Objective To investigate the effect of preoperative single target administrating of fibrinogen(FIB)on the intraop-erative bleeding and coagulation function in posterior lumbar interbody fusion (PLIF)operation.Methods 60 cases of lumbar inter-vertebral disc herniation(LDH)undergoing elective PLIF operation were divided into two groups according to the preoperative FIB levels:normal control group(NC,FIB≥3.0 g/L,n=20)and low FIB group(FIB<3.0 g/L,n=40).The low FIB group was ran-domly re-divided into 2 groups:the low HIB control group(LC,n=20)and the preoperative single FIB administrating group(PF, n=20).After anesthesia induction,the PF group was given FIB;the LC and NC groups were given the same volume of saline solu-tion as solvent volume required by administrating FIB dose.The change of blood coagulation 4 indexes were detected and the activa-ted clotting time(ACT),coagulation time(CR)and platelet function(PF)were detected by the sonoclot analyzer before and after drug administrating.The bleeding amount was weighed after ending operation.Results The FIB concentration after administrating in the PF group was (3.75±0.23)g/L,which was significantly higher than (2.62±0.33)g/L in the NC group and (2.23±0.22) g/L in the LC group,the differences among 3 groups were statistically significant(P <0.05);the CR value after administrating in the PF group was (21.42±7.15)U/min,which was higher than (18.21±5.62)U/min in the NC group and (15.21±5.63)U/min in the LC group.The bleeding amount in the PF group was (516.74±135.53)g,which was lower than (660.71±119.34)g in the NC group and (726.72±160.47)g in the LC group,the difference among 3 groups had statistical significance(P <0.05).Conclusion Preoperative single target administrating of fibrinogen can effectively increase the FIB level,improve the blood coagulation func-tion and reduce the periaoperative bleeding amount.

OBJECTIVETo assess the clinical and imaging features of cementoblastoma for diagnosis and differential diagnosis.

METHODSClinical and imaging data of 14 cases were selected for this retrospective study.

RESULTSA total of 14 cases of cementoblastoma patients with ages at diagnosis ranging from 11 years to 58 years (mean age, 27.6 years; median age, 21.0 years). The tumor affected 7 patients from each gender. The mandible was the main site of occurrence. The most common complaints were swelling and pain. Radiographic results showed that cementoblastoma typically presented as a well-circumscribed and radiopaque mass confluent with the involved tooth root and surrounded by a thin and uniform radio-lucent border. Tumor parenchyma was generally mixed-density, which could be divided into two types, namely, homogeneous and heterogeneous patterns. Other significant imaging features included the periphery bone of the lesion sclerosis and cortical thickening of the lower edge of the mandible.

CONCLUSIONObvious characteristics are found in the clinical and imaging findings of cementoblastoma. Accurate recognition of this lesion is significant in clinic to avoid misdiagnoses.

Adolescent ; Adult ; Cementoma ; Child ; Diagnosis, Differential ; Humans ; Mandible ; Middle Aged ; Pain ; Retrospective Studies ; Tooth Root ; Young Adult

The keratocystic odontogenic tumor (KCOT) is a common cystic lesions of jaw, which has a high recurrence rate but rarely undergo malignant transformation. This study reported a patient with primary intraosseous squamous cell carcinoma developed from KCOT.
Carcinoma, Squamous Cell ; etiology ; Cell Transformation, Neoplastic ; Humans ; Odontogenic Tumors ; complications

Objective To analyze the risk factors of nosocomial infection in Department of Neurosurgery and to provide evidence for the prevention and treatment of infection.Methods A total of 931 patients with neurosurgery operation in our hospital from January 2012-January 2016 were collected medical history data immediately after admission,including age,gender,underlying diseases,and primary diseases.Surgical records include preoperative white blood cell count,blood glucose level before operation,duration of operation,and reoperation.Hospitalization records include hospitalization time,without the use of corticosteroids,with or without the use of proton there is no pump inhibitor,and tracheal intubation / incision.Patients were divided into infection group and non infection group according to whether the hospital infection occurred during hospitalization.The difference of two groups of clinical data with statistically significant variables was Logistic multivariate regression analysis.Results There were 112 patients with nosocomial infection,the infection rate was 12.03％,and the infection occurred in the postoperative 3-25 d.The main infection site was postoperative wound,accounting for 35.7％;respiratory tract,accounting for 34.8％.There were 64 strains of pathogenic bacteria,81 strains of Gram-negative bacteria,accounting for 64.1％,21 strains of gram positive bacteria,accounting for 32.8％,2 strains of fungi,accounting for 3.1％.There were significant difference between infection group and non infection group in ≥ 60 years,with basic diseases,reoperation,combined with other injuries,white blood cells,abnormal preoperative hyperglycemia,glucocorticoid use,proton pump inhibitors use,tracheotomy,hospitalization time,operation time (P ＜ 0.05).Further Logisitc regression analysis showed that age,reoperation,hospitalization time,preoperative high blood sugar and tracheotomy were the risk factors of nosocomial infection in Department of neurosurgery.Conclusions For the older,reoperation,longer hospitalization time,preoperative hyperglycemia and tracheotomy patients can take specific measures to improve the immunity of the patients,the rational use of antimicrobial drugs to avoid the occurrence of postoperative infection.

Objective To explore the effect of Flavokawain B on the proliferation and apoptosis of acute T lymphoblastic leukemia(T -ALL)cells and its preliminary mechanism.Methods After the T -ALL cell lines CEM-C7(sensitive to glucocorticoids)and MOLT -4(resistant to glucocorticoids)cells were treated with different concentrations of Flavokawain B,the influence of Flavokawain B on the growth rate and doubling time of CEM-C7 and MOLT -4 cells was observed by 3 -(4,5 -dimethylthiazol -2 -yl)-5 -(3 -carboxymethoxyphenyl)-2 -(4 -sulfophenyl)-2H -tetrazolium(MTS)assay,and apoptosis was analyzed by using flow cytometry.Furthermore,Wes-tern blot assay was used to detect the expressions of Bim,Bcl -2 and cleaved Caspase -9.At last,the expressions of Bim and Bcl -2 in clinical T -ALL patient samples were also detected by using Western blot assay.Results MTS as-say showed that Flavokawain B significantly inhibited the cellular proliferation of T -ALL cell lines in a dose and time dependent manner(P <0.01 ).Flow cytometry findings revealed that Flavokawain B significantly induced the apoptosis of T -ALL cells in a dose -dependent manner(P <0.001 ).Western blot results indicated that Flavokawain B in-creased the expression of Bim and cleaved Caspase -9,and decreased the expression of Bcl -2 in T -ALL cell lines, which increased Bim and decreased Bcl -2 in clinical T -ALL patients samples,both in a dose -dependent manner. Conclusions Flavokawain B can inhibit the proliferation and induce the apoptosis of T -ALL cells by up -regulating the expression of Bim and down -regulating the expression of Bcl -2 and activating Caspase -9,whether resistant to glu-cocorticoids or not.

Objective To evaluate the diagnostic value of dual-source CT angiography (DSCTA) for intracranial aneurysms.Methods The data of DSCTA and digital subtraction angiography (DSA) were collected from 95 patients with subarachnoid hemorrhage (SAH).The efficacies of detection and description of morphologic features of intracranial aneurysms were analyzed retrospectively.Results A total of 117 aneurysms in 88 patients were detected with DSCTA.Two patients were suspected of having aneurysms,and no aneurysrms were detected in 5 patients.These patients were reexamined with DSA,4 were diagnosed as having aneurysm,and the aneurysms were not detected in 3 patients.DSA results were considered as gold standard,the specificity,sensitivity and accuracy of DSCTA for the detection of intracranial aneurysms were 100％,96.7％and 96.8％,respectively.The larger volume of intracranial aneurysm was,the higher the sensitivity of DSCTA diagnosis would be.Even for small aneurysms,the sensitivity of DSCTA diagnose was more than 90％.In addition,tmeasurement results of the maximum diameter and neck width of aneurysms measured by DSCTA were almost consistent with DSA.Condclusions SCTA is a non-invasive,quick,reliable,and effective method,and can provide accurate imaging information for surgery.The specificity and sensitivity of the diagnosis of aneurysms with DSCTA are almost the same with DSA.It has more advantages than DSA in the emergency operation of intracranial aneurysms.

[Objective]To explore the effect and the possible mechanism of the proteasome inhibitor MG132 on acute T lympho?blastic leukemia cells.[Methods]The influence of different concentrations of MG132 in the viability and proliferation of CCRF-CEM was measured by MTS. Apoptosis rates of CCRF-CEM treated by MG132 were determined by flow cytometry. After being exposed to MG132,the protein levels of FOXO3a in cytoplasm and nucleus were analyzed by Western blotting. qRT-PCR was applied to detect the mRNA of FOXO3a and Puma in cells treated by MG132. Then CCRF-CEM was stably transfected with antisense FOXO3a using Lentivirus infection. We further investigated the effects of MG132 in FOXO3a-shRNA cells and elucidated the mechanisms of FOXO3a and Puma.[Results]MG132 inhibits the proliferation of CCRF-CEM,but has no cytotoxicity in peripheral blood mononu?clear cells(PBMC). Cellular apoptosis was induced in cells treated with MG132. At mRNA level,MG132 had no influence on FOXO3a,but increased the expression of Puma. However,MG132 promoted the expression of both FOXO3a and Puma at protein level. Interestingly,the expression of FOXO3a increased very little in cytoplasm. In FOXO3a-shRNA cells the expression of FOXO3a and Puma decreased at protein level. FOXO3a's knockdown attenuated the proliferation inhibition mediated by MG132.[Conclusion]MG132 inhibits the proliferation and promotes to apoptosis of CCRF-CEM. One of the mechanism is that MG132 inhib? its the degradation of FOXO3a,and then activates FOXO3a/Puma pathway.

Cardiovascular disease is still the world's first cause of death,its morbidity and mortality rates are still increasing. Recent studies have shown that circular RNA is involved in the regulation of gene expression and plays a significant role in the pathogenesis of cardiovascular diseases. Circular RNA is a kind of special non-coding RNA, which can regulate the expression of genes at the level of post-transcription or transcription,then regulate various life activities as well as cardiovascular system diseases,becoming a latest research hot spot in the field of RNA. Nowadays,more and more attention is paid to the role of cyclic RNA in the development, early diagnosis, disease monitoring and other aspects of cardiovascular diseases. In this paper,we make an overview of the latest research on circRNAs from the aspects of genesis, function,and the relationship with cardiovas cular diseases,and so on.

Objective:To investigate the level of endogenous hydrogen sulfide (H 2S) in contrast-induced acute kidney injury (CIAKI), as well as the potential role of H 2S against CIAKI by down-regulating NLRP3 inflammasome. Methods:Twenty-four healthy male Sprague-Dawley rats, weighing 180-220 g, were randomly divided into three groups according to the random number table method: control group, CIAKI group (iopromide 2.9 g/kg) and CIAKI+NaHS group (NaHS 4 mg/kg for three days before 2.9 g/kg iopromide injection). Kidneys were collected for whole-genome sequencing and bioinformatic analysis. HE and PAS staining were used for kidney histological examination. TUNEL assays were applied to detect renal tubular epithelial injury. Expressions of NLRP3 inflammasome (NLRP3, ASC and caspase-1) were evaluated by immunofluorescence staining. The role of H 2S in contrast (iopromide 200 mgI/kg)-induced injury on human renal tubular epithelium (HK-2 cells) was investigated, and CCK-8 assay was used to detect cellular viability. Results:Compared with the control group, the expression of endogenous H 2S synthetases-related genes [cystathionine β-synthase ( CBS), cystathionine-γ-lyase ( CSE) and 3-mercaptopyruvate sulfurtransferase ( 3- MST)] was lower in CIAKI group (all P<0.05). The gene expression levels of CBS, CSE and 3- MST were negatively correlated with renal function biomarkers serum creatinine, blood urea nitrogen and cystatin-C (all P<0.05). Compared with the CIAKI group, CIAKI+NaHS group showed alleviated creatinine, blood urea nitrogen and cystatin-C, improved histological changes, reduced apoptosis. Moreover, the expression levels of NLRP3, ASC and caspase-1 in CIAKI+NaHS group were lower than those in CIAKI group (all P<0.05). In HK-2 cells, compared with the contrast group, the cellular viability was higher in the contrast+NaHS group; reducing endogenous H 2S by CBS inhibitor could enhance contrast-induced cell viability ( P<0.05). Conclusions:Injury of endogenous H 2S system is pivotal to CIAKI pathogenesis. Up-regulation of H 2S ameliorates renal injury of CIAKI rats, which may be related to regulation of NLRP3 inflammasome.

OBJECTIVETo explore the learning curve of transanal total mesorectal excision (taTME) for rectal cancer.

METHODSClinical data of 60 rectal cancer patients undergoing taTME from July 2014 to April 2016 were retrospectively analyzed. According to the sequence of operation date, 60 patients were divided into four groups (A, B, C, D) with 15 cases in each group. General information and perioperative, especially the operative indexes were compared among four groups.

RESULTSThere were no significant differences in age, sex, preoperative staging, BMI, tumor size among four groups (all P>0.05). The distance from tumor to anal verge in A group was(6.7±2.5) cm, which was significantly different with B group (4.6±1.2) cm, C group (4.5±1.0) cm and D group (4.0±1.0) cm (P=0.000, P=0.000, P=0.001). Ratio of receiving neoadjuvant therapy was 0, 60.0%(9 cases), 26.7%(4 cases) and 26.7%(4 cases) in A, B, C, D groups respectively with significant difference (P=0.004). Ratio of receiving complete taTME was 73.3%(11/15) in A group, 26.7%(4/15) in B group, 13.3%(2/15) in C group and 26.7%(4/15) in D group, while other patients underwent laparoscopy-assisted procedures. This ratio of A group was significantly higher as compared to B, C, D groups (P=0.003). The operation time was significantly different among four groups [A group (223.0±105.2) minutes, B group (299.0±131.0) minutes, C group(278.0±44.8) minutes, D group (246.0±34.0) min, P=0.035]. Fluctuation of operation time was more common in A and B groups, which became stable in C and D groups. Though intra-operative blood loss was not significantly different among four groups [A group (249.0±559.6) ml, B group (288.0±568.1) ml, C group (87.0±43.3) ml, D group (69.0±64.5) ml, P=0.225], but it presented a decline trend in C and D groups. Number of harvested lymph node from postoperative pathological specimen was 10.9±5.9 in A group, 9.6±2.7 in B group, 15.8±4.8 in C group, and 14.2±5.1 in D group, with significant difference among groups (P=0.008; A group vs. C group, P=0.010; B group vs. C group, P=0.002; B group vs. D group, P=0.021). There were no significant differences in specimen length, postoperative complication rate, distal margin distance and hospital stay.

CONCLUSIONA well-skilled laparoscopic colorectal surgeon, by following the standard surgical procedures, are likely to overcome the learning curve smoothly after performing approximately 30 cases of taTME for rectal cancer.

Abdomen ; Aged ; Anal Canal ; Blood Loss, Surgical ; Digestive System Surgical Procedures ; methods ; Female ; Humans ; Laparoscopy ; Learning Curve ; Length of Stay ; Lymph Nodes ; Male ; Middle Aged ; Neoadjuvant Therapy ; Operative Time ; Postoperative Complications ; Rectal Neoplasms ; surgery ; Retrospective Studies