OBJECTIVE: To investigate the influence of denervation on myofiber morphology of the adductor and the abductor in patients with recurrent laryngeal nerve (RLN) paralysis and to provide experimental evidence for the clinical feasibility of RLN repair. METHOD: Adductor muscles were acquired from the lateral cricoarytenoid muscle (LCAM) and abductor muscles from the posterior cricoarytenoid muscle(PCAM). Normal human PCAM and LCAM are treated as control group (n = 7). Thirty-eight cases of PCAM with damaged RLN were divided into five groups according to the duration of their RLN damage: 0.5-1 year (7 cases), > 1-2 years (10 cases), > 2-3 years (8 cases), > 3-6 years (8 cases) and > 6 years (5 cases); twenty-nine cases of LCAM were also divided into five groups: 0.5-1 year (7 cases), > 1-2 years (6 cases); > 2-3 years (6 cases), > 3-6 years (6 cases) and > 6 years group(4 cases). They were all stained with HE and Masson three-color staining, the fiber cross-sectional area of muscle tissue and collagen connective tissue were quantitative analyzed. The changes of myofiber morphology of adductor and abductor muscles after the loss of the RLN were analyzed with image analysis system. RESULT: The transverse areas of myofibers gradually decreased and those of collagen fibers gradually increased with the prolongation of denervation. (1) Difference between the denervated groups of LCAM of 0.5-1 year, > 1-2 years and > 2-3 years groups were not significant (P > 0.05). Fiber cross-sectional area of > 3-6 years group decreased most obviously with significantly difference compared with > 2-3 years group (P < 0.05); (2) There were obvious difference between the control group, 0.5-1 year group, > 1-2 years group, > 2-3 years group and > 3-6 years of PCAM(P < 0.05); (3) There was no significant difference between the group of > 3-6 years and > 6 years of two kinds of laryngeal intrinsic muscle (P > 0.05); (4) Fiber cross-sectional area of each group of the LCAM after 1 year denervation were significantly greater than that of the PCAM under same conditions (P < 0.05). CONCLUSION The influence of denervation on myofiber morphology following denervation is different between the abductor and adductor owing to the different fiber type composition and functional properties. The rate of muscle atrophy of the adductor is slower than that of the abductor. To restore the structure and function of denervated laryngeal muscles better, the recurrent laryngeal nerve injury repair surgery for PCA muscle function recovery should be carried out within 1 year after denervation while the surgery for LCA muscle function recovery should be carried out within 3 years after denervation.
Case-Control Studies ; Denervation ; Humans ; Laryngeal Muscles ; innervation ; pathology ; Myofibrils ; pathology ; Neurosurgical Procedures ; Recurrent Laryngeal Nerve ; pathology ; Staining and Labeling ; Vocal Cord Paralysis ; pathology ; surgery

Objective To investigate the clinical and imaging features of extralobar pulmonary sequestration(ELS)with torsion.Methods The clinical and imaging data,surgical records and pathological results of four ELS children with torsion were analyzed ret-rospectively.Results All four children presented with abdominal pain,and all CT scans showed soft tissue masses on the medial side of the lower lobe,and there were 2 masses with long fusculine-shaped in the right pleural cavity,2 round masses in the left pleural cavity,all of which were accompanied by pleural effusion and poor ventilation of adjacent lung lobes.There were 1 case without enhance-ment,1 case with mild enhancement,and 2 cases with simple marginal linear enhancement.There were no patients with definitive supplying artery and 3 cases with peripheral post-intercostal dilated veins.Intraoperative ELS combined with torsion was shown,and the nutrient artery were derived from the thoracic aorta.All ELS showed bleeding and necrosis according to the pathological results,and 1 case was complicated with congenital pulmonary airway malformation(type 2).Conclusion ELS combined with torsion is mostly abdominal pain as the first symptom,and there are soft tissue mass adjacent to the lower lobe with pleural effusion on the affected side as the imaging features with no,mild or marginal linear enhancement,with no supplying artery,and with intracostal posterior venous expansion.

Intestinal mucosal barrier is the first line of defense against exogenous substances. A complete mechanical barrier can separate the body from the contents of the intestines and prevent the translocation of bacteria and microorganisms in the intestines, playing an important role in maintaining the homeostasis of the human body. If the intestinal mechanical barrier function is damaged, it will cause the intestinal endotoxin and bacterial translocation, leading to systemic inflammatory response syndrome and multiple organ dysfunction diseases. The barrier function of intestinal mucosa is a key link in the pathogenesis of nonalcoholic fatty liver disease (NAFLD). Therefore, the maintenance of intestinal mucosal barrier function is of great value for the diagnosis and treatment of NAFLD. In this paper, the research progress in intestinal mechanical barrier function of NAFLD was reviewed, and the main factors maintaining intestinal permeability of NAFLD were introduced, such as apoptosis, autophagy, apical junctional complex, cytoskeleton, main signal pathway, to provide reference for the diagnosis and treatment of NAFLD.

The incidence and mortality rates of gastrointestinal (GI) cancer remain high. Despite constant improvements in diagnostic and therapeutic techniques, the early diagnosis, mid- and late-stage treatment, drug tolerance, and cancer recurrence and metastasis in GI cancer remain challenging. In this review article we summarize the recent research advance in the roles of keratins in GI cancer, with the hope that they will become efficient biomarkers for the prediction, diagnosis, or treatment of these malignancies.
Biomarkers, Tumor ; Gastrointestinal Neoplasms/therapy* ; Humans ; Keratins

Objective:To observe the structural and functional changes of each nucleus group in generalized anxiety disorder(GAD) rat models before and after the massage therapy, and to explore the central regulating mechanism of the massage therapy in GAD.Methods:60 Wistar male rats were randomly divided into blank group, model group and abdominal rubbing group, 20 rats for each group. GAD rat models were established by chronic emotional stress, and the models were evaluated by the elevated cross maze experiment. In the abdominal rubbing group, the GAD rats were treated with abdominal rubbing once a day for 10 min for 14 days. In the control group, the GAD rats were only bound to the experimental platform once a day for 10 min for 14 days. Horseradish peroxidase (HRP) retrograde tracking marker method was used to detect the changes of the structure of each nuclear cluster in the affective loop of the GAD rats in each group. The liquid-mass spectrometry quantitative analysis was used to determine the relative concentrations of N-acetyl aspartate (NAA), glutamic acid, choline and creatine in nuclear cluster of the GAD rats in each group.Results:Compared with the blank group, the HRP labeled cells in the rats of model group were less expressed and the activity of the emotional circuit in the brain was weak. The NAA/creatine ratio in the left hippocampal tissue of the rats in the model group was significantly increased than that of the blank group(0.94±0.08 vs 0.79±0.10, P<0.05), the glutamic acid/creatine ratio in the right hippocampal tissue was significantly decreased (0.95±0.10 vs 1.12±0.13, P<0.01), and the NAA/creatine andglutamic and acid/creatineratios in the left cortical tissue were all significantly decreased (1.04±0.05 vs 1.41±0.23, and 1.21±0.04 vs 1.57±0.11, all P<0.01). Compared with the model group, the hippocampal tissues of the GAD rats in the abdominal rubbing group had a large number of HRP aggregation and spread to the surrounding tissues, the NAA/creatine and glutamic acid/creatine ratios in the left hippocampal tissue of the abdominal rubbing group were significantly decreased (0.74±0.21 vs 0.94±0.09 and 0.92±0.20 vs 1.21±0.12, all P<0.01). The differences between the model group and the abdominal rubbing group in the ratio of glutamic acid/creatine in the right hippocampal tissue (1.01±0.23 vs 0.95±0.10), the ratio of NAA/creatine in the left cortical tissue (1.12±0.09 vs 1.04±0.05), and the ratio of glutamic acid/creatine in the left cortical tissue (1.22±0.12 vs 1.21±0.04) were not statistically significant ( P>0.05). Conclusions:Abdominal rubbing can effectively enhance the activity of affective loop and improve the relative concentration of neuron metabolites in hippocampal and cortical tissues in the affective loop, suggesting that the mechanism of GAD treatment by abdominal rubbing may be closely related to the structure and function of regulating affective loop.

Objective:To observe the effect of abdominal mechanical stimulation on rats with irritable bowel syndrome-Diarrehea (IBS-D), and to explore the possible mechanism of abdominal massage mechanical stimulation to improve IBS-D.Method:60 newborn Wistar rats were randomly divided into blank group, model group and abdominal massage group, 20 rats for each group. The IBS-D rat model was established by separating the mother rats and newborn rats. In the abdominal massage group, the IBS-D rats were treated with abdominal rubbing once a day for 14 days. In the model group, the IBS-D rats were only bound to the experimental platform once a day for 5 min for 14 days. The rats in blank group were not made model and with no intervention. The intestinal motility and visceral sensitivity of rats were measured by the time of glass bulb expulsion and the abdominal lift volume threshold. The pathological changes of rat colon tissue were observed by hematoxylin-eosin staining. The changes of mast cells in colon tissue were observed by toluidine blue staining. The ultramicrostructure of intestinal glial cells was observed by transmission electron microscope. The content of proinflammatory factors IL-6 and IL-1β in rat plasma was determined by ELISA.Results:Compared with the model group, mechanical stimulation of the abdominal massage can significantly prolong the discharge time of the glass beads [(2.5±0.2) min vs (1.6±0.2) min], increase the abdominal lift volume threshold of rats [(0.5±0.1) ml vs (0.4±0.1) ml], improve the pathological state of the colon tissue, and reduce the number of mast cells [(2.64±0.22) per field vs (5.61±0.12) per field], reduce the number of mitochondria in the intestinal glial cells and increase the density of heterochromatin, and can also reduce the secretion of proinflammatory factors IL-6 [(189.4±4.7) pg/ml vs (224.8±8.6) pg/ml] and IL-1β [(178.4±7.1) pg/ml vs (191.4±8.4) pg/ml], and the differences were statistically significant (all P<0.05). Conclusions:Mechanical stimulation of abdominal massage can increase the visceral sensitivity of IBS-D rats, regulate intestinal glial cells and reduce the secretion of proinflammatory factors. The mechanism may be related to the intestinal-brain axis.

Objective:We aimed to develop a novel visualized model based on nomogram to predict postoperative overall survival.Methods:This was a multicenter, retrospective, observational cohort study, including participants with histologically confirmed gastric and colorectal cancer who underwent radical surgery from 11 medical centers in China from August 1, 2015 to June 30, 2018. Baseline characteristics, histopathological data and nutritional status, as assessed using Nutrition Risk Screening 2002 (NRS 2002) score and the scored Patient-Generated Subjective Global Assessment, were collected. The least absolute shrinkage and selection operator regression and Cox regression were used to identify variables to be included in the predictive model. Internal and external validations were performed.Results:There were 681 and 127 patients in the training and validation cohorts, respectively. A total of 188 deaths were observed over a median follow-up period of 59 (range: 58 to 60) months. Two independent predictors of NRS 2002 and Tumor-Node-Metastasis (TNM) stage were identified and incorporated into the prediction nomogram model together with the factor of age. The model's concordance index for 1-, 3- and 5-year overall survival was 0.696, 0.724, and 0.738 in the training cohort and 0.801, 0.812, and 0.793 in the validation cohort, respectively.Conclusions:In this study, a new nomogram prediction model based on NRS 2002 score was developed and validated for predicting the overall postoperative survival of patients with gastric colorectal cancer. This model has good differentiation, calibration and clinical practicability in predicting the long-term survival rate of patients with gastrointestinal cancer after radical surgery.

Background In the process of greenhouse working, labor intensity is high and repetitive work involves multiple body parts such as limbs, neck, upper back, and lower back. The prevalence and comorbidity of work-related musculoskeletal disorders (WMSDs) in greenhouse workers are worthy of attention. Objective This study is conducted to investigate the prevalence and comorbidity, as well as potential influencing factors of WMSDs in greenhouse workers. Methods A total of 722 greenhouse workers were selected as the subjects for a cross-sectional epidemiological survey. Through questionnaire survey and physical examination, basic information of the subjects and the prevalence of WMSDs were collected. The participants were divided into low, medium, and high cumulative exposure groups by cumulative exposure index matrix. Chi-square test was used to analyze the difference of prevalence among different cumulative exposure levels, the correlation between the prevalence of WMSDs in paired sites was calculated as prevalence ratio (PR) by using the log-binomial model, the prevalence of multi-site WMSDs in each group was compared by Wilcoxon rank sum test, and the influencing factors of multi-site WMSDs were evaluated by multi-classification logistic regression model. Results The prevalence rate of WMSDs in the greenhouse workers was 78.7% (568/722). The main affected sites of body were lower back, legs, neck, and shoulders, and associated prevalence rates were 47.6%, 46.0%, 27.1%, and 23.8%, respectively. By constructing a cumulative exposure index matrix, the low, medium, and high cumulative exposure groups contained 121, 196, and 405 workers respectively. The prevalence rates of WMSDs in lower back, legs, or shoulders were significantly different among groups with different exposure levels (P<0.05), and the prevalence rates increased with higher cumulative exposure levels (lower back, \begin{document}${χ} _{{{\rm{trend}}}} ^2$\end{document}=11.144, P<0.05; legs, \begin{document}${χ} _{{{\rm{trend}}}} ^2$\end{document}=6.767, P<0.05; shoulders, \begin{document}${χ} _{{{\rm{trend}}}} ^2$\end{document}=15.666, P<0.05). The results of log-binomial model found that lower back and legs (PR values were 1.57 and 1.43, respectively) as well as neck and shoulders (PR values were 2.00 and 2.07, respectively) among the main affected parts have a strong association with comorbidities. The prevalence of multi-site WMSDs showed that 50.4% of the workers had comorbidity of two or more sites of WMSDs. The results of multi-classification logistic regression analysis indicated that the influencing factors of WMSDs in two sites involved high-level cumulative exposure (OR=2.41, 95%CI: 1.34-4.33) and female (OR=3.27, 95%CI: 2.07-5.16); the influencing factors of WMSDs in three or more sites also included medium-level cumulative exposure (OR=3.78, 95%CI: 1.70-8.39), high-level cumulative exposure (OR=7.34, 95%CI: 3.41-15.80), and female (OR=5.66, 95%CI: 3.48-9.22). Conclusion In this study, the prevalence rates of WMSDs in lower back, legs, neck, and shoulders are high among selected solar greenhouse workers, and WMSDs comorbidity of lower back-legs and neck-shoulders are identified. Greenhouse workers with high cumulative exposure level and female workers report more WMSDs comorbidities in two or more sites.

Background Due to long working time and complex and changeable lighting conditions, greenhouse workers' anisometropia is an issue of concern. Objective This study is conducted to evaluate the relationship between solar greenhouse working and anisometropia of workers. Methods Subjects of a solar greenhouse group and a non-greenhouse group in northwest area of China were selected. Questionnaire survey was used to collect general demographicinformation. Standard Logarithmic Visual Acuity Chart (GB 11533—2011) was used to measure naked eye vision before working, the absolute value of binocular visual acuity difference was calculated and converted into classification variables, and both anisometropia absolute value and classification variables of anisometropia were used as indicators to compare the difference of the two groups. A cumulative exposure index that multiplies exposure time and number of greenhouses was further introduced to evaluate cumulative exposure levels of the greenhouse workers and was used to divide them into low, medium, and high cumulative exposure subgroups. Generalized linear model and logistic regression model were used to analyze possible risk factors associated with anisometropia. Results A total of 1002 subjects were enrolled in this study, including 739 workers in the greenhouse group and 263 workers in the non-greenhouse group. The medians (interquartile intervals) of anisometropia of the greenhouse group and non-greenhouse group were 0.1 (0, 0.2) and 0 (0, 0.1) respectively, and the difference was statistically significant (P<0.05). The proportions of anisometropia=0, ≤0.2, and >0.2 in the greenhouse group were 34.2%, 55.2%, and 10.6%, respectively, and those in the non-greenhouse group were 58.2%, 34.6%, and 7.2%, respectively. The difference of anisometropia distribution between the two groups was statistically significant (P<0.05). According to the cumulative exposure index, the greenhouse group was divided into low, medium, and high cumulative exposure subgroups, with 154 (21.0%), 188 (25.6%), and 392 (53.4%) workers, respectively. There was no statistical significance in anisometropia among workers with different cumulative exposure levels (P>0.05). The results of multiple generalized linear analysis showed that greenhouse working was a risk factor of anisometropia (b=0.053, P<0.05), and the results of multiple logistic regression analysis showed that greenhouse working was associated with an increased risk of anisometropia (OR=2.586, 95%CI: 1.473-4.539). The results of multiple generalized linear analysis showed that medium exposure level increased the degree of anisometropia after adjusting age, gender, and other factors (b=0.054, P<0.05). Conclusion Solar greenhouse working may be a risk factor for increasing anisometropia in workers.