AIM:To observe the secretion of vascular endothelial growth factor(VEGF)when adenovirus induced VEGF165(AdVEGF165)gene transferred into neonatal cardiomyocytes in vitro,and to investigate the impact on heart function after transplanted the transferred cardiomyocytes into infarct myocardium in rats.METHODS:Neonatal cardiomyocytes were cultured in vitro and labeled with BrdU,then transferred by AdVEGF 165.ELISA was applied to assay the expression and secretion of VEGF.Wistar rats,in which left descending branch of coronary artery was ligated,were randomly divided into four groups and transplanted into MI area with transferred cardiomyocytes(group Ⅰ),untransferred cardiomyocytes(group Ⅱ),AdVEGF 165(group Ⅲ)and culture medium(group Ⅳ),respectively.The echocardiograph was applied to evaluate the heart function before and after cell transplantation.Then the rats were executed and the hearts were harvested for histological(hematoxylin-eosin)and immunohistological(anti-BrdU dyeing)examinations.The vessels were also counted in injected area.RESULTS:ELISA indicated that the expression and secretion of VEGF in groupⅠwere higher than those in the rest(P

BACKGROUND: Transplantation of bone marrow mesenchymal stem cell and vascular endothelial growth factor(VEGF) can promote vascular regeneration and improve heart function. However, whether the combined application is superior to single application or not is still unclear.OBJECTIVE: To observe the effect of allogenetic bone manow stem cells transplantation combined with VEGF transfection on vascular regeneration and heart function of rats with acute myocardial infarction.DESIGN: Simple sample observation was used in culturing bone marrow mesenchymal stem cell of rats; Randomized controlled animal experiment was used in cell transplantation and gene transfection.SETTING: Department of Cardiology, Union Hospital of Huazhong University of Science and Technology; Cardiovascular Institute of Tongji Medical College MATERIALS: Totally 94 healthy male Wistar rats and expression vector PAdTrack/VEGF165 were used in this experiment.METHODS: This experiment was carried out at Cardiovascular Institute of Tongji Medical College between June 2004 and June 2005. ①Bone marrow mesenchymal stem cells of rats were isolated, purified and cultured in vitro, then labeled with bromodeoxyuridine(BrdU). ② Preparation , extraction, purification and identification of plasmid PAdTrack/VEGF165. ③Two weeks after coronary artery was ligated to create acute myocardial infarction model, rats were randomly divided into 4 groups (n=12 in each group): stem cell + plasmid group(50 μL BrdU-labeled bone marrow mesenchymal stem cell solution and 100 μL plasmid PAdTrack/VEGF165 were injected into the rats through multiple sites), stem cell group (50 μL bone marrow mesenchymal stem cell solution was injected through multiple sites), plasmid group (100 μL plasmid PAdTrack/VEGF165 was injected through multiple sites) , control group(100 μL serum-free DMEM was injected through multiple sites). ④ Immunohistochemistry andechocardiography were performed 4 weeks later.MAIN OUTCOME MEASURES: ①Immunohistochemical and haematoxylin-eosin stainings were conducted in the infarcted and ischemic areas of rats in each group; ② Blood vessel counts; ③Echocardiography.RESULTS: Totally 48 rats entered the stage of result analysis. ① BrdUlabeled transplanted cells could be seen at the infarcted and ischemic myocardium in the stem cell+plasmid group and stem cell group. Some transplanted cells at ischemic myocardium differentiated into vascular endothelial cells and formed newborn blood capillary. ②Density of Ⅷ factor positively-stained newborn blood capillary took stem cell +plasmid group ＞ plasmid group ＞ stem cell group ＞ control group in order (all P＜ 0.01).③Wall thickness and wall motion range improved after cell transplantation and gene transfection therapy. The increased range of ejection fraction took stem cell +plasmid group ＞ stem cell group ＞ plasmid group ＞ control group in order (all P ＜ 0.01) .CONCLUSION: Allogenic bone marrow mesenchymal stem cell transplantation and VEGF gene transfection could further boost vascular regeneration of infarcted ischemic area and improve wall thickness and heart function of rats.

BACKGROUNDBrain metastasis has become one of the most important factors of the failure of treatment of locally advanced non-small cell lung cancer (LANSCLC). There is no conclusion whether NSCLC patients should receive prophylactic cranial irradiation (PCI) or not. The aim of this study is to analyze the risk factors of brain metastasis of LANSCLC after surgery to find out the sign of PCI for LANSCLC.

METHODSA total of 223 patients with stage III NSCLC who received surgical resection were retrospectively analyzed. The risk factors of brain metastasis were determined to set up a mathematic model for brain metastasis.

RESULTSThe median survival time after surgery was 28.0 months. The 1-, 2- and 3-year survival rate was 84.3%, 56.9% and 44.8% respectively. The incidence of brain metastasis was 38.1% (85/223). Patients with extensive mediastinal lymph node metastasis, more node metastasis and non-squamous carcinoma showed significantly higher incidence of brain metastasis than those with limited mediastinal lymph node metastasis, fewer positive mediastinal lymph nodes and squamous carcinoma (P=0.000, P=0.000, P=0.013). The mathematic model of brain metastasis was: logit(P)=8.215-0.903×NPN-0.872×RT-0.714×HG-1.893×LE-0.948×HS-1.034×PC (NPN=No. of positive nodes, RT=resection type, HG=histology, LE=location and extent of mediastinal lymph node metastasis, HS=histologic stage, PC=postoperative chemotherapy). P≥0.44 meant high risk for brain metastasis.

CONCLUSIONSHigh risk factors of brain metastasis in LANSCLC patients after complete resection of the cancer include non-squamous carcinoma, extensive and more mediastinal lymph node metastasis. P≥0.44 may be considered a sign of PCI in clinical trial.

Objective:To observe the efficacy of platelet-rich fibrin (PRF) membrane tamponade combined with air filling for giant macular hole (MH).Methods:A prospective case-control study. From January 2019 to February 2021, 56 patients (56 eyes) diagnosed with giant MH from Eye Center of Renmin Hospital of Wuhan University were enrolled. Among them, there were 17 males with 17 eyes and 39 females with 39 eyes. The average age of the patients was 64.23±9.30 years old. The average MH minimum diameter was 827.36±83.16 μm. The best corrected visual acuity (BCVA) and optical coherence tomography angiography (OCTA) examination were performed before surgery. The Chinese version of 25-item National Eye Institute visual functioning questionnaire (NEI VFQ-25) was used to investigate patient's visual-related quality of life. There were 28 eyes of 28 cases receiving PRF membrane covering, as PRF group, another 28 eyes of 28 cases receiving inverted internal limiting membrane (ILM) insertion into giant MH, as ILM group. The differences of the age ( t=-1.588), sex ratio ( χ2=0.760), BCVA ( Z=-0.400), macular hole minimum diameter ( t=-0.604), choriocapillary blood flow area (CBFA) ( t=1.331) and NEI VFQ-25 score ( t=0.921) were not statistically significant ( P>0.05). All eyes underwent 23G minimally invasive vitrectomy. In the PRF group, PRF membrane was used to fill the hole, and in the ILM group, the hole was filled with ILM inversion, and filled with sterile air after full gas-liquid exchange. The follow-up time after surgery was ≥6 months. The same equipment and methods as before surgery were used to conduct related examinations, and the changes of BCVA, the shape of hole closure, CBFA and the improvement of vision-related quality of life were compared between the two groups. For comparison between groups, independent samples t-test was used for data with normal distribution, and Mann-Whitney U test was used for data with non-normal distribution. For intra-group comparisons, paired-samples t-test was used for data with normal distribution, and Wilcoxon rank-sum test was used for non-normally distributed data. Results:Six months after surgery, in the eyes of PRF group and ILM group, the hole of 27 (96.4%, 27/28) and 26 (92.6%, 26/28) eyes were closed; the median BCVA was 0.70 and 0.70, respectively; CBFA were 1.99±0.20 and 1.91±0.18 mm 2; NEI VFQ-25 scores were 81.36±12.39 and 78.39±10.12, respectively. Compared with before surgery, the BCVA ( Z=-4.636,-4.550) and CBFA ( t=-27.115,-31.135) of the affected eyes in the PRF group and ILM group were significantly improved after surgery, and the NEI VFQ-25 scores ( t=-15.557, -10.675) was significantly increased, and the difference was statistically significant ( P<0.05). There was no significant difference in BCVA ( Z=-0.167), CBFA ( t=1.554), and NEI VFQ-25 scores ( t=0.980) between the two groups after interocular surgery ( P=0.726, 0.126, 0.331). Conclusion:PRF membrane insertion with air filling has the same efficacy as ILM insertion in the treatment of giant MH, which can improve the closure rate of MH, patients' vision and vision-related quality of life, and increase choroidal blood perfusion.

Objective:To observe and explore the feasibility and effectiveness of platelet-rich fibrin (PRF) membrane packing and air filling in the treatment of refractory macular holes.Methods:A retrospective clinical study. From January 2019 to January 2020, 17 patients with refractory macular hole (17 eyes) who diagnosed in Renmin Hospital of Wuhan University were included in the study. Among them, there were 7 males (7 eyes) and 10 females (10 eyes), with the age of 55.18±7.91 years. All eyes underwent 23G minimally invasive vitrectomy combined with internal limiting membrane stripping and PRF packing, and air filling was performed at the end of the operation. The best corrected visual acuity (BCVA) and optical coherence tomography angiography were performed in all eyes before surgery and at 1 week and 1, 3 months after surgery. The BCVA examination was performed using a international standard logarithmic visual acuity chart, which was converted into logarithm of the minimum angle of resolution visual acuity during statistics. Taking 3 months after surgery was as the time point to judge the efficacy, the changes of BCVA, superficial retinal vascular density (SVD), foveal avascular zone (FAZ) area and central foveal thickness (CFT) before and after surgery were compared. Paired t-test was used to compare the indicators before and after surgery. Results:Among the 17 eyes, there were 6, 7, and 4 eyes with giant macular hole, high myopia macular hole, and recurrent macular hole, respectively; the hole diameter was 723.94±38.30 μm. Three months after surgery, all holes were closed. Compared with before surgery, the BCVA ( t=4.458) and SVD ( t=2.675) increased, and the CFT ( t=6.329) and FAZ area ( t=4.258) decreased at 3 months after surgery, and the differences were statistically significant ( P<0.05). At the last follow-up, there was no complications such as intraocular hypertension and retinal detachment in all eyes. Conclusion:Minimally invasive vitrectomy combined with internal limiting membrane stripping and PRF tamponade in the treatment of refractory macular holes can increase the closure rate, improve visual acuity and retinal blood perfusion.

Objective:To investigate the role of platelet-rich fibrin (PRF) membrane tamponade combined with silicone oil filling in the treatment of high myopia macular hole (HMMH) with retinal detachment (RD).Methods:A randomized controlled study was conducted.A total of 52 patients (52 eyes) with HMMH with RD were enrolled at the Eye Center, Renmin Hospital of Wuhan University from September 2021 to April 2023.The patients were randomly divided into three groups according to the random number table method.All patients in the three groups underwent standard three-channel 23-gauge pars plana vitrectomy.In the internal limiting membrane (ILM) peeling group including 18 cases (18 eyes), the ILM was peeled intraoperatively.In the ILM tamponade group including 16 cases (16 eyes), the ILM flap was inverted and filled into the macular hole (MH).In the PRF tamponade group including 18 cases (18 eyes), the MH was filled with PRF.Intraocular pressure measurement, best corrected visual acuity (BCVA) measurement, and central macular thickness (CMT) measured by optical coherence tomography were performed preoperatively and 1 week, 1 month, 3 months, and 6 months postoperatively.Superficial retinal vessel density (SVD) and deep retinal vessel density (DVD) were determined by optical coherence tomography angiography before surgery and 6 months after surgery.The efficacy of the procedure was determined at six months postoperatively, and the rates of MH closure and retinal reattachment were compared among the three groups.This study adhered to the Declaration of Helsinki and the study protocol was approved by the Ethics Committee of Renmin Hospital of Wuhan University (No.2022-1-X-53).Written informed consent was obtained from each subject before any medical examination.Results:At 6 months postoperatively, the MH closure rates in the ILM peeling, ILM tamponade, and PRF tamponade groups were 83.3%(15/18), 87.5%(14/16), and 94.4%(17/18), respectively, without significant differences among them (fit χ2=1.180, P>0.05).Furthermore, the retinas of all groups were reattached.The postoperative BCVA of ILM peeling, ILM tamponade, and PRF tamponade groups were elevated compared with before surgery, and the differences were statistically significant (all at P<0.05).At 6 months after surgery, the CMT of the PRF tamponade group was significantly thicker than that of the ILM peeling and ILM tamponade groups (both at P<0.05).The CMT of the three groups at different time points after surgery was significantly decreased compared with before surgery, with statistically significant differences (all at P<0.05).SVD and DVD of the three groups at 6 months postoperatively were higher compared with before surgery, with statistically significant differences (all at P<0.05).No serious complications such as endophthalmitis and vitreous haemorrhage occured during treatment and follow-up.Müller cell gliosis was observed in 4 eyes in the ILM tamponade group, and no Müller cell gliosis eyes were seen in the remaining two groups. Conclusions:PRF tamponade combined with silicone oil filling can promote MH healing and retinal reattachment, improve visual acuity and blood flow density in patients suffering from HMMH with RD, and is a safe and effective surgical procedure.

OBJECTIVESTo identify predictors of survival following pneumonectomy for non-small cell lung cancer (NSCLC) and provide evidence for the revision of patient selection criteria.

METHODS81 cases of pneumonectomy for NSCLC from January 1990 to May 1996 at our hospital were reviewed retrospectively. There were 65 men (80.2%) and 16 women (19.8%), with a mean age 53.4 +/- 9.4 years (range 20 - 68 years). Predominant histological types included squamous cell carcinoma (54.3%), adenocarcinoma (24.7%), and squamoadenocarcinoma (17.3%). After follow-up for more than 5 years, data were examined using the chi-square test, Kaplan-Meier method, and Cox-mantel test. The possible factors affecting survival were tested with univariate and multivariate analysis.

RESULTSThe 5-year survival of N(0), N(1) and N(2) disease of NSCLC following pneumonectomy was (20.8 +/- 9.9)%, (15.4 +/- 10.0)% and (4.0 +/- 2.8)%, respectively. There was no perioperative death. The operative complications morbidity was 22.2%. Factors adversely affecting survival with univariate analysis included age over 60 years for right pneumonectomy, cardiopulmonary complications, adenocarcinoma, peripheral location, tumor greatest dimension more than 10 cm, chest wall involvement and N(2) disease. Factors adversely affecting survival with multivariate analysis included cardiopulmonary complications, greatest tumor dimension more than 10 cm, chest wall involvement and N(2) disease.

CONCLUSIONSPneumonectomy provides survival benefit with a high operative complications morbidity. Old age (>/= 60 years) for right pneumonectomy, cardiopulmonary complications, adenocarcinoma, and N(2) disease may be negative prognostic factors of long-term survival. Patient selection should be based on cardiopulmonary evaluation and the stage of disease.

Adult ; Aged ; Carcinoma, Non-Small-Cell Lung ; mortality ; pathology ; surgery ; Female ; Humans ; Lung Neoplasms ; mortality ; pathology ; surgery ; Male ; Middle Aged ; Neoplasm Staging ; Pneumonectomy ; Prognosis ; Retrospective Studies ; Survival Rate

Objective: To develop a native adaptive behavior scale for children with autism spectrum disorder(ASD) and to explore its reliability and validity. Methods: Items of ASD adaptive behavior rating scale were selected based on the scale development theory, ASD knowledge and adaptive behavior concept through preliminary survey and statistical, and 301 ASD children aged 2 to 12 from hospitals in Guangzhou, Huizhou, Shenzhen who met the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition were selected, data was analyzed by the item analysis. Results: After item analysis and exploratory factor analysis, the final version of the scale contains 58 items, and 64.24% of the total variation could be explained by 6 factors; The Cronbach’s α coefficient of the full scale was 0.98, and the coefficient value of dimen sional factors were 0.94，0.93，0.91，0.95，0.88，0.94. The test-test reliability r of full scale was 0.86, the r of the factor were 0.88，0.81，0.81，0.87，0.88，0.79. The criterion-related validity r with the ABAS-Ⅱ scale was -0.77, the criterion-related validity r with the CARS scale was 0.64. Conclusion The ASD Child Adaptive Behavior Scale showed good reliability and validity, and could be used widely.

Objective:To investigate the efficacy of acidified aliphatic ester in the treatment of atopic dermatitis (AD) in mouse models, and to preliminarily explore its mechanisms of action.Methods:Twenty female BALB/c mice aged 6 to 8 weeks were randomly divided into 2 groups: 5 mice in the blank control group were topically treated with absolute ethanol on both ears (14.3 μl per ear) every day, and 15 mice in the model group were topically treated with calcipotriol liniment (14.3 μl per ear) and 20 g/L ovalbumin (25 μl per ear) on both ears every day for 10 consecutive days to establish AD-like mouse models. From day 11, 15 mice in the model group were randomly divided into 3 groups (5 mice in each group), including AD model group, aliphatic ester group, and acidified aliphatic ester group; in the forenoon, all the 3 groups continued to be topically treated with calcipotriol liniment and ovalbumin to maintain AD-like models; in the afternoon, the aliphatic ester group and acidified aliphatic ester group were topically treated with aliphatic ester and acidified aliphatic ester respectively (10 μl per ear), and no treatment was given to the AD model group. Changes in body weight, ear thickness, ear skin lesion scores, and scratching frequency were observed. Ear skin swabs were obtained from the mice on days 10 and 14 for 16S rRNA gene - based microbial diversity tests. On day 14, mice were sacrificed after reflectance confocal microscopy examinations of the ear skin, ear tissues were resected for hematoxylin and eosin staining, mast cell staining, and real-time fluorescence-based quantitative PCR (RT-qPCR), and blood samples were collected for detection of serum IgE levels. One-way analysis of variance was used for analysis of data that met homogeneity of variance criteria, and least significant difference- t test for multiple comparisons. Results:On day 14, the severity of mouse ear lesions was the highest in the AD model group, followed in turn by the aliphatic ester group, acidified aliphatic ester group, and blank control group; compared with the AD model group, the acidified aliphatic ester group showed significantly decreased mouse ear thickness ( F = 897.50, P < 0.001), skin lesion scores ( F = 268.80, P < 0.001), scratching frequency ( F = 64.36, P < 0.001), and epidermal thickness ( F = 256.20, P < 0.001). In addition, RT-qPCR indicated that the expression of inflammatory factors such as interleukin (IL) -33, thymic stromal lymphopoietin, IL-4, and tumor necrosis factor-α in lesional areas, and the degree of mast-cell infiltration were all significantly lower in the acidified aliphatic ester group than in the AD model group ( F = 3.38, 8.70, 41.73, 44.30, 134.30, P = 0.049, = 0.001, < 0.001, < 0.001, <0.001, respectively). Microbial diversity tests showed that the acidified aliphatic ester treatment could inhibit the colonization of Staphylococcus spp. in the ears of AD-like mouse models, and the Shannon index and Simpson index significantly differed among the 4 groups ( F = 9.00, 7.92, P = 0.001, 0.002, respectively) . Conclusion:Acidified aliphatic ester could improve skin lesions of AD-like mouse models, possibly by regulating immunity, suppressing inflammation, and restoring skin microecological diversity.

In the context of high-quality development in medical institutions, the supply-processing-distribution(SPD) management mode has gradually been widely applied. The authors described in detail the procurement, supply, inventory, distribution, and settlement management of medical consumables and in vitro diagnostic reagents in a certain hospital under the SPD mode. It was found that SPD was conducive to strengthening the supervision of medical consumables and in vitro diagnostic reagents in the hospital, ensuring quality and safety of use, reducing hospital operating costs, and improving hospital′s competitiveness. However, attention should be paid to preventing data security risks, strengthening operational management, and improving the cost-benefit analysis of in vitro diagnostic reagents.