OBJECTIVEThis study measures the glutaredoxin (Grx) gene and protein expression in umbilical vein endothelial cells upon exposure to Porphyromonas gingivalis (P. gingivalis) lipopolysaccharide (LPS). The involvement of the Akt-signaling pathway is also determined.

METHODSEA-hy926 cells were pretreated with 1,000 ng · mL⁻¹ P. gingivalis LPS for 4, 12, 18, and 24 h, and then real-time reverse transcription polymerase chain reaction was employed to detect Grx1 expression. The effect of Grx on Akt activity was investigated using Western blot for the control, LPS (1,000 ng · mL⁻¹ LPS), and carmus- tine (BCNU) groups (1,000 ng · mL⁻¹ LPS, and the EA-hy926 cells were pretreated with 25 μmol · ml⁻¹ BCNU for 30 min).

RESULTSGene expression of Grx1 significantly increased in LPS group compared with that in the control group. The Grx1 expression reached the peak level in 12 h, and the variation between the expression in 4 and 12 h was significant (P < 0.05). After 12 h, the protein levels of Grx and phosphorylated-Akt (p-Akt) significantly increased in the LPS group (P < 0.05), whereas the BCNU group showed a considerable decrease in both Grx and p-Akt expression levels (P < 0.05). Moreover, a slight difference was observed in the total Akt protein levels in the three groups (P > 0.05).

CONCLUSIONGrx expression increased upon exposure of EA-hy926 cells to the LPS. Akt activity could be inhibited by BCNU (a Grx inhibitor), which indicated that Akt might act as a downstream regulator of Grx.

Endothelial Cells ; Glutaredoxins ; genetics ; Humans ; Lipopolysaccharides ; pharmacology ; Oxidative Stress ; drug effects ; Phosphorylation ; Porphyromonas gingivalis ; pathogenicity ; Proto-Oncogene Proteins c-akt ; drug effects ; Signal Transduction ; drug effects ; Umbilical Veins

Objective:To evaluate the preventive effect of proximal splenic vein ligation after splenectomy on the splenic vein originated portal vein thrombosis (PVT) in portal hypertension.Methods:The clinical data of 94 patients of portal hypertension who had received splenectomy were retrospectively analysed. The proximal splenic vein was ligated in 36 cases during pericardial devascularization and coronary renal shunt with splenectomy. The other 58 cases who had received pericardial devascularization without proximal splenic vein ligation served as control. All of the patients in both groups were given heparin infusion postoperatively through the catheter which was placed in the right gastroepiploic vein during operation. CT portal veinography was performed at the 7th-14th postoperative day for detection of PVT.Results:None of the PVT occurred in the splenic vein ligation group. In the control group, PVT occurred in 22 cases(38%) and splenic vein thrombosis occurred in all the 58 cases (100%). PVT incidence between the two groups is significantly different (0 vs. 38%, χ 2=17.828, P<0.05). Conclusions:Ligation of the proximal splenic vein during splenectomy can effectively prevent the postoperative splenic vein originated PVT in portal hypertension.

Objective To express and purify the glycoprotein extracellular domain (Ex-GP) of Rabies virus strain CTN in soluble form with high efficiency.Methods A recombinant expression plasmid containing the gene encoding the Ex-GP was constructed.Various expression conditions were screened to obtain an optimum prokaryotic expression system for Ex-GP in soluble form.The expressed target protein was purified using affinity chromatography and gel filtration chromatography.Results The target protein Ex-GP with high antigenicity was efficiently expressed in soluble form by using the recombinant PBCX expression system and effectively purified by using affinity and gel filtration chromatography.Conclusion The soluble form of Ex-GP is successfully expressed and purified in a simple and convenient way.This study paves the way for further researches on the biological functions of rabies virus glycoprotein,the pathogenic mechanism of rabies and the development of diagnostic reagent and vaccines for rabies virus.

Objective To study the baseline level of fraction anisotropy (FA) and the normal value of apparent diffusion coefficient (ADC) in deep white matter of preterm and its application.Methods From Oct.2010 to Dec.2013,in Department of Neonatology,Jiangsu Province Hospital,magnetic resonance imaging (MRI) (T1,T2) and diffusion tensor imaging (DTI) were done on 13 preterm infants of less than 37 weeks of corrected gestational age (CA),42 preterm infants of term-matched age,and 15 term infants.ADC and FA were measured in genu and splenium of corpus callosum (CC),anterior limb and posterior limb of internal capsule (IC).Results 1.The ADC values in genu,splenium,anterior limb of right IC,posterior limb of right IC,anterior limb of left IC,posterior limb of left IC in CA ＜ 37 weeks infants were higher than those in term-matched infants and in term infants.The ADC values in the 6 regions in term-matched infants and in term infants were significantly different with those in CA ＜ 37 weeks infant(F =5.559,5.775,21.948,19.462,30.586,15.452,all P ＜ 0.01).The differences of ADC values between CA ＜ 37 weeks infants and term-matched infants,between CA ＜37 weeks infants and term infants were significant(all P ＜0.05),except that in CC between CA ＜ 37 weeks infants and term-matched infants.2 The FA values in genu,splenium,anterior limb of right IC,posterior limb of right IC,anterior limb of left IC,posterior limb of left IC in CA ＜ 37 weeks infants were lower than those in term-matched infants and in term infants.The FA values in the 6 regions in term-matched infants and in term infants were significantly different from those in CA ＜ 37 weeks infants (F =9.835,7.500,4.811,11.430,8.674,12.666,all P ＜ 0.01).The differences of FA values between CA ＜ 37 weeks infants and term-matched infants (P ＜ 0.05),between CA ＜ 37 weeks infants and term infants were significant (all P ＜ 0.05).Conclusions The baseline values of FA and ADC in different deep white matters were obtained.As corrected gestational age of preterm babies' increased,FA values in brain white matter increased,while ADC values decreased.The myelination in most white matter of preterm infants at matched term can catch up with that of term infants.The diagnostic value of ADC and FA needs to be studied further.

Objective To observe the significance of rehabilitation integrated system for stroke patients. Methods From October, 2013 to June, 2015, 95 stroke patients were divided randomly into experimental group (n=48) and control group (n=47). The experimental group received rehabilitation under the guide of rehabilitation integrated system, while the control group in the routine process. They were assessed with simplified Fugl-Meyer Assessment (FMA) and Barthel Index (BI) before and 3 months after treatment. The satisfaction was also inves-tigated. Results There was no significant difference between groups in the differences of scores of FMA and BI before and after treatment (t<1.044, P>0.05), while the satisfaction was higher in the experimental group (t=4.287, P<0.01). Conclusion The application of rehabilitation integrated system may improve the process of treatment and the efficiency of management, and result in more satisfaction of the stroke pa-tients.

Objective:To investigate the factors related to recurrence and prognosis of retroperitoneal liposarcoma.Method:The clinical data of patients with primary retroperitoneal liposarcoma who underwent surgical treatment in the First Affiliated Hospital of Zhengzhou University from June 2011 to January 2020 were analyzed retrospectively. There were 42 males and 47 females and patients’median age was 53 (26-78). Sixty-five cases were treated by operation in our hospital, and 24 cases were primarily treated by the operation in another hospital. The clinical manifestations of the initial diagnosis included retroperitoneal mass in 41 cases, abdominal distension in 12 cases, abdominal pain in 10 cases, fever in 11 cases, nausea, vomiting and poor appetite in 8 cases, frequent urination and dysuria in 6 cases, and bilateral lower limb edema in 1 case. Preoperative CT imaging showed that the tumor body was located in the retroperitoneal kidney area in 58 cases, while in the retroperitoneal space or the pelvic extraperitoneal space in 31 cases. There were 55 single cases and 34 multiple cases. The median tumor length was 20(3-52) cm. Among the primarily treated 65 patients, 47(72.3%) were considered as primary retroperitoneal liposarcoma by preoperative imaging examination. Among the 89 patients treated by surgery, 78 underwent endoscopic surgery, among which 21 underwent laparoscopic surgery, 38 cases of retroperitoneal laparoscopic surgery, 19 cases of Da Vinci robot-assisted laparoscopic surgery. Open operation was performed in 11 cases. There were 87 patients undergoing radical resection and 2 patients undergoing palliative resection. Forty-two patients underwent intraoperative combined resection of the adjacent organs. The recurrence and survival status of patients were followed up.Results:All the 89 patients underwent the operation successfully, with the median operative blood loss of 200 (10-2000) ml. There were 23 cases being diagnosed of well differentiated liposarcoma, 40 cases of dedifferentiated, 20 cases of myxoid/round, 5 cases of myxoid liposarcoma, and 1 cases of mixed type. Pathologically, there 42 cases with low grade histology and 47 cases with high grade histology. In this study, 89 patients were followed up for 3 to 108 months, and the median follow-up time was 28 months. The 5-year recurrence free survival rate, disease-free survival rate and overall survival rate of the patients were 16.7%, 16.1% and 52.6%, respectively. There were 57 patients presenting local recurrence, 1 patient of lung metastasis, and 1 patient of liver metastasis, and the median disease-free survival time was 24 months. There were 42 patients died of the disease, with a median survival time of 64 months. Univariate analysis showed that intraoperative blood loss( P<0.01), whether multiple cases( P<0.01), pathologic types( P<0.01), and histological grades ( P<0.01) were related to disease-free survival.The intraoperative blood loss( P<0.01), multiple cases( P<0.05), pathologic types ( P<0.05), and recurrence ( P<0.01)were related with overall survival. Gender, age, tumor size, tumor location, whether primary surgery, radical resection or combined resection of adjacent organ had no effect on the prognosis of patients ( P>0.05). Cox regression model multivariate analysis revealed that surgical bleeding ( RR=2.360, 95% CI 1.313-4.241, P=0.004), multiple tumor ( RR=1.899, 95% CI 1.068-3.375, P=0.029), and pathological type ( RR=4.976, 95% CI 1.622-15.264, P=0.005) were independent factors affecting disease-free survival. The recurrence was an independent factor affecting the overall survival of patients ( RR=31.495, 95% CI 1.062-933.684, P=0.046). Conclusions:Retroperitoneal liposarcoma is a rare disease with high recurrence rate. The intraoperative blood loss, whether multiplicity and pathological type are independent factors affecting the disease-free survival, and recurrence is independent factors affecting the overall survival.

Objective:To explore the relationship between disease uncertainty, coping style, and self-perceived burden (SPB) in patients with lower extremity deep vein thrombosis (DVT) .Methods:Totally 280 patients with lower extremity DVT who were hospitalized in the Department of Vascular Surgery of three ClassⅢ Grade A hospitals in Cangzhou from September 2020 to April 2021 were selected by convenience sampling and investigated with the general information questionnaire, Medical Coping Style Questionnaire, Self-Perceived Burden Scale (SPBS) , Medical Coping Modes Questionnaire (MCMQ) , and Mishel's Uncertainty in Illness Scale (MUIS-A) . Pearson correlation was used to analyze the correlation between variables. A total of 280 questionnaires were distributed in this study, and 262 valid questionnaires were recovered, with an effective recovery rate of 93.6%.Results:The SPB score of the 262 patients with lower extremity DVT was (28.83±7.43) ; disease uncertainty, avoidance, and yielding were positively correlated with the patients' SPB ( r=0.651, 0.477, 0.469; P<0.01) , while facing was negatively correlated with SPB ( r=-0.485, P<0.01) . The path analysis revealed that avoidance and yielding played a partial mediating effect between disease uncertainty and SPB, accounting for 14.6% of the total path effect. Conclusions:Disease uncertainty can indirectly affect SPB in patients with lower extremity DVT through avoidance and yielding. Clinical medical staff should formulate targeted intervention and health guidance strategies to improve patients' disease cognition and coping ability, and reduce their SPB.

Objective To understand the physical activity of early stage pregnant women and explore its influential factors. Methods From June 2015 to June 2016, 2122 pregnant women with early pregnancy card in Ma An Shan Maternal and Child Health Hospital were selected and surveyed with a questionnaire. The Physical Activity Questionnaire was used to understand the physical activity of pregnant women in their early pregnancy. Analysis of variance and t-test were used to describe the distribution of energy expenditures of physical activity of pregnant women with different demographic characteristics, and multiple linear regression analysis was used to analyze the factors influencing the energy expenditure of their physical activity. Result The duration of activities of sleep and sitting type was (16.56 ± 3.54) h, accounting for 83.38％of total activity time;the energy consumption value was (17.17±5.59) METs·h;mild physical activity time was (2.62±1.86) h, accounting for total time. 13.19％and the energy consumption value was (6.06±4.43) METs·h;the average time of moderate to severe physical activity was (0.68±0.93) h, accounting for 3.42％of total physical activity time, and the energy consumption value was (3.22±4.58) METs·h. In the univariate analysis, the energy expenditures of physical activity between the different groups (t=-3.551), education level (F=1.347), and occupation type (F=1.485) were different, and the difference was statistically significant (P<0.05). In multiple linear regression analysis, different occupational types and education were the energy expenditure levels of physical activity during early pregnancy. Influencing factors (P<0.05). Conclusion Pregnant women have longer periods of sleep and meditation during the first trimester, and shorter duration of physical activity than mild and above;the energy expenditure of physical activity during the first trimester of pregnancy is affected by the occupational type and educational level of the pregnant woman.

Objective:To investigate the efficacy and safety of transperitoneal robot-assisted nephroureterectomy (RANU) with a single body position and original ports for upper urinary tract urothelial carcinoma(UTUC).Methods:Clinical data of 21 patients from March 2018 to November 2019 in the First Affiliated Hospital of Zhengzhou University was retrospectively analyzed, including 14 males and 7 females. The age was (63.8±11.4) years and the BMI was (23.6±2.5) kg/m 2.Of the 21 localized UTUC patients, 8 pelvic tumors, 3 middle ureter tumors, 10 lower ureter tumors; 11 on the left, 10 on the right; 20 of 21 tumors (95.2%) were high risk. Surgery was done by the same urologist. Under general anesthesia, the patients were in 75 ° healthy side lying position and overall 15 ° head down and foot high position. Improved layout of ports: camera port C was located at two fingers lateral to the umbilicus, 2 cm below the umbilicus; robotic arm port 1 and 2 were respectively located at pararestus line, close to costal margin and 2 cm below the midpoint between C and the affected iliac crest. Assistant port 1 and 2 were respectively located at 2 cm above the umbilicus and 4 cm below the umbilicus. The right cases need an additional assistant port under the xiphoid to provoke the liver. Hem-o-lok cliped the ureter distal to the tumor and the affected kidney was radically removed. Under the principle of tumor free, the ureter and the surrounding bladder wall within 1 cm were excised and the bladder was sutured. Lymphadenectomy was performed when the kidney and ureter were dissociated. Results:All 21 procedures were successful without open surgery or position change and intraoperative complications. No patients required a blood transfusion. The operation time was (205.2±57.3) min. The median intraoperative blood loss was 50 ml (20-120 ml). The median drainage tube indwelling time was 4d(3-7 d) and the median urinary catheter indwelling time was 7 d(5-8 d), the median postoperative hospital stay was 7 d(6-12 d).7 cases(33.3%)of Clavien-Dindo grade Ⅰ complications after surgery and they all relieved after giving symptomatic treatment. All postoperative pathology showed UTUC and negative resection margins. The median follow-up time was 12 months (4-22 months), 1 patient died of an accident 7 months after surgery and 3 patients had recurrence at 6, 8, and 10 months after surgery, survival at the last follow-up after treatment.Conclusions:The transperitoneal RANU with a single body position and original ports is safe and effective. The operation time is saved, the incidence of intraoperative and postoperative complications is low, the postoperative patients recover quickly.Short-term follow-up results prompt low recurrence rate and good tumor control effect.

Objective:To describe the status quo and subtypes of postoperative delirium (POD) in children with congenital heart disease in China.Methods:A total of 216 children with congenital heart disease who underwent surgery in Fuwai Hospital, Chinese Academy of Medical Sciences from December 2020 to June 2021 were prospectively observed. The status quo and subtypes of POD in children with congenital heart disease was evaluated according to the results of the Cornell assessment of pediatric delirium (CAPD).Results:POD occurred in 114 children (52.78%) during the study period. The onset time of POD was most on the first postoperative day (50.88%). POD lasted only 1 day in 54.39% of the children who developed it. The incidence of POD subtypes (hyperactive delirium, hypoactive delirium, mixed delirium) were 35.09%, 29.82% and 35.09%, respectively, and there was no significant difference in the incidence distribution among them ( χ2=0.63, P>0.05). The onset time of mixed delirium was significantly later than that of hyperactive delirium ( χ2=7.07, P<0.05), and the duration of mixed delirium was significantly longer than that of hypoactive delirium ( χ2=16.81, P<0.001). The results showed that if the child had blood transfusion during operation or the operation was difficult, the probability of reduced activity delirium after operation was higher ( P<0.016 7). Children wieth moderate to severe postoperative pain or short duration of muscle relaxant use during the evaluation period were more likely to have a hyperactive postoperative delirium.( P<0.016 7). The time of tracheal intubation, the time of hospitalization after operation and the the postoperative time in PICU were the longest in the children with mixed type of postoperative delirium ( P<0.016 7). Conclusions:POD has a high incidence in children with congenital heart disease, and it is more likely to occur in the early postoperative stage. Therefore, early postoperative identification and intervention of POD is of great significance for children with congenital heart disease. Children with different characteristics are prone to different types of POD, which should be paid attention to.