Objective To study the role of saccharomyces cerevisiae DRE2 in endoplasmic reticulum response induced by tunica‐mycin .Methods The der2 ::URA3 gene deletion cassette was amplified from the wild type genomic DNA by PCR ;DRE2 deficiency heterozygote strain was made by gene recombination .The heterozygote strain resistant ability to tunicamycin and the replicative li‐fespan were analyzed in this study .Results DRE2 deficiency strain was resistant to tunicamycin ,but the replicative lifespan was decreased compared to wild type strain (P< 0 .05) .Conclusion DRE2 may be involved in the yeast endoplasmic reticulum response and replicative lifespan regulation .

The data of 30 patients simulated before surgery were analyzed using Dextroscope operation planning system in Department of Neuresurgery,General Hospital of Chinese PLA between August 2004 and September 2005,including 2 patients with basilar artery aneurysm,1 with posterior cerebral artery aneurysm,3 with ophthalmic aneurysm,2 with middle cerebral artery aneurysms,1 with anterior cerebral artery aneurysm,7 atlas-occipital malformation,4 meningioma,5 schwannomas,and 5 deep gliomas. The primary CT and MRI data of 30 patients were input to the workstation of Dextroscope system for 3D reconstruction,reunion,segmentation and simulation the entire process of the operation. The relationship of the cranial nerves,vessels and skull base bone with lesions during operations were similar with that of the preoperative simulation on the workstation. The time of clipping aneurysms was reduced from (37.60±13.43) minutes to (23.51±7.62) minutes following application of Dextroscope system,and time of resections of odontoid processes was shortened from 81 minutes to 50 minutes. The ratios of complications were decreased and the patients' Karnofsky scales were 88.7 scores 3 months after operation. Dextroscope operation planning system can help doctors to analyze the patients' image data on a 3-D view and video outlook. The system can raise a precise and detailed operation plan before operation based on the simulation of the operation process,to well know the difficulty and shorten operation duration.

BACKGROUND: The anatomical position of facial nerve is often abnormal because of the acoustical neuroma growth, so sometimes, the facial nerve injury is inevitable in the surgery treatment for acoustic neuroma.OBJECTIVE: To investigate the technology, veracity and practicality as well as the relationship between intraoperative monitorning and prognosis of facial nerve, and the clinical experiment was summed up of facial nerve function monitoring in 120 cases of acoustic neuroma surgery.DESIGN: Self-control observation.SETTING: Department of Neurosurgery, General Hospital of Chinese PLA.PARTICIPANTS: Totally 120 patients with acoustic neuroma who received treatment in the Department of Neurosurgery, General Hospital of Chinese PLA from May 1996 to February 2000 were recruited. Among them, 3 cases suffered from small-type acoustic neuroma (＜ 2 cm in diameter), 9 cases from middle-type acoustic neuroma (＞ 2 cm in diameter) and 108 from large-type acoustic neuroma (＞ 3 cm in diameter), including 1 case of bilateral acoustic neuroma and 1 cases of recrudescent acoustic neuroma; Suboccipital retromastoid approach was used in 119 cases and transretrolabyrinthine approach in 1 case.METHODS: American Viking-Ⅳ type monitor was used to monitor facial nervous function. When facial nervous function was monitored, recording electrode was put on orbicular muscle of eye, orbicular muscle of mouth or quadrate muscle of upper lip. When trigeminal motor branch was monitored, recording electrode was put on masseter muscle; When accessory nerve was monitored, recording electrode was put on trapezius muscle.Measurement of evoked auditory brainstem potential: recording electrode was positive electrode and was put at the midline in the frontal region (electroencephalogram 10-20 classification system). The recorded waveshape presented upward deflection. Reference electrode A1 or A2 and ground electrode were put in the midline of frontal pole (relevant to root of nose); Recording electrodes were all needle electrodes and were fixed with adhesive tape. Common stimulus intensity was 80 to 90 nHL, and 40 nHL noise was used in contralateral ear. Facial nerve was reserved following intraoperative monitoring. CT (enhancement scanning was necessary) or MRI was rechecked after operation to investigate the cutting degree of tumor; Facial nerve function was evaluated by H-B scoring (at 2 weeks, or 6 to 9 months following operation).MAIN OUTCOME MEASURES: Facial nerve function by H-B scoring before and after acoustic neuroma surgery.RESULTS: Totally 120 patients were enrolled, and no one dropped out.① Facial nerve anatomy was reserved in 117 cases; One case was failure to reserve facial nerve anatomy because pinnate facial nerve lay behind of acoustic neuroma, and electrical stimulation was not given at the beginning of neuroma resecting, then he received anastomosis of hypoglossal and facial nerve. Nerve of 2 cases was pulled and broken carelessly, and its two stumps were long enough that end-to-end anastomosis of facial nerve was performed with 7-0 absorbable suture following trimming. H-B score was Ⅳ to Ⅴ in the 6th month after surgery. ②Grade Ⅰ of facial nervous function at postoperative 2 weeks was found in 10 cases, grade Ⅱ in 57 cases,grade Ⅲ in 44 eases, grade Ⅳ in 4 cases, grade Ⅴ in 2 cases and gradeⅥ in 3 cases. ③Grade Ⅰ of facial nervous function at postoperative 9 weeks was found in 94 cases, grade Ⅱ in 18 cases, grade Ⅲ in 4 cases,grade Ⅳ in 1 case and grade Ⅵ in 2 cases.CONCLUSION: Spontaneous and evoked facial muscle electromyogram may be helpful to make sure the facial nervous position exactly and estimate the prognosis of facial nerve.

Objective To investigate the potential role of disc repositioning and condyle restoration in the treatment of type Ⅲ traumatogenic temporomandibular joint (TMJ) ankylosis. Methods Eight patients including four females and four males at age range of 7-22 years (mean 13.6 years) were enrolled in this study. The patients suffered from traumatogenic TMJ ankylosis for 1-12 years. The preoperative interincisal opening distances ranged from 2 mm to 10 mm. During surgery, the traumatogenic callus of the lateral condyle process was removed, the condyle process was formed, and then the dislocated disc was sutured to the articular capsule or soft tissues around. Results All patients were followed up for 6-38 months and the last follow-up examination showed that the average interincisal opening distance was 30 mm. No recurrence or TMJ symptoms were found during the period of follow-up. Conclusions Disc repositioning and condyle restoration has the advantages of simple procedures, minor trauma and little recurrence and proves to be a feasible and effective method for the treatment of type Ⅲ traumatogenic TMJ ankylosis.

Objective: To explore the clinical useness of intraoperative functional neuronavigation and fluorescent indocyanine green(ICG) angiography as well as electrophysiological evaluation during microsurgical resection of cerebral arteriovenous malformations (AVM). Methods: A series of 42 consecutive cases with AVM underwent microsurgery by intraoperative functional neuronavigation at Department of Neurosurgery of People′s Liberation Army General Hospital from January 2009 to February 2015 were retrospectively analyzed. Of the 42 patients, 29 were males and 13 were females aging from 4 to 62 years (mean age 32.6 years). Preoperative assessment included functional magnetic resonance imaging and diffusion tensor imaging to identify the relationship between lesions and eloquent areas. The results of images were integrated into three-dimensional datasets to achieve intraoperative microscopic-based functional neuronavigation during AVM resection. Operations involved in motor areas and corticospinal tract were performed under continuous electrophysiological monitoring. ICG angiography was performed at pre-dissection, post-clipping of the feeders, and post-resection of the nidus. FLOW 800 software presented a color map and ICG intensity-time curve to demostrate the vascular architecture. Postoperative digital subtraction angiography was re-examined routinely to evaluate the extent of resection. Clinical outcomes were evaluated with the modified Rankin Scale. Results: All patients underwent surgery under intraoperative navigation. Of the 42 patients, total resection was achieved in 36 cases (85.7%, 36/42) including 14 cases of AVM in eloquent areas. A total of 40 ICG angiographies were successfully performed among 11 patients. Average number of ICG injections per operation was 3.6 (ranging from 3 to 6). Feeders were visualized in 10 patients and drainers were visualized in 9 cases. The post-surgical follow-up period varied from 3 months to 70 months (mean 22.5 months). 83.8% of the patients returned to normal work and life during the followed-up period. Conclusion Combining intraoperative neuronavigation and electrophysiological monitoring, as well as fluorescent ICG angiography contribute to microsurgical resection of cerebral AVM effectively in selecting suitable patients, further avoiding neurologic compromise as well.

Objective:To investigate the clinical effect of Ilizarov bone transport technique with assisted guiding pin in medullary cavity for treatment of posttraumatic bone defect of tibia.Methods:A retrospective case series study was conducted to analyze the clinical data of 17 patients with post-traumatic bone defect of tibia admitted to Third Hospital of Hebei Medical University form November 2014 to March 2018.There were 13 males and 4 females, aged 19-60 years [(37.2±13.4)years]. The bone defect length was 4.6-14.0 cm [(8.6±2.8)cm] after debridement. All patients underwent treatment with Ilizarov bone transport technique. The alignment of transport bone segment was controlled by a guiding pin in medullary cavity of tibia. Bone grafts were performed to accelerate fracture healing of docking point. The wound healing, bone healing, external fixation time, external fixation index (EFI), alignment recovery were recorded. Bone healing and functional results were evaluated according to the criteria given by Association for the Study and Application of the Method of Ilizarov (ASAMI). The complication was recorded according to Paley's criteria. The physical component summary score (PCS) and mental component summary score (MCS) ware recorded according to the MOS 36-item Short-form Health Survey (SF-36) questionnaire and compared with the national norm to evaluate the quality of life.Results:After removal of the apparatus, follow-up period was 12-37 months [(29.9±4.4)months]. Wound healing was achieved without flap transfer. At the latest follow-up, all patients achieved bone healing without recurrent infection. External fixation time was 242-801 days [(436.5±154.6)days] and external fixation index was 35.7-60.5 d/cm [(50.6±6.2)d/cm]. The affected extremity alignment was restored in all patients except for residual angular deformity in one patient. According to ASAMI, the excellent and good rate of bony results and functional results were 88% and 94%. According to Paley's criteria, complications included 12 problems, 7 obstacles and 1 sequelae. The PCS and MCS in SF-36 questionnaire were (85.8±11.6)points and (69.6±11.1)points. Compared with the national norm [PCS: (87.6±16.8)points, MCS: (78.8±15.4)points], PCS showed no statistical difference ( P>0.05), but MCS showed statistical difference ( P<0.05). Conclusions:Ilizarov bone transport combined with intramedullary guiding pin can accelerate wound and fracture healing, control infection and restore lower limb alignment. The physical function of the affected extremity can be restored in spite of some complications and psychological effects. The technique is an effective treatment for posttraumatic bone defect of tibia.

Objective:To investigate the effects of Five-Element music intervention on anxiety, depression, and weaning successful rate in intensive care unit (ICU) patients with difficult weaning.Methods:A prospective randomized controlled trial was conducted. Eighty patients with difficulty in weaning accompanied by anxiety and depression disorders admitted to the respiratory intensive care unit (RICU) of Henan Provincial People's Hospital from January 2019 to January 2021 were enrolled as research subjects. They were divided into an observation group and a control group using a random number table method, 40 cases in each group. The patients in the control group received routine respiratory rehabilitation treatment, with daily assessments of weaning and gradual reduction of mechanical ventilation support until weaning was achieved. The patients in the observation group received additional Five-Element music therapy, in addition to routine respiratory rehabilitation treatment. Based on the clinical manifestations of the patients and applying traditional Chinese medicine theory for syndrome differentiation, music therapy was applied accordingly. The intervention used traditional Chinese Five-Element music (composed by Shi Feng, published by China Medical Electronic Audio and Visual Publishing House). Baseline data including the gender, age, etiology of acute respiratory distress syndrome (ARDS), and acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score of patients were recorded. A twelve-lead synchronous Holter monitor continuously recorded the R-wave dominant electrocardiogram signal for 24 hours or more. Heart rate variability (HRV) indices [standard deviation of all normal sinus R-R intervals (SDNN), standard deviation of 5-minute average R-R intervals (SDANN), percentage of continuous normal R-R intervals with differences greater than 50 ms (PNN50), and the root mean square of successive differences in adjacent R-R intervals (RMSSD)] were calculated, as well as HRV frequency domain parameters [low-frequency band (LF, 0.05-0.15 Hz), high-frequency band (HF, 0.16-0.50 Hz), and LF/HF ratio]. Additionally, the incidence of delirium, weaning successful rate, reintubation rate within 7 days, length of ICU stay, and hospital mortality were documented.Results:There were 8 cases in the control group dropping out, and resulting in 32 were participated, and the 40 cases in the observation group were all enrolled the analysis. There were no statistically significant differences in terms of gender, age, ARDS etiology, and APACHEⅡ score between the two groups, indicating balanced baseline data for comparison. There were also no significant differences in HRV indices and frequency domain parameters before the intervention between the two groups. After the intervention, the observation group showed significant increases in HRV indices and frequency domain parameters as compared with the control group [SDNN (ms): 77.21±11.75 vs. 63.81±13.50, SDANN (ms): 83.51±19.45 vs. 50.40±14.55, PNN50: (10.75±3.42)% vs. (7.79±3.13)%, RMSSD (ms): 47.15±6.57 vs. 31.74±6.37, HF (ms 2/Hz): 568.50±144.48 vs. 496.94±151.56, LF (ms 2/Hz): 840.13±110.76 vs. 587.81±144.51, LF/HF ratio: 1.60±0.60 vs. 1.22±0.21, all P < 0.05]. Seventeen patients in the control group developed delirium, including 12 cases of hyperactive delirium, 3 cases of hypoactive delirium, and 2 cases of mixed-type delirium; whereas in the observation group, 9 patients developed delirium, including 7 cases of hyperactive delirium, 1 case of hypoactive delirium, and 1 case of mixed-type delirium. There was no significant difference in the types of delirium between the two groups ( P > 0.05); however, the incidence of delirium in the observation group was significantly lower than that in the control group (22.50% vs. 53.12%, P < 0.01). The weaning successful rate in the observation group was significantly higher than that in the control group [95.00% (38/40) vs. 78.12% (25/32), P < 0.05], the reintubation rate within 7 days and hospital mortality were slightly lower than those in the control group [reintubation rate within 7 days: 5.00% (2/40) vs. 15.62% (5/32), hospital mortality: 0% (0/40) vs. 3.12% (1/32), both P > 0.05], and the length of ICU stay was also slightly shorter than that in the control group [days: 18.00 (17.00, 25.75) vs. 22.50 (15.00, 34.50), P > 0.05]. Conclusion:Five-Element music therapy is beneficial in improving anxiety and depression disorders in ICU patients with difficult weaning, reducing the incidence of delirium, and increasing the weaning successful rate.

Objective: To analyze the expression and prognostic significance of esophageal squamous cell carcinoma associated long non-coding RNA-1 (ESCCAL-1) in esophageal squamous cell carcinoma (ESCC) tissues. Methods: From August 2011 to May 2013, 73 patients with ESCC, who received radical resection in The First Affiliated Hospital of Zhengzhou University and Henan Cancer Hospital, were enrolled. The expressions of ESCCAL-1 in esophageal tumor tissues and corresponding adjacent non-tumor tissues were detected by quantitative real-time polymerase chain reaction (qRT-PCR). T test, chi square test and multivariate analysis were performed for statistical analysis. Results: The expression of ESCCAL-1 was 28.03±9.37 in esophageal tumor tissues of patients with ESCC, which was higher than that in corresponding adjacent normal tissues (11.39±4.15), and the difference was statistically significant (t=2.964, P<0.01). However there were no statistically significant differences in the expressions of ESCCAL-1 among the patients with different age, gender, histological grade, classification of Union for International Cancer Control (UICC), T stage or lymph nodes metastasis (all P>0.05). The median disease-free survival (DFS) time and overall survival (OS) time of patients with low ESCCAL-1 expression were 39 months and 42 months, respectively, which were longer than those of patients with high ESCCAL-1 expression (30 months and 37 months), and the differences were statistically significant (χ²=9.049, P=0.003; χ²=10.165, P=0.001). The results of multivariate analysis showed that ESCCAL-1 expression was the independent risk factor of DFS and OS (high risk (HR)=2.45, 95% confidence interval (CI) 1.22 to 4.93, P=0.012; HR=2.29, 95%CI 1.14 to 4.59, P=0.019). Conclusions ESCCAL-1 may be involved the genesis and development of ESCC. The expression of ESCCAL-1 in esophageal tumor tissues may be a prognostic parameter for patients with ESCC receiving radical resection.

AIM:To investigate the effect of Tongsai granules(TSG)on epithelial barrier dysfunction in acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and the underlying mechanism.METHODS:Twenty-four Sprague-Dawley rats were randomly divided into control group,model group,TSG group,and moxifloxacin(MXF)+salbutamol(STL)group.Rat COPD model was established over 8 weeks.On day 3 of week 9,the rats with COPD were intratracheally administered Klebsiella pneumoniae to establish the AECOPD model.On days 1 to 2 and 4 to 7 in week 9,saline was administered via oral gavage to the rats in control and model groups,and the rats in TSG and MXF+ STL groups were treated daily with TSG and MXF+STL by gavage,respectively.Peak expiratory flow(PEF),histopatho-logical changes,and the expression levels of interleukin-1β(IL-1β),IL-6,tumor necrosis factor-α(TNF-α),matrix me-talloproteinase 2(MMP2),MMP9,zonula occludens-1(ZO-1),E-cadherin(E-Cad)and occludin(OCC)were deter-mined.Moreover,human bronchial epithelial BEAS-2B cells were exposed to cigarette smoke extract(CSE)and treated with different TSG fractions,and the protein levels of ZO-1,E-Cad,OCC,epidermal growth factor receptor(EGFR),phosphorylated EGFR(p-EGFR),extracellular signal-regulated kinase(ERK)and phosphorylated ERK(p-ERK)were determined.RESULTS:Treatment with TSG significantly reduced bronchial wall thickness,mean linear intercept,and the levels of IL-1β,IL-6,TNF-α,MMP2 and MMP9(P＜0.05 or P＜0.01),significantly increased mean alveolar number and PEF(P＜0.01),and up-regulated the ZO-1,E-Cad and OCC protein levels(P＜0.01)in the lungs of AECOPD rats.Treatment with TSG2,the second TSG fraction,increased the protein levels of ZO-1,E-Cad and OCC in a dose-dependent manner in CSE-exposed BEAS-2B cells(P＜0.05 or P＜0.01).Network pharmacology analysis of 328 targets of the com-pounds in TSG2 and 3 864 genes related to AECOPD suggested that TSG2 relieved AECOPD likely through the regulation of ERBB2,ERK,EGFR,IL and WNT signaling pathways.Treatment with TSG2 also inhibited CSE-induced increases in p-EGFR and p-ERK levels in BEAS-2B cells(P＜0.05 or P＜0.01).CONCLUSION:Treatment with TSG could maintain airway epithelial barrier function in AECOPD rats,likely through the inhibition of EGFR/ERK signaling pathway.

Objective To observe neuropsychological development status in children after surgical treatment of congenital heart diseases(CHDs)and analyze the risk factors. Methods 89 children who received outpatient review in Fuwai Hospital from September 2015 to March 2016 after surgical treatment of CHDs were recruited in this study and 90 normal children were recruited as the control group. The children with CHDs were divided into simple CHDs group(RACHS- 1 score≤2)and com-plex CHDs group(RACHS- 1 score≥3)according to RACHS- 1 classification. Neuropsychological development status was meas-ured according to pediatric-psychological mental test scale developed by Capital institute of pediatrics,Beijing and statistical a-nalysis was compared. Results The measurements of neuropsychological development showed the normal children behaved better than the children with CHDs(P < 0. 05). The simple CHDs group achieved better distribution of development quotient than complex CHDs group(P = 0. 032)and there was no difference between the normal control group and simple CHDs group (P = 0. 420). Multivariate regression analysis indicated that younger age at cardiac surgery,lower preoperative blood urea ni-trogen(BUN),higher preoperative creatinine(Cr)and prolonged duration of cardiopulmonary bypass(CPB)accounted for low-er scores in the test scale(P < 0. 05). Conclusion Distinct neuropsychological difficulties could be present especially in chil-dren with complex CHDs. Younger age at cardiac surgery,preoperative BUN,Cr and CPB duration were perioperative factors that were associated with long-time neuropsychological development.