Anesthesia modalities for endovascular treatment of acute ischemic stroke include general anesthesia and conscious sedation.Several recent studies have shown that the general anesthesia is associated with the poor outcome of endovascular treatment in patients with acute ischemic stroke.The underlying reason of causing worse outcome is unknown.It may be associated with hemodynamic instability and hypotension.Currently,it is considered that both general anesthesia and conscious sedation have their advantages and disadvantages.We must choose individualize anesthesia modalities for each patient before we obtain highquality evidence.

Objective To explore the feasibility of laparoscopically assisted one-stage anorectoplasty for the treatment of intermediate imperforate anus. Methods Under laparoscopic visualization, the rectum was mobilized. Then the rectourethral (or rectovaginal) fistula was repaired laparoscopically (6 cases) or through perineal approach (4 cases). Afterwards a tunnel was made through the center of pelvic floor musculature by combined use of laparoscopic and perineal approach. The rectum was pull-through the perineum and anastomosed with skin. At Last the colostomy was closed. Results Laparoscopically assisted anorectal pull-through was successfully performed in all cases. The mean duration of laparoscopic dissection was 32.8 minutes (range, 25~78 minutes). The mean blood loss was 5.3 ml (range, 2~10 ml). No blood transfusion was needed. The intraurethral catheter or cystostomy tube was removed on the 11th postoperative day. No intraoperative complication was encountered and all infants had uneventful postoperative recovery without wound infection. During a follow-up for 3~66 months (mean, 45 months), the fecal continence evaluation showed excellent in 8 cases and good in 3 cases. Conclusions Laparoscopically assisted anorectoplasty is an effective and minimally invasive technique for the treatment of intermediate imperforate anus. This technique has advantages of simple performance, accurate identification of the center of the pelvic floor musculature, and low infection rate.

Objective To study the effects on inhibit tumor growth and enhance immune function of Ganoderma lucidum polysaccharide(GLP)combined with low-dose cisplatin in tumor-bearing mice.Methods 2 × 106 Lewis cells in 0.1 mL PBS were injected subcutaneously into the flanks of healthy female BALB/c nude mice (5～6 weeks old).When the tumor volume reached 100 mm3,mice were randomly assigned to 4 groups,control group (Oral gavage of 0.5 ml PBS and intraperitoneal injection of 0.5 ml),GLP group (gavage once every two days,40 mg/kg GLP in 0.5 ml),cisplatin group (intraperitoneal injection once every two days,2 mg/kg cisplatin in 0.5 ml) and the combination group (such as the above dose of cisplatin and GLP).After the treatment regimen was complete,the mice were sacrificed,and the tumors were removed,photographed,weighed,and prepared for histological analysis.The immune cells in spleen and peripheral blood were analyzed by flow cytometry.Results GLP can effectively increase anti-tumor effect of the small dose cisplatin,improve the survival of tumor-bearing mice,promote Th cells convert to Th1 in peripheral blood,increased the expression of CD 11c + on DC cell surface (GLP group 4.59％ VS the control group 1.06％,the combined group 7.21％ VS the cisplatin group 2.8％).Conclusion GLP can improve the immune function of tumor-bearing mice,had synergistic anti-tumor growth with low dose cisplatin,moreover,reduce renal toxic effects of cisplatin.

Objective: Proto-oncogene Zbtb7A has been characterized as a molecular switch in the process of cancer initiation and development.Our goal is to obtain the POZ domain of the Zbtb7A protein and prepare its polyclonal antibodies.Methods: We optimized the coding sequence of the POZ domain according to the codon bias of E.coli and synthesized the sequence with two-step PCR,which was then introduced into the pET-26b(+) vector to express the protein.The recombinant protein was analyzed by 15% SDS-PAGE and the corresponding band was cut out from gel.The minced gel slice that contained the POZ domain protein was injected to immunize rabbits.The collected rabbit antiserum was purified using the saturated ammonium sulfate method in combination with protein G antibody purification,and the purified polyclonal antibodies was evaluated by Western blot.Results: The optimized sequence of the POZ domain was correctly obtained and successfully constructed into the pET-26b(+) vector.After induction,an expected protein band about 14 KD was detected on 15% SDS-PAGE,and highly purified polyclonal antibodies were obtained,which were specifically bound to human Zbtb7A.Conclusion: The obtained recombinant protein of the POZ domain and its polyclonal antibodies can be used for further studies of Zbtb7A.

OBJECTIVE: To establish a quality standard for Jieyinling lotion. METHODS: Cortex Phellodendri and Epimedium Herb were identified by TLC, and the content of Icariin was determined by HPLC. RESULTS: The TLC spots were fairly clear and a good reproducibility was obtained. The linear range of Icariin was 2.0 ～10.0?g(r=0.999 6),with average recovery at 100.1%,RSD =1.92%. CONCLUSION: The established method is reliable and accurate, and suitable for the quality control of Jieyinling lotion.

Objective To investigate the relationship between the marrow edema and general clinical index,quadriceps muscle area,and the meniscus grade of knee osteoarthritis(OA).Methods 72 patients were collected with knee OA in our hospital, underwent X-ray and routine MRI examination of knee, and the same X-ray and MRI were reviewed at 12 months later in different time point.The K-L grading, bone marrow edema score, meniscal grading and VAS score of each knee joint were evaluated.The t-test and Rank-sum test were used to compare the two groups of general data, Spearman was used to perform bivariate correlation analysis.Results The age and VAS score of bone marrow edema group at the initial follow-up were significantly lower than those without edema group(P<0.05),the degree of marrow edema was moderately correlated with age and VAS score, and was not significantly correlated with other indexes.12 months later, BMI and the area of quadriceps femoris in the group with marrow edema were different from those in the group without bone marrow edema(P<0.05), the degree of marrow edema was moderately correlated with age, quadriceps area and VAS.Conclusion The range of marrow edema was related to age, quadriceps area, BMI index and VAS score in MRI.The MRI measurement could reflect the progression of knee OA more than that of X-ray.It also revealed some factors related to the progression of knee OA.

BACKGROUNDImmunocytochemistry is valuabale in differentiating malignant fluids from benign ones. However, the diagnostic value of a single tumor marker is limited. The aim of this study is to evaluate the clinical value of capture of cancer cells in pleural fluids of patients with lung cancer by cytochip.

METHODSA new pattern cytochip was developed to immunize hybridization of cells in pleural fluids of patients with 42 lung cancers and with 20 lung benign lesions. Ten antibodies were fixed on the cytochip, they were epithelial specific antigen (ESA), CD44V6, ND-1, T cell (CD3), CD45RO, B cell (CD20), CD79a, Hodgkin's cell (CD15), CD30 and macrophage (CD68).

RESULTSThe point of positive hybridization showed round distribution with clear border, and the shape of cell displayed well. The positive numbers of ESA, CD44V6, ND-1 were 35, 30, 38 respectively in pleural fluids of 42 patients with luog cancers; lymphocytes and neutrophils were found on the 1 ESA and 1 ND-1 respectively, and only lymphocytes were found on the 3 CD44V6 in 20 ones with lung benign lesions; the other 7 antibodies did not capture cancer cells except for lymphocytes, neutrophils and macrophages from two pleural fluids.

CONCLUSIONSThe cytochip could be an important practical foreground in clinic for diagnosing cancer cells in pleural fluids of patients with lung cancer.

Objective To analyze the relationship between the expression of serum DNA methyltransferase 1(DNMT1)messenger RNA(mRNA)and long non-coding RNA(LncRNA)urothelial carcinoembryonic antigen 1(UCA1)levels and pregnancy outcomes in patients with hypertensive disorder complicating pregnancy(HDCP).Methods A total of 195 HDCP patients treated in Handan Maternal and Child Health Hospital from March 2021 to August 2023 were selected as the case group,and 195 healthy pregnant women were regarded as the control group.Clinical data of all pregnant women were collected,and biochemical indicators were detected 1 day before delivery.Serum DNMT1 mRNA and LncRNA UCA1 levels were detected by fluorescence quantitative PCR.The case group was divided into pregnancy induced hypertension(PIH)group,mild preeclampsia(PE)group,and severe PE group based on their condition.HDCP patients were divided into good pregnancy outcome group and bad pregnancy outcome group according to the adverse pregnancy outcome at delivery.Clinical data,biochemical indexes,serum DNMT1 mRNA and LncRNA UCA1 levels were compared between control group and case group.The serum DNMT1 mRNA and LncRNA UCA1 levels of HDCP patients with different severity were compared.The clinical data,biochemical indexes,serum DNMT1 mRNA and LncRNA UCA1 levels of HDCP patients with different pregnancy outcomes were compared.The correlation between serum DNMT1 mRNA and LncRNA UCA1 in HDCP patients,factors affecting pregnancy outcomes in HDCP patients,and the predictive value of serum DNMT1 mRNA and LncRNA UCA1 in adverse pregnancy outcomes in HDCP patients were analyzed.Results Compared with control group,the levels of systolic blood pressure,diastolic blood pressure and white blood cell count in case group were increased,while the levels of serum DNMT1 mRNA(0.72±0.18 vs 1.00±0.04)and LncRNA UCA1(0.61±0.16 vs 1.00±0.02)were decreased,and the differences were statistically significant(t=40.651,32.595,7.837,21.205,33.775,all P＜0.001).Serum DNMT1 mRNA(0.85±0.20,0.74±0.18,0.50±0.15)and LncRNA UCA1(0.77±0.18,0.58±0.16,0.43±0.13)levels in PIH group,mild PE group and severe PE group were decreased successively,and the differeences were statistically significant(F=52.687,64.030,all P＜0.001).Serum DNMT1 mRNA in HDCP patients was positively correlated with LncRNA UCA1(r=0.582,P＜0.001).Compared with good pregnancy outcome group,the severity of HDCP,systolic blood pressure,diastolic blood pressure and white blood cell count were increased in the bad pregnancy outcome group,and the serum DNMT1 mRNA(0.80±0.20 vs 0.59±0.15)and LncRNA UCA1(0.72±0.17 vs 0.43±0.14)levels were decreased,and the differences were statistically significant(x2=18.386,t=2.615～12.290,all P＜0.05).Severe PE[OR(95％CI)=1.708(1.193～2.445)],systolic blood pressure[OR(95％CI)=1.495(1.090～2.049)]and diastolic blood pressure[OR(95％CI)=1.621(1.076～2.442)]were risk factors for adverse pregnancy outcomes in HDCP patients,while DNMT1 mRNA[OR(95％CI)=0.833(0.725～0.957)]and LncRNA UCA1[OR(95％CI)=0.796(0.696～0.909)]were protective factors for adverse pregnancy outcomes in HDCP patients(all P＜0.05).The area under curve(AUC)predicted by the combination of DNMT1 mRNA and LncRNA UCA1 for adverse pregnancy outcomes in HDCP patients was greater than that predicted by DNMT1 mRNA alone and LncRNA UCA1 alone(0.926 vs 0.832,0.844),and the differences were statistically significant(Z=2.932,2.345,all P＜0.05).Conclusion Both serum DNMT1 mRNA and LncRNA UCA1 levels are low in HDCP patients,which is related to the degree of disease and pregnancy outcome.DNMT1 mRNA combined with LncRNA UCA1 detection may have a better predictive effect on adverse pregnancy outcome.

Chemical cleaning and disinfection are crucial steps for eliminating infection in root canal treatment.However,irrigant selection or irrigation procedures are far from clear.The vapor lock effect in the apical region has yet to be solved,impeding irrigation efficacy and resulting in residual infections and compromised treatment outcomes.Additionally,ambiguous clinical indications for root canal medication and non-standardized dressing protocols must be clarified.Inappropriate intracanal medication may present side effects and jeopardize the therapeutic outcomes.Indeed,clinicians have been aware of these concerns for years.Based on the current evidence of studies,this article reviews the properties of various irrigants and intracanal medicaments and elucidates their effectiveness and interactions.The evolution of different kinetic irrigation methods,their effects,limitations,the paradigm shift,current indications,and effective operational procedures regarding intracanal medication are also discussed.This expert consensus aims to establish the clinical operation guidelines for root canal irrigation and a position statement on intracanal medication,thus facilitating a better understanding of infection control,standardizing clinical practice,and ultimately improving the success of endodontic therapy.

Endodontic diseases are a kind of chronic infectious oral disease.Common endodontic treatment concepts are based on the removal of inflamed or necrotic pulp tissue and the replacement by gutta-percha.However,it is very essential for endodontic treatment to debride the root canal system and prevent the root canal system from bacterial reinfection after root canal therapy(RCT).Recent research,encompassing bacterial etiology and advanced imaging techniques,contributes to our understanding of the root canal system's anatomy intricacies and the technique sensitivity of RCT.Success in RCT hinges on factors like patients,infection severity,root canal anatomy,and treatment techniques.Therefore,improving disease management is a key issue to combat endodontic diseases and cure periapical lesions.The clinical difficulty assessment system of RCT is established based on patient conditions,tooth conditions,root canal configuration,and root canal needing retreatment,and emphasizes pre-treatment risk assessment for optimal outcomes.The findings suggest that the presence of risk factors may correlate with the challenge of achieving the high standard required for RCT.These insights contribute not only to improve education but also aid practitioners in treatment planning and referral decision-making within the field of endodontics.