammatory mediators.

Primary hepatic carcinoma, hepatic carcinoma for short, is a common gastrointestinal tumor with an insidious onset and rapid progression, and its incidence rate is increasing year by year, seriously threatening the life and health of our people. At present, there is still a lack of specific markers for early diagnosis and treatment of hepatic carcinoma, so the research on its biological characteristics and pathogenesis has become very urgent. Metabolic reprogramming is one of the main characteristics of tumor cells, and lipid metabolic reprogramming is involved in the occurrence and development of hepatic carcinoma. Therefore, the key metabolic enzymes and regulatory molecules in the process of lipid metabolism are considered as important targets for the diagnosis and treatment of hepatic carcinoma. This paper mainly focuses on the signaling pathways and regulatory molecules related to hepatocellular carcinoma lipid metabolism, as well as the related anti-hepatoma drugs, so as to provide new ideas for the prevention and treatment of hepatic carcinoma.

Objective To investigate the effect of very-long-chain saturated fatty acids on Tau protein phosphorylation and membrane fluidity in human neuroblastoma SH-SY5Y cells,and to explore its role in the pathogenesis of Alzheimer's disease(AD).Methods Human neuroblastoma SH-SY5Y cells in logarithmic growth phase were randomly divided into control group,C22∶0 group,and C24:0 group.Cells in the control group were routinely cultured,while cells in the C22:0 and C24:0 groups were treated with culture medium containing 10 μmol·L-1very-long-chain saturated fatty acids C22:0 and C24:0,respectively.After 24 hours of incubation,cells were collected.The expression levels of total Tau protein,phosphorylated Tau protein at serine 396 site(p-Tau-ser396),glycogen synthase kinase 3β(GSK-3β),and phosphorylated GSK-3 β protein at serine 9 site(p-GSK-3β-Ser9)in cells of each group were detected by using Western blot.The malondialdehyde(MDA)level in cells of each group was determined by using the thiobarbituric acid method.The fluorescence recovery rate and diffusion coefficient of cell membranes were measured by using fluorescence recovery after photobleaching technique,and the fluidity of cell membranes was evaluated.Results The total Tau protein level in SH-SY5Y cells showed no statistically significant difference among the three groups(F=1.807,P＞0.05).However,there was a statistically significant difference in the level of p-Tau-ser396 in SH-SY5Y cells among the three groups(F=18.397,P＜0.05).Specifically,the level of p-Tau-ser396 in SH-SY5Y cells in the C22:0 and C24:0 groups was significantly higher than that in the control group(P＜0.05),and the level of p-Tau-ser396 in SH-SY5Y cells in the C24:0 group was significantly higher than that in the C22:0 group(P＜0.05).There was no statistically significant difference in the GSK-3 β protein level in SH-SY5Y cells among the three groups(F=0.351,P＞0.05).However,there was a statistically significant difference in the level of p-GSK-3β-Ser9 in SH-SY5Y cells among the three groups(F=13.330,P＜0.05).Specifically,the level of p-GSK-3β-ser9 in SH-SY5Y cells in the C22:0 and C24:0 groups was significantly lower than that in the control group(P＜0.05),and there was no statistically significant difference in the level of p-GSK-3β-ser9 in SH-SY5Y cells between the C22:0 group and C24:0 group(P＞0.05).The MDA level in SH-SY5Y cells in the C24:0 group was significantly higher than that in the control group and C22:0 group(P＜0.05);there was no statistically significant difference in the MDA level in SH-SY5Y cells between the control group and C22:0 group(P＞0.05).The fluorescence recovery rate and diffusion coefficient of SH-SY5Y cells in the C22:0 and C24:0 groups showed a decreasing trend compared to the control group,but there was no statistically significant difference in the fluorescence recovery rate and diffusion coefficient of SH-SY5Y cells among the three groups(F=3.891,3.649,P＞0.05).Conclusion Very-long-chain saturated fatty acids C22:0 and C24:0 can promote hyperphosphorylation of Tau protein,induce cellular oxidative damage,and tend to reduce the fluidity cell membranes.Very-long-chain saturated fatty acids may be one of the factors that cause the onset of AD.

Waardenburg syndrome is a rare genetic disease of auditory pigmentation. The main symptom is sensorineural hearing loss. Pigment disorders and other developmental defects in skin, hair, iris, fundus and other parts are specifically divided into four different subtypes, each of which corresponds to different pathogenic genes, which encode transcription factors and signaling molecules that play a key role in the development process of neural crest cells into melanocytes. Because there are multiple subtypes of Waardenburg syndrome, different subtypes exhibit different symptoms, signs and ocular manifestations. Patients with Waardenburg syndrome are often first treated in ENT head and neck surgery due to hearing loss. Lack of theoretical knowledge related to Waardenburg syndrome by ophthalmologists may lead to misdiagnosis or missed diagnosis. Although there are currently limited treatments for the disease, with the continuous development of gene therapy and hearing management methods, the future treatment prospects will be broader.