Adult ; Epilepsy ; genetics ; Humans ; Hyperhomocysteinemia ; genetics ; Hypogonadism ; genetics ; Intellectual Disability ; genetics ; Male ; White Matter ; pathology

Objective To compare the outcomes between modified McKeown minimally invasive approach and open left chest-neck incision approach esophagectomy for treatment cancer of mid-to-distal thoracic esophagus.Methods We retrospectively analyzed clinical data from 128 patients with mid-to-distal thoracic esophageal cancer who underwent thoracoscopic and laparoscopic esophagectomy from March 2009 to March 2012.One hundred and fifty patients were served as control that underwent open left chest-neck incision approach esophagectomy in the same period.Results All the operations were performed successfully.There was significant difference between modified McKeown minimally invasive approach and open left chest-neck incision approach esophagectomy with regard to respiratory complications (10.9 ％ vs.20.7％),pneumonia (4.7％ vs.11.3 ％),atelectasis (3.1％ vs.10.5 ％,),pleural effusion (3.1％ vs.10.0％) and delayed gastric emptying (8.6 ％ vs.1.3 ％) (P ＜ 0.05).Hospital stay was significantly shorter in the minimally-invasive group than the open group [(11.7 ± 3.6) days vs.(13.9 ± 6.5) days,P＜0.05],and had significantly less blood loss [(88.1 ±41.8) ml vs.(360.5 ±80.6) ml,P＜0.05] and the number of lymph nodes harvested (22.9 ±5.7 vs.16.8 ±4.5,P ＜0.05).No significant differences were observed on the operative time,mortality and other complication between the two groups.Conclusion Modified McKeown minimally invasive approach esophagectomy is techeniqually feasible and safely which have lower blood loss,lower respiratory complication,shorter hospital stay and more number of lymph nodes harvested comparing to open left chest-neck incision approach.

Objective To evaluate the effect of propofol on mitochondrial fission in a rat hippocampal neuron model of hypoxia/reoxygenation (H/R) injury.Methods Primarily cultured hippocampal neurons of neonatal Sprague-Dawley rats were randomly divided into 4 groups (n =42 each) using a random number table:control group (group C);vehicle group (group V);H/R group;H/R+propofol group (group H/R+P).In group V,H/R was not produced,the vehicle dimethyl sulfoxide with the final concentration of 0.01％ was added,and the cells were then incubated for 6 h.In group H/R,the hippocampal neurons were subjected to oxygen-glucose deprivation for 6 h followed by 20 h reoxygenation.In group H/R+P,propofol with the final concentration of 1 μmol/L was added at 6 h of hypoxia.At 20 h of reoxygenation,the cell apoptosis (using flow cytometry),Ca2+ concentrations in cytoplasm (with the laser scanning confocal microscope),calcineurin (CaN) activities (by enzyme-linked immunosorbent assay),and expression of mitochondrial fission proteins dynamin-related protein 1 (Drp1) and fission 1 (Fis1),and apoptosis-related proteins cytochrome c (Cyt c) and apoptosis-inducing factor (AIF) (by Western blot) were measured.The apoptotic rate was calculated.Results Compared with group C,the apoptotic rate,Ca2+concentrations,CaN activities,and expression of Drp1,Fis1,Cyt c and AIF were significantly increased in H/R and H/R+P groups (P＜0.05),and no significant changes were found in the parameters mentioned a2+.bove in group V (P＞0.05).Compared with group H/R,the apoptotic rate,Ca+ concentrations,CaN activities,and expression of Drp1,Fis1,Cyt c and AIF were significantly decreased in group H/R+P (P＜0.05).Conclusion Propofol can reduce the H/R injury to rat hippocampal neurons through inhibiting mitochondrial fission.

Objective To explore clinic effect analysis of improved V-shaped osteotomy to correct thoracolumbar kyphosis. Methods A total of 64 patients with thoracolumbar kyphosis were divided into two groups, traditional group and improved group, the traditional surgery group of 30 patients underwent the traditional V-shaped osteotomy, includ-ing 20 males and 10 females with an age range of 45 to 68 years. Improved surgery group of 34 patients underwent the improved V-shaped osteotomy, including 22 males and 12 females with an age range of 53 to 65 years. Perioperative complications and Cobb angle of kyphosis were compared between two groups. Results The improved group and tradi-tional group in correction Cobb of kyphosis had no obvious difference(P>0.05), the incidence of postoperative gastroin-testinal complications in improved group was obviously lower than traditional group with statistical difference(P<0.05). Conclusion The improved V-shaped osteotomy surgery can correct thoracolumbar kyphosis with cobb angle< 80o and the gastrointestinal complications and vascular events can be significantly reduced.

Objective To investigate the protective role of Sestrin2 overexpression in hypoxia and re-oxygenation injury (H/R) injury of hippocampal neurons and its mechanism in rats.Methods Neurons were enzymatically isolated from hippocampi of newborn Sprague-Dawley rats (less than 24 h old) and culturedinvitro. These neurons were randomly assigned into 4 groups (n=20) using a random number table: control group, H/R group, vector group and Sestrin2 overexpression group. The hippocampal neurons were seeded in 6-well plates at a density of 2×104 cells/mL; neurons in the latter two groups were transfected with lentiviruses containing empty vector andSestrin2overexpressed genes, respectively; the hippocampal neurons in the later three groups were subjected to oxygen-glucose deprivation (OGD) for 6 h followed by restoration of O2 supply for 20 h. The reactive oxygen species (ROS) content was detected by Reactive Species Assay Kit, and the ATP concentration was detected by ATP Assay Kit. Cell apoptosis rates were measured by flow cytometry. The levels of Sestrin2, dynamin-related protein 1 (Drp1), Fis1, and apoptosis-related proteins Bcl-2, Bax and cytochrome C (Cyt C) were measured by Western blotting. The ratio of Bcl-2 to Bax was calculated. The ultrastructure of mitochondria was observed by transmission electron microscopy.Results As compared with control group, H/R group had significantly lower ATP concentration, Bcl-2 protein expression and ratio of Bcl-2 to Bax ([11.15±0.42] nmol/mg proteinvs. [5.30±0.39] nmol/mg protein; 2.20±0.26vs. 0.91±0.02; 6.46± 0.41vs. 1.04±0.05), statistically higher average fluorescence intensity of ROS and cell apoptosis rate (152.41±17.38vs. 1530.00±14.69; 3.77％±0.74％vs. 56.57％±1.35％), and significantly higher protein levels of Sestrin2, Drp1, Fis1, Bax and Cyt C (0.66±0.06vs. 1.11±0.20; 0.48±0.03vs. 1.16±0.07; 1.14± 0.09vs. 2.47±0.09; 0.34±0.03vs. 0.88±0.04; 0.17±0.03vs. 0.30±0.03,P<0.05); what's more, the structure of mitochondria was obviously destroyed in I/R group. As compared with H/R group, Sestrin2 overexpression group had significantly increased ATP concentration, Sestrin2 and Bcl-2 protein expressions and ratio of Bcl-2 to Bax ([8.95±0.27] nmol/mg protein; 2.67±0.07; 1.80±0.19; 3.95±0.28), significantly lower average fluorescence intensity of ROS and cell apoptosis rate (337.27±15.32; 10.33％±2.60％), and statistically lower protein levels of Drp1, Fis1, Bax and Cyt C (0.43±0.02; 1.11±0.08; 0.45± 0.02; 0.17±0.02,P<0.05); the structure of mitochondria was relatively completed in Sestrin2 overexpression group.Conclusion Sestrin2 overexpression can inhibit mitochondrial fission, reduce accumulation of reactive oxygen species, improve mitochondrial energy metabolism and block mitochondria mediated apoptosis pathway, thereby alleviating I/R injury of rat hippocampal neurons.

Objective To describe the effects of surgical intervention on the prognosis in non-small-cell lung cancer patients with pleural carcinomatosis detected at thoracotomy.Methods Retrospectively analyzed clinical data from 54 patients who have unexpected malignant pleural nodules and/or malignant pleural effusions first detected at thoracotomy from January 2009 and December 2013.The effects of surgical intervention on the prognosis were also discussed.Results Sixteen cases had only biopsy,whereas 38 (70.4％) cases had primary tumor resection.The median survival time of 54 patients with pleural carcinomatosis were 23 months.The overall 1 and 5-year survival rates were 64％ and 18％,respectively.Primary tumor resection had significantly better outcome compared with biopsy(MST:respectively,24 vs 15 months,5-year survival rate 39％ vs 6％,P ＜0.05).Univariate analysis showed that primary tumor resection,no smoking history,lower T and N stage has favorable survival(P ＜ 0.05).Multivariate analysis showed that the best N stage(P =0.002) and adenocarcinoma(P =0.035) were favorable prognostic factors in these patients.Conclusion For patients with pleural careinomatosis first detected at thoracotomy,limited primary tumor resection may have survival benefits,lower T and N stage for them was associated with better survival.

ObjectiveTo count and analyze the toxic traditional Chinese medicines and their characteristics in Chinese Materia Medica， so as to provide reference for the development and application of toxic drugs. MethodThe traditional Chinese medicines included in Chinese Materia Medica were screened one by one， and the inclusion criteria were "drug properties"， "usage and dosage" and "major poison， highly poisonous， poisonous， slightly poisonous， slightly poisonous" appearing in ancient books. Standard toxic traditional Chinese medicines were entered into an excel sheet for statistical analysis. ResultA total of 1 408 toxic Chinese medicines were included. The properties and flavors were mainly cold， bitter， pungent and sweet； the main meridians were liver， lung， spleen and stomach； the root， whole grass and leaves were the most used medicinal parts， and there were many toxic drugs. The pre-treatment methods are mainly sun-dried， fresh， fried， calcined， and sunburned； the efficacy categories are mainly heat-clearing drugs， rheumatism drugs， blood-activating and stasis-removing drugs； oral administration methods are mainly decoctions， pills， and powders ， mainly for external application， dipping， and coating； the dosage for oral administration is mostly 9-15 g， 3-9 g， 3-6 g， and an appropriate amount is mainly for external use. ConclusionThere are many toxic Chinese medicines clearly recorded in Chinese Materia Medica， but only 83 kinds of clearly toxic Chinese medicines are included in Chinese Pharmacopoeia， which need to be further strengthened by experimental observation and clinical data verification. The clinical application of toxic traditional Chinese medicine is mainly based on heat toxin blood syndrome and rheumatic arthralgia， which is closely related to its nature， taste and meridian return. Able to move， has the effect of activating Qi and activating blood， "sweet" can replenish energy and slow down， and has the effect of tonic， alleviation and pain relief， and mostly used for the treatment of heat syndrome， blood syndrome and arthralgia syndrome. However， there are certain limitations in the classification and processing conditions of toxic traditional Chinese medicines， which need to be further improved and scientifically verified.

Hepatic ascites is one of the common and difficult complications in the decompensated stage of liver cirrhosis， and its incidence is increasing. In clinical practice， the prognosis of patients with hepatic ascites after surgery is worse， and the disease is recurrent. Traditional Chinese medicine （TCM） has certain advantages in treating hepatic ascites. However， there is no uniform standard for the preparation of animal models of hepatic ascites in accordance with TCM evidence. Therefore， this paper summarized the literature on animal models of hepatic ascites and analyzed the existing animal models of hepatic ascites based on the clinical diagnostic criteria of hepatic ascites in TCM and western medicine. The results show that the commonly used modeling methods for hepatic ascites mainly include the single-factor method， composite factor induction method， surgical method， and immunization method. Most of them are guided by western medicine theories， and their pathogenic mechanisms are mostly consistent with those of western medicine and are different from TCM evidence. Therefore， it is suggested that TCM intervening factors should be imposed in the process of model preparation， so as to prepare an animal model of hepatic ascites that meets the clinical evidence characteristics of TCM and western medicine.

ObjectiveTo collect and analyze the properties and application characteristics of external use of roots and rhizomes of Chinese herbal medicines in the Chinese Materia Medica（《中华本草》） to provide data references for the research on clinical external use of Chinese medicine， in order to provide data reference for clinical external use of traditional Chinese medicine（TCM）. MethodThe Chinese herbal medicines included in the Chinese Materia Medica were systematically screened. The inclusion criterion was the explicit mention of terms like "root", "rhizome", "root bark", "tuber", "tuberous root", etc. under the "Source" in the Chinese Materia Medica. Information on properties, flavors, meridian tropism, medicinal parts, fresh use, toxicity, efficacies and indications, and dosage of roots and rhizomes of Chinese herbal medicines was collected. The information was then entered into an Excel spreadsheet for statistical analysis. ResultThe Chinese Materia Medica records 2 662 roots and rhizomes of Chinese herbal medicines, of which 1 653 are suitable for external use. The predominant properties and flavors are cool, cold, bitter, pungent, and sweet. These Chinese herbal medicines mainly act on the liver, lung, and spleen meridians. The primary medicinal parts used include root, rhizome, and root bark. More than half of the roots and rhizomes of Chinese herbal medicines can be used in their fresh form. The main efficacies include clearing heat, removing toxins, resolving stasis, dispersing accumulation, resolving blood stasis and stopping bleeding, reducing swelling and alleviating pain, dispelling dampness and relieving pain. The main indications are skin sores, traumatic injuries, and rheumatic diseases. Common external application methods include poultice, decoction for washing, and applying powdered form. Most of these Chinese herbal medicines lack specific dosage guidelines for external use, with an emphasis on using an appropriate amount. ConclusionThe Chinese Materia Medica contains a wide range of roots and rhizomes of Chinese herbal medicines suitable for external use, with definite therapeutic effects, providing a broad perspective for the application of Chinese medicine externally. However, there are still problems such as unclear dosages and limited research. Further studies are necessary to better utilize the advantages of the external use of Chinese medicine.