Objective This study was to analyze the early and long-term effect of completion pneumonectomy.Methods Retrospective analysis was made on the patients who underwent completion pneummonectomy in Shanghai Chest Hospital.Results There were totally 56 cases patients underwent completion pneumonectomy during January 2003 to July 2013.Among them,45 patients received CCP,and other 11 patients received RCP.CCP refers to the complete removal of lung tissue remaining after an initial ipsilateral partial pulmonary resection.RCP refers to the complete removal of residual lung due to the severe complications after pneumonectomy.The mortality and morbidity rate of CCP were 4.4％ and 33.3％ respectively.In the case of CCP,the incidence of benign lesions is significantly higher than the incidence of malignant tumor(80.0％ vs 27.5％,P =0.04).The mortality and morbidity rate of RCP were 27.3％ and 90.9％ respectively.In the case of RCP,higher postoperative mortality often occurs in aged patients (P =0.046) and patients with preoperatie mechanical ventilation (P =0.03).Overall five-year survival rate for patients with benign lesions was 80％,and for malignant lung cancer patients,the number was 30％.Survival time differs according to the TNM staging(a median of 60.0 months,35.0 months,10.0 months,stage Ⅰ,stage Ⅱ,stage Ⅲ,P ＜0.01),and survival rate was higher when the time interval(between the initial pulmonary resection and the completion pneumonectomy) ＞ 2 years(a median of 60.0 months,18.0 months,P ＜ 0.01).Conclusion Completion pneumonectomy is a high-risk surgery,especially RCP.Advanced age and preoperative mechanical ventilation are associated with higher postoperative mortality rate for RCP.As for CCP,higher postoperative risk exists in patients with benign lesions,but the survival rate is also higher.In patients with malignant lung tumor,survival rate is higher when the time interval (between the initial pulmonary resection and the completion pneumonectomy) ＞2 year.

Chronic liver diseases can further develop to liver fibrosis and cirrhosis. Currently, there is no effective treatment except liver orthotopic transplantation at this point. The extreme shortage of liver organ source forced people to find alternative treatment strategies. Mesenchymal stem cells ( MSCs) have the abilities of immunomodulatory, hepatocyte differentiation, promotion of liver cells regeneration in situ and inhibiting the activation of hepatic stellate cells. Therefore, MSCs transplantation provides a very broad prospect for cell therapy. It is important to provide preclinical evaluation of the efficacy and safety before the application of cell therapy in clinical trials. The progress of various animal models of human liver diseasees and significance of using MSCs to treat liver diseases in preclincal studies based on these animal models were reviewed in this paper.

The term,cerebral small vessel disease (CSVD),describes a syndrome of neuroimaging,pathological,and associated clinical features caused by small intracranial vascular lesions.Recent studies have found different MRI features of CSVD in patients with ischemic strokes caused by large artery atherosclerosis (LAA),significantly influencing the stroke outcomes.This paper reviews the effects of CSVD on clinical outcomes of cerebral infarction patients caused by LAA and their mechanisms.

The shortage of donor lung remains one of the major problem for lung transplantation?With the development of modern lung preservation and repair technique, increasing marginal lung donors have been re?assessed and finally utilized for transplantation? The ex vivo lung perfusion technique ( EVLP ) was designed and has been developed for evaluation and repair of the lung? Nowadays, the indication of EVLP and the standard of qualified donor lung have reached a consensus according to the foreign publications? The EVLP system could be classified into three categories: the Toronto technique, the Lund technique and Hannover?Madrid technique? The major differences between the Toronto technique and the other two technique are the open left atrium status, the use of Steen solution mixed with erythrocyte and the perfusion at flows correspondent to 100% of the donor predicted cardiac output? With the accumulating experience, researchers have tried to imply some drugs in the circulation, modify the ventilation gas and delivery of adenoviral vector gene in order to improve the lung quality? But these are still in the research phase? Recently, the portable EVLP device has been developed and the lung preservation, assessment and repair could be conducted during transportation? So it could prolong the preservation time and expand the transportation distance of donor lung.

The shortage of donor lung remains one of the major problem for lung transplantation?With the development of modern lung preservation and repair technique, increasing marginal lung donors have been re?assessed and finally utilized for transplantation? The ex vivo lung perfusion technique ( EVLP ) was designed and has been developed for evaluation and repair of the lung? Nowadays, the indication of EVLP and the standard of qualified donor lung have reached a consensus according to the foreign publications? The EVLP system could be classified into three categories: the Toronto technique, the Lund technique and Hannover?Madrid technique? The major differences between the Toronto technique and the other two technique are the open left atrium status, the use of Steen solution mixed with erythrocyte and the perfusion at flows correspondent to 100% of the donor predicted cardiac output? With the accumulating experience, researchers have tried to imply some drugs in the circulation, modify the ventilation gas and delivery of adenoviral vector gene in order to improve the lung quality? But these are still in the research phase? Recently, the portable EVLP device has been developed and the lung preservation, assessment and repair could be conducted during transportation? So it could prolong the preservation time and expand the transportation distance of donor lung.

Objective To investigate the effects of the estrogen synthesis inhibitor letrozole on the composition,diversity,and abundance of the intestinal microbiota in rats with polycystic ovary syndrome(PCOS).Methods A rat model of PCOS was induced using the estrogen synthesis inhibitor letrozole.The gut microbiota structures of normal and PCOS rats were analyzed 16S rRNA sequencing.Results At the phylum level,rats in the PCOS group had a lower abundance of Firmicutes(73.29%±5.34%vs.77.17%±4.01%)and a higher abundance of Bacteroidetes(23.85%±6.22%vs.17.21%±6.90%)compared with the normal group.At the genus level,the abundances of Rochella(5.61%±3.20%vs.16.13%±6.20%)and Zurichella(1.75%±2.23%vs.9.98%±7.34%)were lower in the PCOS group than in the normal group,but the abundances of Lactobacillus(18.83%±11.50%vs.15.88%±7.06%),Prevotella(4.58%±1.09%vs.0.46%±0.15%),and Ruminococcus(2.97%±1.56%vs.1.16%±0.60%)were increased.Analysis of Kyoto Encyclopedia of Genes and Genomes signaling pathways of the differentially expressed bacteria showed that signaling pathways related to bile acid biosynthesis in the intestine were changed in the PCOS rat model.Conclusions The structure of intestinal flora in PCOS rat model constructed by intragastric administration of letrozole is significantly disordered,which may be related to the signaling pathways related to bile acid biosynthesis.

BACKGROUND: In recent years, the development of tissue engineering has provided a new approach for the treatment of periodontal bone defect. Tissue engineering therapy includes seed cells, scaffolds and growth factors. Platelet gel contains a large number of platelet growth factors, and collagen is often used for the preparation of scaffold materials. Therefore, the platelet gel and collagen biologically active composite membrane can provide scaffolds and growth factors for the defect bone. OBJECTIVE: To investigate the effect of autologous platelet gel-collagen biologically active composite membrane on the repair of periodontal bone defect in rats. METHODS: Forty-two Wistar rats (Shanghai Xipuer-Bikai Experimental Animal Co., Ltd., China) were selected. (1) Collagen was cut into 5 mm×2 mm size, and 10 mL of whole blood was extracted from 6 rats to obtain platelet-rich plasma. Autologous platelet gel-collagen composite membrane was prepared by adding bovine thrombin, calcium chloride and collagen in a certain proportion. Platelets in whole blood and in platelet-rich plasma were detected. The levels of platelet derived growth factor AB, transforming growth factor-β, basic fibroblast growth factor and vascular endothelial growth factor in whole blood and platelet-rich plasma were detected by ELISA. (2) The models of mandibular periosteal defect were established in 36 rats (the size of the bone defect was 5 mm×2 mm, and the root surface cementum was removed) , and randomly divided into two groups. Autologous platelet gel-collagen group placed the autologous platelet gel-collagen composite membrane in the bone defect, and the control group did not place any materials. The hematoxylin-eosin staining of periodontal tissues of rats in each group was analyzed at 2, 4 and 8 weeks after surgery. Rate of new born, new centumum formation, new alveolar bone formation, and new periodontal ligament tissue formation height were measured. The expression of bone morphogenetic protein-2 was detected by immunohistochemical staining. RESULTS AND CONCLUSION: (1) The mean platelet count in platelet-rich plasma was 4.78 times as high as the whole blood, indicating that the number of platelets increased significantly after prepared into platelet-rich plasma (P < 0.05) . The levels of platelet derived growth factor AB, transforming growth factor-β, basic fibroblast growth factor and vascular endothelial growth factor in platelet-rich plasma were 3.10, 3.45, 7.17 and 5.45 times of the whole blood, respectively (P < 0.05) . (2) The results of hematoxylin-eosin staining observed that the rate of new born, new centumum formation, new alveolar bone formation, and new periodontal ligament tissue formation height at 2 weeks in the autologous platelet gel-collagen group showed no significant difference from the control group (P> 0.05) . At 4 and 8 weeks, all above indexes in the autologous platelet gel-collagen group were significantly higher than those in the control group (P < 0.05) . (3) Results of immunohistochemical staining revealed that at 2 weeks, bone morphogenetic protein-2 in the autologous platelet gel-collagen group began to express, and the expression of bone morphogenetic protein-2 was highest at 4 weeks (P < 0.05) , and the positive expression was weakened at 8 weeks (P> 0.05) . (4) Our results clarify that autologous platelet gel-collagen bioactive composite membrane can significantly promote the regeneration of new tooth, which is associated with the expression of bone morphogenetic protein-2, and reduce the repair time after periodontal tissue defect.

Background: Pancreatic encephalopathy (PE) is one of the severe systemic complications of severe acute pancreatitis (SAP). In recent years, the incidence of PE was on the rise. There are few tools for early prediction of SAP complicated with PE. Aims: To screen the early independent risk factors of PE from clinical testing indices and scoring system of SAP patients, and then construct an early predictive scoring model of PE and used for intervening in advance. Methods: The clinical data of 130 patients with SAP from Jan. 2016 to Sept. 2020 at Shaanxi Hanzhong 3201 Hospital were analyzed retrospectively. Early independent risk factors of PE was screened by univariate analysis and multivariate Logistic regression analysis. The predictive scoring model was constructed by the weighted least square method. Results: Univariate analysis showed that history of alcohol abuse, lactic acid, intra-abdominal pressure (IAP), CT severity index (CTSI), extrapancreatic inflammation on CT (EPIC) and Glasgow coma scale (GCS) score were correlated to PE (P<0.05). Multivariate Logistic regression analysis showed that history of alcohol abuse (OR=2.843, 95% CI: 1.759-4.595, P=0.011), IAP (OR=1.077, 95% CI: 1.020-1.138, P=0.007), and EPIC score (OR=1.768, 95% CI: 1.181-2.649, P=0.006) were independent risk factors for PE in the early stage. According to the early predictive scoring model constructed, risk of PE was divided into low risk (0-3), medium risk (4-6) and high risk (>6), and differences in the incidence of PE in SAP patients among the three groups were statistically significant (P<0.05). Conclusions: The predictive scoring model constructed has the value for early prediction and evaluation of SAP complicated with PE, and risk stratification is helpful for taking intervention measures in advance to reduce the incidence of PE.

Objective To explore the efficacy of moderate dose bromocriptine by one-off oral administration in treatment of patients with non-acute prolactin (PRL) type pituitary adenoma.Methods Forty-three patients with definite diagnosis of non-acute prolactin type pituitary adenoma,admitted to our hospital from January 2016 to December 2017,were chosen in our study.All patients were administrated with 5 mg bromocriptine at 18 pm;the serum PRL levels were examined at 2,3 and 12 h after bromocriptine administration.The curative effects of these patients were judged by decline rate of PRL,and the curative effects of patients with different genders,different initial PRL levels and different ages were compared.Results In these 43 patients,bromocriptine showed excellent effect in 20 patients,obvious effect in 18 and invalid effect in 5.There were statistically significant differences in the efficacy of bromocriptine between different genders (P＜0.05).There were statistically significant differences in efficacy of patients with different genders after taking bromocriptine (P＜0.05).The female patients had obviously higher rate of obvious effect than the male patients.Patients with different initial PRL values had statistically significant differences in efficacy after taking bromocriptine (P＜0.05).Patients with PRL initial value of 40-200 ng/mL had significantly higher rate of obvious effect than patients with PRL initial value of ＞200 ng/mL.There was no significant difference in efficacy between patients ＜ 45 years old and patients＞45 years old (P＞0.05).Conclusion The treatment ofhyperprolactin caused by prolactin type pituitary adenoma with moderate dose bromocriptine by one-off oral administration is effective;female patients have obviously better effect than male patients;and for patients with initial prolactin＞200 ng/mL,the effect is better.

Microplastics(MPs)and nanoplastics(NPs)have become hazardous materials due to the massive amount of plastic waste and disposable masks,but their specific health effects remain uncertain.In this study,fluorescence-labeled polystyrene NPs(PS-NPs)were injected into the circulatory systems of mice to determine the distribution and potential toxic effects of NPs in vivo.Interestingly,whole-body imaging found that PS-NPs accumulated in the testes of mice.Therefore,the toxic effects of PS-NPs on the reproduction systems and the spermatocytes cell line of male mice,and their mechanisms,were investigated.After oral exposure to PS-NPs,their spermatogenesis was affected and the spermatogenic cells were damaged.The spermatocyte cell line GC-2 was exposed to PS-NPs and analyzed using RNA sequencing(RNA-seq)to determine the toxic mechanisms;a ferroptosis pathway was found after PS-NP exposure.The phenomena and indicators of ferroptosis were then determined and verified by ferroptosis inhibitor ferrostatin-1(Fer-1),and it was also found that nuclear factor erythroid 2-related factor 2(Nrf2)played an important role in spermatogenic cell ferroptosis induced by PS-NPs.Finally,it was confirmed in vivo that this mechanism of Nrf2 played a protective role in PS-NPs-induced male reproductive toxicity.This study demonstrated that PS-NPs induce male reproductive dysfunction in mice by causing spermatogenic cell ferroptosis dependent on Nrf2.