OBJECTIVETo observe the effect of anisodamine (Ani) injection on the survival rate and histologic result of flaps with ischemia-reperfusion injury, so as to demonstrate the protective effect of Ani on the flap survival.

METHODSA total of 48 healthy male Wistar rats were randomly divided into model control, normal saline(NS) and anisodamine groups, with 16 rats in each group. An 3 cm x 6 cm axial flap was formed at the right lower abdomen with abdominal superficial blood vessel as the pedicle. 0.5 cm x 0.5 cm skin tissue was taken from the middle part of flaps in each group, immediately after operation, 12, 18, 24 h after operation. The superoxide dismutase (SOD), nitric oxide (NO), nuclear factor-kappaB contents in the specimens were detected. The histologic study was also performed. The flap survival rate was recorded 7 days after operation.

RESULTSFlap survival rate was (78.6 +/- 7.3) % in Anisodamine group. 12, 18, 24 h after reperfusion injury, the SOD was (103.3 +/- 3.9), (82.6 +/- 3.8), (67.5 +/- 4.6) U/mg; the NO was (5.33 +/- 2.05), (4.75 +/- 1.68), (4.15 +/-1.59) nmol/mg; the NF-kappaB was 0.211 +/- 0.039, 0.313 +/- 0.033, 0.096 +/- 0.028. The contents of SOD, NO and NF-kappaB had the statistical difference of at different time. The skin pathological changes in Anisodamine group was obviously better than those in NS group. Flap survival rate in Anisodamine group was significantly higher than that in NS group.

CONCLUSIONSIn the flap with ischemia-reperfusion injury, Anisodamine can reduce the damage of free radical, increase the blood flow, reduce the production of NF-KB, decrease inflammatory reaction. So Anisodamine can increase the survival rate of flaps with ischemia reperfusion injury.

Animals ; Graft Survival ; drug effects ; Male ; NF-kappa B ; analysis ; Nitric Oxide ; analysis ; Random Allocation ; Rats ; Rats, Wistar ; Reperfusion Injury ; prevention & control ; Solanaceous Alkaloids ; therapeutic use ; Superoxide Dismutase ; analysis ; Surgical Flaps ; blood supply ; pathology ; Vasodilator Agents ; therapeutic use

Objective To systematically evaluate the efficacy and safety of paclitaxel and carboplatin dose-dense weekly compared with the same chemotherapeutics administered every 3 weeks for ovarian cancer. Methods The databases, including PubMed, EMbase, The Cochrane Library (Issue 2, 2016), WHO ICTRP, CNKI, VIP and WanFang Data, were electronically searched from inception to February 2016 to collect the randomized controlled trials (RCTs) about dose-dense weekly paclitaxel and carboplatin vs paclitaxel and carboplatin administered every 3 weeks for ovarian cancer. According to the inclusion and exclusion criteria, two reviewers independently screened literatures, extracted data and assessed the risk of bias of included studies, and then meta-analysis was conducted by RevMan5.3 software. Results A total of 9 studies involving 2723 patients were included. The results of meta-analysis showed that, compared with the conventional treatment group, the dose-dense treatment group could significantly prolong the OS (Overall survival) (HR=0.85, 95%CI 0.73-0.98, P=0.03), but no significant difference existed between the two groups in clinical response (OR=1.13, 95%CI 0.91-1.39, P=0.27), survival (OR=1.10, 95%CI 0.99-1.22, P=0.07) and PFS (progression-free survival) (HR=0.89, 95%CI 0.74-1.06, P=0.18). A significantly higher blood system adverse reaction rate was in dose-dense treatment group than in conventional treatment group (OR=1.68, 95%CI 1.20-2.36, P=0.003); however, significantly lower rates of vomiting (OR=0.67, 95%CI 0.54-0.83) and hair loss (OR=0.57, 95%CI 0.44-0.74, P<0.0001) were in dose-dense treatment group. There were no significant difference existed between the two groups in liver function (OR=1.30, 95%CI 0.88-1.90, P=0.19), kidney function (OR=1.07, 95%CI 0.65-1.77, P=0.79), paresthesia (OR=1.13, 95%CI 0.91-1.41, P=0.26) and ECG (OR=0.74, 95%CI 0.35-1.58, P=0.44). Conclusions Current evidences have shown that dose-dense weekly paclitaxel and carboplatin can prolong the OS, lower the rates of vomiting and hair loss, while no significant difference exist between the two groups in clinical response, survival, PFS, liver function, kidney function, paresthesia and ECG. However, a significantly higher blood system adverse reaction rate may occur in dosedense treatment group than in conventional treatment group.

Objective To analyze the clinical significance of MTA1 overexpression in cervical cancer and bioinformatically screen the potential treatment targets from the gene network correlated with MTA1 overexpression. Methods SPSS software package was used to analyze the correlation of MTA1 with clinical metastasis and pathological grade of cervical cancer based on TCGA-CESC data set. The edgeR software was used to screen the gene set whose expression was correlated with MTA1 in cervical cancer at a global transcriptional level. DAVID platform was adopted to identify the enriched biological functions of the gene set significantly correlated with MTA1 expression. The transcriptional regulation network of the gene set was constructed with STRING online platform and Cytospace softwares to identify the key regulators. Results TCGA-CESC database assay showed a significant positive correlation of MTA1 expression with clinical metastasis of cervical cancer (P<0.01). There was a gene set in which gene expression was closely correlated with MTA1 level. Functional enrichment of the gene set indicated that cancer pathways, stem cell pathways, cell migration, cell differentiation, etc. were closely linked to MTA1-correlated malignant behaviors of cancers. Bioinformatical screening showed that Agt, Acta1, Fpr2, Pmch and RGS18, which are correlated with MTA1 expression in cervical cancer, were the key regulators in differentially expressed gene sets. And these genes were located to the GPCR pathway. Conclusions MTA1 overexpression is significantly correlated with clinical metastasis of cervical cancer and paralleled with the activation of gene regulation involved in stem cell pathway, cytokine receptor signaling, cell migration and differentiation pathways. These genes are correlated with MTA1 expression and potential treatment targets in cervical cancer and should be further experimentally evaluated in the future.

Objective:To evaluate the clinical value of percutaneous transhepatic cholangial drainage (PTCD) and percutaneous transhepatic cholangial stent(PTCS)implantation therapy for malignant biliary obstruction in the elderly patients.Methods:Fifty three patients over 60 years-old were treated with PTCS implantation (n=35),PTCD for internal-external drainage(n=11),or single external drainage(n=7). The imaging examination was performed for all the patients one week after surgery. The serum levels of total bilirubin (TBIL) and alanine aminotransferase (ALT) were detected before and after surgery.Rusults:Metallic stents were successfully implanted in 32 patients during the surgery, and 3 patients were implanted 5 to 7 days later after PTCS. Both total serum levels of TBIL and ALT were significantly decreased at one week after surgery (P<0.05). The mean survival periods were 11.5 months for stent implantation patients and 5.5 months for PTCD patients. Conclusion:PTCD and PTCS are easy to perform and safe and effective in the treatment of malignant biliary obstruction of elderly patients.

Due to the low effectiveness of traditional assisted reproductive technology (ART), new technological possibilities are constantly explored. Lots of studies have demonstrated the potential of microfluidics to revolutionize the fundamental processes of in vitro fertilization (IVF). With the advantages of high efficiency, short time, harmless collection, real-time observation of separation, similar microenvironment, and automation, the application of microfluidics in sperm isolation and IVF has shown an evident superiority over the conventional approaches and provided a new platform for ART. This review highlights the application of various microfluidic techniques in sperm motility assessment and isolation, sperm chemotaxis assay, IVF, sperm concentration, and sperm separation and enrichment in recent years. It also briefly introduces the basic principles, structural design, and operation processes of the microfluidic platform, focusing on the advantages and disadvantages of each method and the potential of their clinical application. Obviously, there are still some challenges to the application of microfluidics in ART. However, it is believed that the development of this new technology would be toward a highly integrated application of several steps in one single device, known as IVF-lab-on-a-chip.
Fertilization in Vitro ; methods ; Humans ; In Vitro Techniques ; Male ; Microfluidics ; methods ; Reproductive Techniques, Assisted ; Sperm Motility ; Spermatozoa

ObjectiveTo explore the effectiveness and practicability of training technique in hemiplegia.Methods313 stroke patients with hemiplegia were divided randomly into the control group and training group, and treated with integrative training technique for hemiplegia impairment during 3 months. Locomotor recovery and the performance of activities of daily living (ADL) of patients in two groups were assessed before and after one, two and three months training respectively, using Fugl-Meyer Assessment (FMA), Functional Independence Measure (FIM) and the scale of impairment in community rehabilitation.ResultsAfter treatment, FMA, FIM and the scale of impairment in community rehabilitation of the patients in the training group improved significantly ( P<0.001), the effectiveness was better than that of the control group ( P<0.05～0.001).The scales of FMA and FIM were proportional to the scale of impairment in community rehabilitation.ConclusionThe training technique for hemiplegia has ideal rehabilitation effectiveness.

ObjectiveTo investigate the characteristic of hindlimb movement recovery in adult rats after spinal cord injury and how to assess it.Methods 26 adult female rats were randomized in sham,completely midthoracic spinal cord transected(at T8 level) or body weight supported treadmill training(BWSTT) groups.Their motor function were assessed with Basso,Beattie,Bresnahan locomotor rating scale for open field(BBB scale) and average combined scores(ACOS).ResultsNone of the rats exhibited hindlimb movements after operation.30 d and 45 d after operation,BBB and ACOS score of rats in BWSTT group showed better than that in SCI group.There were significant differences in ACOS score among 15 d,30 d and 45 d after operation in both group.ConclusionPartial spontaneous hindlimb functional recovery can be found in chronic adult spinal cord injured rats and BWSTT would facilitate the recovery.Both semiquantitative and qualitative assessment were strongly correlated with locomotor recovery,but the semiquantitative assessment shows more sensitive.

ObjectiveTo determine the utility of the simple body weight support training apparatus used to improve ambulatory function in patients with hemiplegia or paraplegia.Methods38 cases with hemiplegia or paraplegia were randomly divided into control(C,n=10),regular body weight support treadmill training group(R,n=14),simple body weight support training group(S,n=14).All the patients received comprehensive rehabilitation for 6 months.Function Independence Measured(FIM),10 meters ambulatory velocity,Fugl-Meyer Assessment(FMA),Barthel Index(BI) were used to evaluate the effect of training.ResultsThe FIM scores and ambulatory velocity of the patients in group R and S improved significantly compared with that of group C.There was no difference of FIM scores and ambulatory velocity between group R and S.ConclusionThe effect of simple body weight support training on improving the ambulatory function is similar to regular body weight support treadmill.

Objective:To evaluate the safety and feasibility of the in-situ needle fenestration combined with the in vitro physician modified fenestration technique to reconstruct supra-aortic branches during thoracic endovascular aortic repair (TEVAR) for aortic arch lesions requiring landing at Z0 and Z1.Methods:From Nov 2017 to Dec 2019, eighteen patients who underwent both the in-situ needle fenestration and the in vitro physician modified fenestration techniques to extend the proximal landing zone to Z0 and Z1 during TEVAR were included in our study.Results:Sixteen patients underwent in vitro physician modified fenestration ,two patients underwent in vitro physician modified fenestration to reconstruct both the left common carotid artery and the innominate artery. All eighteen patients received in-situ needle fenestration to preserve the left subclavian artery. Supra aortic branches were preserved in all patients (38/38, 100%). There was no Type Ⅰ endoleak. Type Ⅱ endoleak was found in four paitnets (4/18). Type Ⅲ endoleak occurred in one patient (1/18). Type Ⅳ endoleak in four patients (4/18). Type Ⅲ endoleak needed open aortic arch repair 6 months later. The median follow-up time was 12 months. One (1/18) died in 12 months and the other patients were doing well.Conclusions:The joint application of the in-situ needle fenestration and the in vitro physician modified fenestration to reconstruct supra-aortic branches during TEVAR for aortic arch pathologies requiring landing at Z0 and Z1 was satisfactory.

OBJECTIVETo investigate the role of gap junction in ischemic preconditioning (IPC).

METHODSSprague-Dawley rats were subjected to a 30 min coronary artery occlusion followed by 4 h of reperfusion (I/R). Rats were divided into seven groups: I/R, IPC/R, IPC/R + 5-hydroxydecanoic acid (mitochondrial ATP sensitive potassium channel antagonist), I/R + diazoxide (mitochondrial ATP sensitive potassium channel agonist), I/R + 5-hydroxydecanoic acid + diazoxide, I/R + 18beta-glycyrrhetinic acid (gap junction blocker) and I/R + 18beta-glycyrrhetinic acid + 5-hydroxydecanoic acid. Hemodynamics and myocardial infarct size were measured and connexin43 phosphorylation and subcellular distribution were determined by quantitative immunoblotting and confocal immunofluorescence.

RESULTSInfarct size was reduced in IPC/R, I/R + diazoxide and I/R + 18beta-glycyrrhetinic acid group (13.34% +/- 7.87%, 11.02% +/- 2.24%, and 15.03% +/- 11.35%, respectively; P < 0.001 vs. I/R group: 45.81% +/- 7.91%). 5-hydroxydecanoic acid abolished the cardioprotective effects of IPC and diazoxide (46.57% +/- 5.36% and 47.36% +/- 3.17%; P > 0.05 vs. I/R) but not the effects of glycyrrhetinic acid (14.60% +/- 7.36%; P < 0.001 vs. I/R). Phosphorylation of connexin43 was significantly increased, dephosphorylation and connexin43 intracellular redistribution significantly decreased (Cx43 size in the cellular membrane 1.00% +/- 0.35% and 0.83% +/- 0.31%, P < 0.001 vs. I/R: 0.19% +/- 0.06%) by IPC and diazoxide and these effects could be abolished by 5-hydroxydecanoic acid.

CONCLUSIONIschemic preconditioning could reduce myocardial infarction size by activating mitochondrial ATP sensitive potassium channel and modulating connexin43 phosphorylation and internalization.

Animals ; Connexin 43 ; metabolism ; Gap Junctions ; physiology ; Ischemic Preconditioning, Myocardial ; Male ; Myocardial Infarction ; metabolism ; pathology ; Phosphorylation ; Rats ; Rats, Sprague-Dawley