Objective To compare the hemodynamic responses to orotracheal intubation during emergency operation with the proseal laryngeal mask airway and endotracheal Intubation.Methods Fifty six patients who were ASA GRADE Ⅰ-Ⅱ before onset undergoing orotracheal intubation were randomly dirideed into either without laryngoscope direct proseal laryngeal mask intubation(PLMA) group or direct laryngoscope endotracheal intubation(TT) group.SBP、DBP、HR and SpO2 were recorded before,durring and 5 minutes after intubation.Intubation time and first attempt insertion success rate were recordeddso.All patients were followed up postoperatively for adverse effects like sore throat or hoarseness.Results In intubation time、first attempt insertion success rate and adverse effects like sore throat or hoarseness,PLMA group was 96.43%,(19.7?5.7)s and 7.1%,TT group was 100%,(27.9?11.3)s and 39.29%.Intubation time was significantly shorter and adverse effects like sore throat or hoarseness were lower in the PLMA group than TT group(P

Objective To evaluate a new TNM staging system inclusive of intraperitoneal free cancer cells in terms of postoperative survival of patients with gastric cancer. Methods Free cancer cells (FCC) in the peritoneal washes of gastric cancer patients were estimated by measuring CEA mRNA levels using real-time RT-PCR. After 5-year follow-up, we get the cut-off value of CEA mRNA level by using MedCalc software to analyze the ROC curve. When CEA levels are more than the cut-off value, it may considered as FCC(+), and then using FCC(+) as distant metastasis (MI) to make a new TNM staging and analyze patients life-span. Results (1) Under the ROC curve analysis, when the cut-off value of CEA mHNA level was at 31.21 copies/ml, the Youden's index is the highest. (2) When FCC (+) considered as M1 to make a new TNM staging, the 5-year survival rate showed as below: Ⅰ-Ⅱ, P=0. 134; stage Ⅱ-Ⅲ P=0.004 and Ⅲ-Ⅳ P=0.022,repecetively. Conclusion (1) The best cut-off value of CEA mRNA levels for FCC in peritoneal washes is 31.2 copies/ml. (2) Our study demonstrated that application of FCC(+) in the TNM staging may have a better estimation of prognosis of patients suffering from advanced gastric cancer.

Objective To establish a more sensitive method to detect free cancer cells in peritoneal washings of gastric cancer cases during surgery. Methods The CEAmRNA levels in peritoneal washings in 65 cases of gastric cancer were detected by Real-time RT-PCR. PLC was applied simultaneously to detect free cancer cells. Negative controls included the peritoneal washings from 5 cases of benign gastric diseases and the blood samples from 5 cases of healthy adult volunteers. Results (1)CEAmRNA was not found in peritoneal washings in benign gastric diseases and in blood of healthy adult volunteers. (2)The positive percentage of free cancer cells detected by Real-time RT-PCR was 47.7%, while PLC′s was only 12.3%.(3)The positive rate of CEAmRNA showed a significant difference between gastric cancer with serosal invasion and without serosa invasion groups, between peritoneal metastasis group and no peritoneal metastasis groups, and also between stages I+II and III+IV diseases(all P

BACKGROUND: Degeneration of the annulus fibrosus (AF), an important structure of the intervertebral disc, is one of the main causes of degenerative disc disease. Fabrication of scaffolds replicating the stratified microstructure of the AF is critical for the successful regeneration of AF. METHODS: In this study, we cultured rabbit AF-derived stem cells (AFSCs) using fabricated electrospun fibrous poly-Llactic acid scaffolds with different diameters. We applied cyclic tensile strain (CTS) on the scaffolds to regulate the differentiation of AFSCs into specific cell types that resided at the inner, middle, and outer zones of the AF. RESULTS: We found that the morphologies of AFSCs on the smaller-fiber-diameter scaffolds were nearly round, whereas spindle-like cells morphologies were observed on large-diameter scaffolds. CTS enhanced these phenomena and made the cells slender. The expression levels of collagen-I in cells increased as a function of the fiber diameter, whereas collagen-II and aggrecan exhibited opposite trends. Moreover, the application of CTS upregulated the gene expressions of collagen-I, collagen-II, and aggrecan. CONCLUSION Overlaying the scaffolds with different CTS-stimulated cells could eventually lead to engineered AF tissues with hierarchical structures that approximated the native AF tissue. Thus, the proposed methodologies could be potentially applied for AF regeneration.

BACKGROUND: Degeneration of the annulus fibrosus (AF), an important structure of the intervertebral disc, is one of the main causes of degenerative disc disease. Fabrication of scaffolds replicating the stratified microstructure of the AF is critical for the successful regeneration of AF. METHODS: In this study, we cultured rabbit AF-derived stem cells (AFSCs) using fabricated electrospun fibrous poly-Llactic acid scaffolds with different diameters. We applied cyclic tensile strain (CTS) on the scaffolds to regulate the differentiation of AFSCs into specific cell types that resided at the inner, middle, and outer zones of the AF. RESULTS: We found that the morphologies of AFSCs on the smaller-fiber-diameter scaffolds were nearly round, whereas spindle-like cells morphologies were observed on large-diameter scaffolds. CTS enhanced these phenomena and made the cells slender. The expression levels of collagen-I in cells increased as a function of the fiber diameter, whereas collagen-II and aggrecan exhibited opposite trends. Moreover, the application of CTS upregulated the gene expressions of collagen-I, collagen-II, and aggrecan. CONCLUSION Overlaying the scaffolds with different CTS-stimulated cells could eventually lead to engineered AF tissues with hierarchical structures that approximated the native AF tissue. Thus, the proposed methodologies could be potentially applied for AF regeneration.

【Objective】 To investigate the effects of remimazolam and propofol on postoperative nausea and vomiting (PONV) in patients undergoing painless prostate biopsy, so as to optimize the anesthesia protocols. 【Methods】 A retrospective analysis was conducted on the clinical data of 1217 patients who underwent painless prostate biopsy in our hospital during Jan. 2023 and Jun.2024. Among them,1093 patients met the inclusion criteria and were divided into two groups: the remimazolam group (n=294) and the propofol group (n=799). After 1∶1 propensity score matching, with 267 patients in either group, a comparison was conducted regarding the incidence of PONV and anesthesia recovery time. 【Results】 Before propensity score matching, the remimazolam group had older age [66(53, 83) years vs.63(49, 78) years] , higher body mass index (BMI) [25.30(21.83, 29.23) vs.24.46(20.79, 28.91)] , larger intraoperative use of sufentanil [9(8, 10)μg vs.7(6, 9) μg] , higher intraoperative use rate of ondansetron (55.4% vs.47.6%), and longer surgical duration [16(14, 20) min vs.15(13, 17) min] , with statistically significant differences (P<0.05). There were no statistically significant differences in the aforementioned factors between the two groups after propensity score matching (P>0.05). Before propensity score matching, the incidence of PONV was higher in the remimazolam group than in the propofol group (17.7% vs.11.5%,P=0.007), while after propensity score matching, the incidence of PONV did not differ significantly between the two groups (12.7% vs.17.2%,P=0.146). Before and after propensity score matching, the anesthesia recovery time was significantly shorter in the remimazolam group than in the propofol group [3(2, 4) min vs. 7(4, 10) min,P<0.001] . 【Conclusion】 Compared with propofol, remimazolam does not increase the incidence of PONV in patients undergoing painless prostate biopsy but can shorten anesthesia recovery time.

¹⁷⁷Lu- prostate specific membrane antigen (PSMA) radio-ligand therapy has been approved abroad for advanced prostate cancer and has been in several clinical trials in China. Based on domestic clinical practice and experimental data and referred to international experience and viewpoints, the expert group forms a consensus on the clinical application of ¹⁷⁷Lu-PSMA radio-ligand therapy in prostate cancer to guide clinical practice.