Objective: The aim of this study is to evaluate the impact of glucose-6- phosphate dehydrogenase deficiency in Chinese on the intracellular glucose-6-phosphate dehydrogenase activity and reactive oxygen intermediates production of peripheral neutrophil. Methods: Glucose-6-phosphate dehydrogenase, its mRNA expression and reactive oxygen intermediates production(NBT test) in silent or stimulated neutrophil from health controls and patients with glucose-6-phosphate dehydrogenase deficiency were analysized. Results: Compared with health controls, the activities of glucose-6-phosphate dehydrogenase of peripheral neutrophil from patients with glucose-6 -phosphate dehydrogenase deficiency was decreased, and its mRNA expression increased. Reactive oxygen intermediate production increased(no statistical signification) in silence but decreased following stimulation by LPS in neutrophil from normal individuals than that from patients. Conclusion: Decreased activity of G-6-PD and production of reactive oxygen intermediates following stimulation in neutrophil could be caused by G-6-PD deficiency in Chinese.

Objective:To evaluate the efficacy of posterior subtotal vertebrectomy in the treatment of thoracolumbar vertebral refractures after vertebroplasty.Methods:A retrospective analysis was conducted in the 28 patients with refracture after percutaneous vertebroplasty(PVP) or percutaneous kyphoplasty(PKP) who had been treated at Department of Spinal Surgery, Henan Provincial People's Hospital from June 2017 to October 2019. They were 7 males and 21 females, with an average age of 62.4 years(from 61 to 76 years). A total of 28 vertebrae were involved, including 5 T11s, 9 T12s, 11 L1s and 3 L2s. Their previous operations were PKP in 17 cases and PVP in 11. After the spinous process, vertebral plate, articular process and transverse process were resected by posterior approach, the vertebral body, bone cement and upper and lower intervertebral discs were partially resected by trans-vertebral lateral approach. At the same time, nerve decompression was performed. Finally, the inter-vertebral support was fixated followed by the posterior screw-rod orthopedic fixation. The operation time and intraoperative bleeding volume were recorded. The cobb angles of kyphosis were compared on the X-ray films of the whole spine between preoperation and the last follow-up to evaluate correction. Functional improvement of the spine was evaluated by comparison of the visual analogue scale (VAS) and JOA(Japanese Orthopedics Association) scores between preoperation and the last follow-up.Results:The operation time averaged 182.1 min and intraoperative bleeding volume 996.2 mL. All the 28 patients were followed up for 8 to 29 months (mean, 19.8 months). No obvious neurological lesions or other serious complications were observed. The cobb angle was improved from preoperative 41.3°±10.3° to 6.4°±2.5° at the last follow-up, the VAS score from preoperative 7.3±1.8 to 2.5±1.0 at the last follow-up, and the JOA score from preoperative 8.4±2.3 to 21.3±2.5 at the last follow-up, showing a significant difference in all the comparisons ( P<0.05). Conclusion:The posterior subtotal vertebrectomy is effective for thoracolumbar vertebral refractures after vertebroplasty because it can remove bone cement, decompress the spinal canal, fuse the inter-vertebral graft and reconstruct the spinal stability in one stage.

ObjectiveTo evaluate the clinical value of infrahyoid myocutaneous flap in the reconstruction of mouth floor tissue defects. MethodsInfrahyoid myocutaneous flap was made including stenohyoid,thyrohyoid,omohyoid and the affiliated skin based on the axis of superior thyroid artery,vein and ansa cervicalis. The clinical data of 11 patients with reconstruction of mouth floor tissue defects using infrahyoid myocutaneous flap (maximum area was 8 cm × 3 cm) from Match 1993 to June 2009 were retrospectively reviewed.ResultsSeven infrahyoid myocutaneous flaps which reserved platysma branch of superior thyroid artery were all alive, while 2 patients presented epidermal necrosis of 4 un-protected patients. The follow-up period was range from 24 months to 195 months, one patient received salvage surgery for local regional lymphatic recurrence in level Ⅰ,which survived without diseases until now.The rest cases had turned out a success.No dysphagia,dysphonia,and tongue extension difficulty was reported in any patient.ConclusionInfrahyoid myocutaneous flap is one of the valuable donor sites for the reconstruction of mouth floor tissue defects after radical oncologic operations,especially for those with early stage carcinoma of the mouth floor.

Objective To evaluate the clinical characters, management and prognostic factors of patients with differentiated invasive thyroid carcinoma (DITC). Methods The data were analyzed retrospectively for 114 DITC patients treated at Department of Head and Neck Surgery of Sun Yat-sen University Cancer Center. Survival analysis was performed by Kaplan-Meier method, comparison among/between groups was performed using log-rank test, and multivariate analysis was carried out using Cox proportional hazard model. Results After surgery, 68 patients were with tumor residue. The 5-year and 10-year overall survival rate were 91.9% and 80.1% respectively in all patients, while the 10-year overall survival rate were 88.5% 、78.5% and 53.1% in no tumor residue group, micro-residue group and grossresidue group respectively. This study failed to prove that radiotherapy might improve the survival rate in patients with postoperative tumor residue. Multivariate analysis indicated that age, invasion to esophagus and recurrence predict the prognosis. Conclusion DITC may be treated mainly by surgical operation. Radical resection is the key factor in the treatment of DITC. Patients with DITC have a relatively poor prognosis.Age, esophagus invasion and status of tumor residue are the most important factors affecting the prognosis.

Objective:To invest the risk factors associated with delayed hemorrhage after pancreaticoduodenectomy occurred.Methods:A retrospective analysis was performed from January 2012 to June 2015 Shengjing hospital 511 cases of patients who accepted pancreaticoduodenectomy.Results:The incidence of PD postoperative delayed hemorrhage was 8.81％ (45/511).Univariate analysis shows:Preoperative bilirubin levels,pancreatic fistula,biliary fistula,postoperative abdominal infection are all the meaningful related factors(P＜0.05).With the application of multivariate logistic regression analysis,pancreatic fistula (OR=2.158) and abdominal infection (OR=3.051) were independent risk factors for postoperative delayed hemorrhages (P＜0.05).Conclusion:Dealing with the postoperative complications of PD like pancreatic fistula,abdominal infection and others,early detection and rapid diagnosis and correct treatment can effectively reduce the incidence of delayed hemorrhage.

Objective:To evaluate the security of recombinant human brain natriuretic peptide (rhBNP)in the treatment of acute decompensated heart failure (ADHF ), and to provide the basis for its application.Methods:Both foreign language databases including PubMed,The Cochrane Library (Issue 1,2015),EMBase and Chinese databases involving CNKI,VIP and Wanfang Data were searched.Two reviewers independently extracted the data,and assessed the quality;then the Meta-analysis was performed by using RevMan 5.1 software and Stata 12.0 software.Results:A total of 35 randomized controlled trials (RCTs)involving 12 143 patients were included. The results of Meta-analysis showed that compared with control group the 1-month mortality (RR=1.01,95%CI:0.85-1.21,P =0.88),3-month mortality (RR=0.89,95%CI:0.63-1.27,P =0.53)and 6-month mortality (RR = 0.97, 95% CI: 0.87 - 1.08,P = 0.59 )in rhBNP group had no statistical differences;no statistical difference was found in the incidence of side effects (RR=1.01,95%CI:0.71-1.43,P =0.97).The incidence of hypotension in rhBNP group was significantly higher than that in control group (RR= 1.42,95%CI:0.99 -2.03,P =0.06).Conclusion:Compared with dobutamine,vasodilator drugs and placebo,rhBNP doesn’t change the mortality and incidence of adverse reactions of the patients with ADHF,but increases the risk of hypotension.Clinical application of rhBNP should be reasonable and its effectiveness should be exerted sufficiently,meanwhile,as much as possible to avoid hypotension,etc.

Objective To analyze the clinical characteristics of gravidas with HBV in Nanfang Hospital from 2008 to 2014. Methods 22 906 gravidas were retrospectively investigated. Results The HBsAg positive rates were 11.64% and 6.16% when the gravidas were divided into Cantonese and non-Cantonese groups (χ2 =193.370, P < 0.005). The ALT abnormal rates in HBeAg positive and HBeAg negative gravidas were 17.96% and 6.68% (χ2=62.594, P<0.005). Conclusion The HBsAg positive rate of gravidas in Guangdong and the ALT abnormal rate of HBeAg positive gravidas are higher.

Objective:To study and compare the prognosis of different pathological subtypes of renal cell carcinoma (RCC).Methods:Clinicopathological and prognostic data of 1 346 cases of postoperative renal cell carcinoma during July 2002 to June 2014 in West China Hospital were collected retrospectively.There were 839 males and 507 females, aged (55.1±13.4)years, including 1 120 cases of clear cell RCC, 62 cases of papillary RCC, 79 cases of chromophobe RCC and 85 cases of the other pathological types respectively. ECOG 0 and ≥1 were 911 and 435 cases, with; T 1, T 2, T 3 and T 4 of 1 019, 177, 102 and 48 cases respectively; WHO nuclear grade for well, intermediate, poor differentiation and unknown were 587, 530, 85 and 144 cases separately.Tumor size <5cm, 5-10cm, ≥10cm and unknown were 685, 541, 104 and 16 cases.Combined with necrosis or sacromatoid differentiation were 200/1 146 and 27/1 319 cases separately. Meanwhile, data of 80 439 cases from Surveillance, Epidemiology, and End Results Program (SEER) were also collected.There were 51 371 males and 29 068 females, aged (60.9±12.4) years; , with 66 261, 8 680, 5 022 and 476 cases of White, Black, Asian, American native, or unknown race separately. There were 62 600 of clear cell RCC, 12 170 of papillary RCC, 4 354 of chromophobe RCC and 1 315 of other pathological types, with T 1, T 2, T 3 and T 4 of 55 332, 8 687, 15 516 and 904 cases respectively; WHO nuclear grade for well, intermediate and poor differentiation were 52 323, 22 700 and 5 416 cases separately.Tumor size <5cm, 5-10cm, ≥10cm were 46 741, 25 760 and 7 938 cases respectively. Kaplan-Meier survival analysis were performed on these two group of cases, with different factors between subgroups (gender, age, pathological types, tumor stage, size and nuclear grade) evaluated by log-rank test. To evaluate accuracy of outcome prediction models of SSIGN, Leibovich and UISS score, concordance index of these models were evaluated. Results:In 1 346 cases of our cohort, those with chromophobe RCC were well prognostic, survival were relatively better in clear cell RCC than that of papillary RCC, and worst prognosis were demonstrated in those with other types of RCC (5 year overall survival rate: 97.5%, 87.9%, 79.7% and 68.4% separately). Poor prognosis were seen in those older than 50 years, with poor T stage or nuclear grade, large tumor size and tumors with necrosis or sacromatoid differentiation ( P<0.05). In 80 439 seer cases, the best prognosis was also seen in chromophobe RCC and the worst in other type of RCC separately (5 year overall survival rate: 96.3% and 85.3%). In addition, longer survival was seen in papillary RCC than clear cell RCC (5 year overall survival rate: 92.5% and 88.9%). However, similar results with our cohort were seen in Asian and American native subgroup of SEER cases (95.1%, 88.6%, 86.7%, 80.2% for chromophobe, clear cell, papillary and other types of RCC respectively). Poor prognosis were seen in those older than 50 years, males, Asian/ American Indian, poor T stage or nuclear grade and large tumor size ( P<0.05). Concordance index for SSIGN, Leibovich and UISS models in our cohort were 0.763-0.781, 0.725-0.752 and 0.641-0.660, respectively. The chromophobe RCC subgroup was relative better based on predictive value of prognosis models(c-index of UISS of 0.670-0.781, SSIGN and Leibovich of 0.733-0.903). Conclusions:In Asian RCC population, prognosis of chromophobe RCC is best, clear cell RCC is slightly better than papillary RCC, and the prognosis of other types of RCC is the worst. Concordance index of SSIGN and Leibovich in our cohort were higher than that of UISS, and the use value for predictive model was better in the chromophobe RCC subgroup.

Objective:To evaluate the effect of selective inhibitor of caspase-1 VX-765 on cognitive function in a rat model of hemorrhage shock and resuscitation (HSR).Methods:Forty-eight clean-grade healthy male Sprague-Dawley rats, aged 9-10 weeks, weighing 350-400 g, were divided into 4 groups ( n=12 each) using a random number table method: sham operation group (S group), HSR group (H group), VX-765 group (V group), and solvent control group (C group). The rats in H, V and C groups were subjected to hemorrhage by bleeding from femoral vein to achieve mean arterial pressure of 25-35 mmHg which was maintained at this level for 60 min followed by resuscitation with shed blood within 15 min to restore blood pressure, and normal saline was infused when needed.VX-765 1 mg/kg and 0.4% polyethylene glycol 1 mg/kg were intravenously injected via the femoral vein immediately after the end of resuscitation in V and C groups, respectively.Six rats in each group were selected and sacrificed at 12 h after the end of resuscitation, and the cerebral cortex was removed for determination of neuronal pyroptosis (by immunofluorescence) and degree of cortical edema (using T2-weighted imaging). Cognitive function was measured by open field test on day 7 after resuscitation in the rest 6 rats in each group. Results:Compared with S group, the pyroptosis rate in cortical neurons at 12 h after resuscitation and degree of cortical edema were significantly increased, the distance in the central square and the number of standing on the back legs were decreased on day 7 after resuscitation, and the time spent in the central square was shortened in H, V and C groups ( P<0.05). Compared with H and C groups, the pyroptosis rate in cortical neurons at 12 h after resuscitation and degree of cortical edema were significantly decreased, the distance in the central square and the number of standing on the back legs were increased on day 7 after resuscitation, and the time spent in the central square was prolonged in V group ( P<0.05). Conclusion:VX-765 can improve the cognitive function, and the mechanism may be associated with inhibiting pyroptosis in cortical neurons in a rat model of HSR.

Objective:To evaluate the effect of exogenous carbon monoxide (CO) on cell apoptosis during acute renal injury induced by hemorrhagic shock and resuscitation (HSR) in rats.Methods:Forty-eight clean-grade healthy male Sprague-Dawley rats, aged 9-10 weeks, weighing 350-400 g, were divided into 4 groups ( n=12 each) by a random number table method: sham operation group (S group), HSR group (H group), HSR plus CORM-3 group (HC group) and HSR plus iCORM-3 group (HiC group). Mean arterial pressure was maintained at 30-35 mmHg for 45 min by withdrawing blood from the femoral vein, and the shed blood was re-transfused within 15 min to reach the initial blood pressure for resuscitation.Normal saline was infused when necessary, and the model of HSR was established.CORM-3 4 mg/kg and iCORM-3 4 mg/kg were added during resuscitation in HC group and HiC group, respectively.Only femoral vein and artery puncture was performed in S group.Blood samples were obtained from the tail vein at 3 h after resuscitation for measurement of serum urea nitrogen (BUN) and creatinine (Scr) concentrations.Rats were sacrificed at 12 h after resuscitation, and renal tissues were obtained for determination of the expression of Bcl-2 and Bak protein and cleaved caspase-3 (by Western blot) and cell apoptosis (by TUNEL). The damage to the renal tubules was assessed by paller assay after HE staining.Bcl-2/Bak ratio and apoptosis rate were calculated. Results:Compared with group S, the serum BUN and Scr concentrations, paller scores, and apoptosis rate were significantly increased, Bcl-2/Bak ratio was decreased, and the expression of cleaved caspase-3 was up-regulated in H, HC and HiC groups ( P<0.05). Compared with group H, the serum BUN and Scr concentrations, paller scores, and apoptosis rate were significantly decreased, Bcl-2/Bak ratio was increased, and the expression of cleaved caspase-3 was down-regulated in group HC ( P<0.05). Compared with group HC, the serum BUN and Scr concentrations, paller scores, and apoptosis rate were significantly increased, Bcl-2/Bak ratio was decreased, and the expression of cleaved caspase-3 was up-regulated in group HiC ( P<0.05). There was no significant difference in the indexes mentioned above between group H and group HiC ( P>0.05). Conclusion:The mechanism by which exogenous CO improves acute kidney injury may be related to inhibiting cell apoptosis in a rat model of HSR.