OBJECTIVETo explore the clinical effects of Dynesys system combined with posterior lumbar interbody fusion (PLIF) in treating multiple lumbar degenerative disease.

METHODSThe clinical data of 46 patients with multiple lumbar degenerative diseases treated by Dynesys system combined with PLIF from September 2010 to May 2013 were retrospectively analyzed. There were 17 males and 29 females, aged from 38 to 68 years old with an average of (56.38±11.63) years. Operation section was in L2-L5 of 16 patients (6 with fusion of L4,5 and 10 with fusion of L4,5,L5S1) and in L3-S1 of 30 patients (11 with fusion of L5S1 and 19 with fusion of L4,5,L5S1). Patients were followed up for three times: postoperative 3 months, 1 year and final follow-up. Visual analogue scale (VAS) and Oswestry Disability Index (ODI) were used to assess clinical symptoms preoperatively and postoperatively. All patients underwent flexion/extension radiographs examinations before surgery and at final follow-up. Range of motion (ROM) and disc height index (DHI) were recorded.

RESULTSAll patients were followed up from 16 to 48 months with the mean of (23.23±7.34) months. At third follow-up after operation, ODI and VAS of lumbago and leg pain were significant improved than that of preoperative (P<0.01). DHI of fusion segment was significantly increased than that of preoperative (P<0.05). There was no significant difference in adjacent non-fusion segment between preoperative and postoperative (P>0.05). Postoperative ROM of fusion and non-fusion segments were obviously decreased than that of preoperative. There was no significant difference in ROM of upper adjacent non-fusion segment between 3 months and 1 year after operation (P>0.05), but at final follow-up, the ROM was increased (P<0.05).

CONCLUSIONThe preliminary clinical results of the Dynesys system combined with PLIF in the treatment of multiple lumbar degenerative diseases are satisfactory. It can be determined in fusion or non-fusion according to the individual needs and can reserve the some intervertebral motion, prevent the early degeneration of adjacent segments. However, its long-term clinical efficacy should be verified with long time.

Humans ; Lumbar Vertebrae ; surgery ; Range of Motion, Articular ; Retrospective Studies ; Spinal Diseases ; physiopathology ; surgery ; Spinal Fusion ; methods ; Visual Analog Scale

OBJECTIVEThis investigation aimed to examine how buccal mucosa microbiome succeeds in a healthy population with different ages and dentition stages.

METHODSTwenty-five subjects were recruited and subdivided into five groups: primary dentition group, mixed dentition group, adolescent group, adult group, and elderly group. Individual mucosal microbiota was obtained by gently scraping both sides of the buccal mucosa with a cotton swab. Microbial diversity was analyzed by polymerase chain reaction-denaturing gradient gel electrophoresis (PCR-DGGE).

RESULTS1) The composition of buccal mucosa microbiota has great intra-individual divergence. 2) The average band numbers of the primary dentition group, mixed dentition group, adolescent group, adult group, and elderly group were 21.2 +/- 4.0, 17.8 +/- 3.9, 15.8 +/- 4.3, 16.8 +/- 3.7, and 22.2 +/- 6.5, respectively. No between-group differences was observed (P > 0.05), indicating that predominant strains in the oral cavity may be stable throughout an individual's lifetime. 3) The Shannon indices of primary dentition group, mixed dentition group, adolescent group, adult group, and elderly group were 1.73 +/- 10.2, 1.43 +/- 0.1, 1.05 +/- 0.2, 1.45 +/- 0.2, and 1.63 +/- 0.3, respectively. A significant between-group difference was observed (P = 0.003), indicating that the microbial diversity of the buccal mucosa decreases from childhood through adolescence, but increases from adult through senescence. 4) The clustering analysis showed that most of the samples in the same group clustered together, indicating higher intra-group community structure similarity.

CONCLUSIONComposition of the buccal mucosa microbiota was different among age groups. Adolescence may be an essential turning point of microbial ecology succession throughout life.

Adolescent ; Adult ; Aged ; DNA, Bacterial ; Humans ; Microbiota ; Mouth Mucosa ; Polymerase Chain Reaction ; RNA, Ribosomal, 16S

Laparoscopic hepatectomy has brought new techniques and concepts to the liver surgery.Compared with the traditional laparotomic resection, the approaches of laparoscopic hepatectomy are quite different and have advantages.In this article, the characteristics, selection and application of various laparoscopic hepatectomy approaches are summarized and described.Different surgical strategies lead to different approaches, and the choice of each approach is not fixed and independent.The safety and effectiveness of laparoscopic hepatectomy can be guaranteed to the greatest extent by reasonable selection and combination of various approaches.

Renal fibrosis is a pathological process presented in all chronic kidney diseases and lacks effective treatment. Renal anti-aging protein Klotho displays impressive anti-renal fibrosis capacities, but sustainedly depressed during the initiation and progression of renal fibrosis due to aberrant epigenetic modifications, making Klotho a potential target of epigenetic intervention in anti-renal fibrosis therapy. The author has performed a series of studies and first established TGFb as an essential upstream pathological factor that causes Klotho suppression by inhibiting miR-152 and miR-30. This inhibition subsequently induces DNMT1 and DNMT3a and leads to Klothopromoter hypermethylation and Klotho suppression. Further, it has been found that Rhein from the Chinese medicinal herbal plant and a specific inhibitor of histone deacetylase (HDAC) 3 are capable of either inhibiting the aberrant DNMT1/3a induction and Klotho promoter DNA hypermethylation or enhancing PPARg acetylationat lysine 240/265 and its up-regulation of Klotho, resulting in Klotho restoration and reduced renal fibrosis and the associated renal and bone injuries. Therefore our findings have revealed the distinct epigenetic features of Klotho suppression in renal fibrosis and demonstrated the promising potentials of Klotho-targeted strategies in the treatment of renal fibrosis and the related disorders.

There has been increasing interest in the psycho-socio-relational and sexual disorders of infertility, as the risk of psychological burden among infertile men with sexual dysfunctions is significant. The purpose of this study was to develop and to validate a predictive model to estimate individual psychological burden among infertile men with sexual dysfunction and study the association between them. Comprehensive data were collected for infertile men (n = 480) who sought treatment for infertility in a reproductive medicine center between June 2012 and December 2013. Using independent predictors of psychological burden from the least absolute shrinkage and selection operator, univariable and multivariable analyses were developed into two models. Predictive accuracy was compared between the models. We explored the association between sexual dysfunction and psychological burden. A total of 480 patients were analyzed using 10-fold cross-validation. Independent predictors of psychological burden were incorporated into a model to measure anxiety (corrected-area under curve (AUC): 77.3%) and a model to measure depression (corrected-AUC: 70.2%). Anxiety and depression were both associated with erectile dysfunction (P < 0.05), with anxiety demonstrating the strongest association. Only anxiety was associated with premature ejaculation (P < 0.05). Premature ejaculation was not found to be associated with depression (P > 0.05). Predictive models for psychological burden among infertile men with sexual dysfunction are presented, and we found that there is an association between psychological burden and sexual dysfunction. According to the models, proper counseling and treatment of sexual dysfunction in infertile men may reduce the psychological burden, help attain natural pregnancy, and improve the quality of life.

Objective To establish a one-step recombinase polymerase amplification (RPA) method for pathogen screening and rapid detection in the field targeting for five hemorrhagic fever related viruses (Zaire ebola virus, Sudan ebola virus, Marburg virus, Lassa virus and Yellow fever virus). Methods The specific nucleic acid (NA) fragments of each virus were selected as target genes by genome sequence analysis, and the primers and probes for RPA assays were designed according to the sequence. A series of diluted template genes were used for RPA detection to determine the sensitivity. The hemorrhagic fever-related viral nucleic acids were used for RPA detection to determine the specificity. The amplification experiments were carried out at different temperature ranging from 37℃ to 42℃ to validate the reaction temperature range. Results The RPA reaction systems of the five hemorrhagic fever viruses could effectively amplify the target genes, the sensitivities were between 1.5×102 and 1.5×103 copies. No cross reactions existed with the other hemorrhagic fever-related viral genes. Meanwhile, RPA assay could effectively amplify the target genes at 37-42℃. Conclusion The isothermal RPA assays of five hemorrhagic fever viruses are established, which may amply target genes fast and react at a wide temperature range, and be potentially useful for in field pathogens detection.

Objective:To investigate the application value of one-stitch prophylactic ileostomy in late ileostomy closure.Methods:The prospective randomized control study was conducted. The clinicopathological data of 141 patients with rectal cancer who underwent low anterior resection combined with prophylactic ileostomy in the Affiliated Tumor Hospital of Zhengzhou University from January 2016 to July 2020 were selected. There were 127 patients being selected after excluding 14 cases who did not undergo ileostomy closure. Patients undergoing one-stitch prophylactic ileostomy were divided into observation group, and patients undergoing traditional ileostomy were divided into control group. Observation indicators: (1) grouping situations of the enrolled patients; (2) surgical situations of ileostomy closure; (3) postoperative situations; (4) follow-up. Follow-up was conducted using outpatient examination and telephone interview once a month after low anterior resection combined with prophylactic ileostomy to detect complication and death of patients. The end point was at 3 months after ileostomy closure. The follow-up was up to July 2020. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M( P25, P75) or M (range), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test. Comparison of ordinal data between groups was conducted using the Mann-Whitney U test. Results:(1) Grouping situations of the enrolled patients: a total of 127 patients were selected for eligibility, aged from 31 to 83 years, with a median age of 64 years. Of 127 patients, there were 66 cases in observation group and 61 cases in control group. (2) Surgical situations of ileostomy closure: all patients from the two groups underwent ileostomy closure successfully. The incision length, operation time, volume of intraoperative blood loss, cases with abdominal adhesion degree as slight adhesion or obvious adhesion were 4.25 cm(4.00 cm, 5.00 cm), 48.00 minutes(33.75 minutes, 58.00 minutes), 30 mL(20 mL, 50 mL), 34, 32 of the observation group, versus 7.50 cm(7.00 cm, 8.50 cm), 70.00 minutes(57.00 minutes, 80.00 minutes), 30 mL(30 mL, 50 mL), 13, 48 of the control group, showing significant differences between the two groups ( Z=-9.549, -6.133, -2.758, χ2=12.405, P<0.05). (3) Postoperative situations: cases with incision infection of the observation group and the control group were 5 and 13, respectively, showing a significant difference between the two groups ( χ2=4.917, P<0.05). (4) Follow-up: all the 127 patients were followed up for 6-21 months, with a median follow-up time of 10 months. During the follow-up, 3 cases of the control group had postoperative incisional hernia and were cured after conservative treatment. None of patient had anastomotic leakage related complications or died during the follow-up. Conclusion:The one-stitch preventive ileostomy has the advantage of ileostomy closure, which can reduce the operation time, volume of intraoperative blood loss and shorten the incision length effectively, so as to reduce the incidence of postoperative incision infection related complications.

Objective:To investigate whether adjuvant chemotherapy could be beneficial for patients with pT1N1M0 (stage ⅠB) gastric cancer.Methods:From Jan 2010 to Dec 2016, 185 patients with pT1N1M0 gastric cancer who were surgically resected at Henan Cancer Hospital were retrospectively analyzed. The patients were divided into chemotherapy group ( n=100) and non chemotherapy group ( n=85). Results:For disease-free survival (DFS) analysis, univariate survival analysis showed that age, examined lymph nodes, vascular invasion, nerve invasion and adjuvant chemotherapy were associated with DFS (all P<0.05); multivariate analysis showed that lymph node resection ≥ 16 ( HR=0.363, 95% CI: 0.160-0.827, P=0.016), vascular invasion ( HR=4.117, 95% CI: 1.796-9.436, P=0.001) and postoperative chemotherapy ( HR=4.530, 95% CI: 1.932-10.622, P=0.001) were independent risk factors for DFS. For disease-specific survival (DSS) analysis, univariate survival analysis showed that lymph node resection, vascular invasion, nerve invasion and adjuvant chemotherapy were associated with DSS; multivariate analysis showed that lymph node resection ≥ 16 ( HR=0.344, 95% CI: 0.144-0.822, P=0.016), vascular invasion ( HR=5.113, 95% CI: 2.029-12.887, P=0.001) and postoperative chemotherapy ( HR=4.694, 95% CI: 1.854-11.888, P=0.001)were independent risk factors for DSS. According to examined lymph nodes and vascular invasion , pT1N1M0 patients were divided into three risk categories (high, medium and low). DFS and DSS were significantly different among the three risk groups (all P<0.001, respectively). Conclusion:pT1N1M0 gastric cancer patients are expected to benefit from adjuvant chemotherapy. Patients with less than 16 lymph nodes and vascular invasion may be particularly suitable for adjuvant chemotherapy.

OBJECTIVE: To explore whether knockdown serglycin's expression level in MDA-MB-231 cells by transient transfection can improve the sensitivity of breast cancer cells to the doxorubicin. METHODS: At first, qRT-PCR, Western-Blot and immunofluorescence were used to examine the expression level in two different cell lines, MDA-MB-231 and MCF-7.Then serglycin's expression level in MDA-MB-231 was knocked down by using transient transfection, qRT-PCR and immunofluorescence were used to test the efficiency of this approach; and then, between the NC group and the Si-SG group, MTS was used to measure the IC50 of doxorubicin and the proliferation curve under the treatment of the doxorubicin. Also the numbers of colony formation in this two groups was observed when treating with different concentration of doxorubicin. RESULTS: It was found that in these two cells, the expression of serglycin in MDA-MB-231 is significantly higher than MCF-7.The efficiency of knockdown in MDA-MB-231 is above 70%. In Si-SG group, the IC50 and the growth curve under treatment with doxorubicin is significantly lower than the NC group. Same results can be found in the colony formation assay, when treating with the doxorubicin, the decreasing rate of colony numbers is significantly quicker in the Si-SG group than NC group. CONCLUSION: Knockdown serglycin's expression level in MDA-MB-231 cells by transient transfection can improve the sensitivity to the doxorubicin.

OBJECTIVE: To explore the role of clinical pharmacists in drug therapy by assisting the clinician to diagnose and treat a case of disseminated prevotella loescheii infection. METHODS: Clinical pharmacists offered reasonable suggestions for antibiotics selection by analyzing the disease condition of the patient, asking about allergy history, looking up domestic and foreign literature and drug sensitivity test result. And the pharmacists also provided pharmaceutical care and discharging medication education to the patient. RESULTS: The treatment regimen suggested by the clinical pharmacists was adopted by the physicians, and the disease condition was relieved significantly after treatment. CONCLUSION: Clinical pharmacists can demonstrate their value by taking advantage of their pharmacy knowledge and assisting clinicians to develop safe and effective therapeutic regimens.