Objective To investigate the method and the effect of posterior approach low lumbar spinal nerve root sheath decompression under microendoscope (MED-Ⅱ). Methods Thirty-nine patients with low lumbar disc herniation, accompanying severe preoperative limb numbness and radiculalgia, who were found obvious edema of nerve root with adhesion during surgery, entered the study. In the course of lumbar discectomy, a self-made mini-scalpel was used for the incision and decompression of the nerve root sheath, in which a 3～5 mm longitudinal incision was made along the dorsal side of the nerve root. Results Decompression was achieved under microendoscope (MED-Ⅱ) in all the 39 patients. Limb numbness and radiculalgia subsided completely in 17 patients within 24 postoperative hours, while the symptoms trailed off within 2 weeks following the surgery in the remaining patients. The time to complete disappearance of the symptoms was 1～14 d (mean, 6 5 d). Conclusions Minimally invasive spinal nerve root sheath incision and decompression can give a prompt relief from limb numbness and radiculalgia, improving the recovery of nervous system. Lumbar spinal nerve root sheath incision and decompression under microendoscope (MED-Ⅱ) is a safe and effective procedure.

Objective To explore the technical feasibility and effects of ant erior cervical discectomy and interbody fusion using endoscopic technique. Metho ds A retrospective study was undertaken in 23 patients with single segmental cer vical fracture and dislocation or cervical spondylotic myelopathy. There were 14 males and 9 females with an average age of 41.5 years (range, 23 to 64). The fr acture and dislocation patients consisted of 2 cases with complete tetraplegia e ither of C3,4 or C4,5, 3 with incomplete tetraplegia of C5,6 and 2 of C4,5 free from nervous symptoms. The operative procedures included anterior cervical disce ctomy and interbody fusion with insertion of cage or/and plate fixation through an endoscopic working canal. Results All 23 cases were followed-up from 6 to 18 months. The operative incisions healed smoothly. All patients achieved interbody fusion, and no loosening or displacement of the cage and plate occurred. For th e cervical fracture and dislocation patients, by Frankel's classification, 2 cas es with complete tetraplegia showed no any improvement, 2 cases with incomplete tetraplegia improved from grade C preoperatively to grade D postoperatively, 1 c ase with incomplete tetraplegia upgrade from C to E, 2 cases without nervous sym ptoms maintained preoperative status. For cervical spondylotic myelopathy patien ts, according to Odom's scoring system, 10 cases were assessed as excellent (dis appearance of all symptoms), 5 good (alleviation of main symptoms), 1 fair (alle viation of partial symptoms). 94% patients gained excellent and good results. No complications occurred in this series. Conclusion With the improvement of the t echnique and instrument, the endoscopic procedures can be used for anterior cerv ical discectomy, interbody fusion and internal fixation. It presents microsurgic al advantages such as minimal incision, less traumatic reaction, clear intraoper ative visualization, and less postoperative discomfort comparing to traditional approach.

Objective To investigate effect of serum apoptosis factor and long-term effect on medical abortion patients by sequential misoprostol. Methods 80 cases of early pregnancy patients who required termination pregnancy, were selected and randomly divided into 2 groups.40 cases in control group were treated with mifepristone 25mg oral, misoprostol 600μg, 4 times a day.40 cases in experiment group were treated with sequential use of misoprostol.Effect of medical abortion, survivin and caspase-3 were compared after 7d treatment.Gynecological inflammation, dysmenorrhea and infertility were compared for 2 years.Results Compared with control group, complete abortion rate of the experiment group was higher (P<0.05).The incidence of adverse drug reactions of the experiment group was lower than control group (P<0.05) after 2 years follow.up.Compared with the control group, HCG,E3 and P of experimental group were lower (P<0.05).After 7 days of medication,survivin decreased,caspase-3 increased,compared with control group, survivin of the experiment group was lower, caspase-3 was higher ( P<0.05 ) .Conclusion Misoprostol sequential can improve the success rate of medical abortion abortion, reduce the complications of abortion, presumably with the inhibition of survivin expression, is associated up regulation of caspase-3 levels.

Objective To assess patients' self-management behaviors and examine factors influencing self-management behaviors in patients undergoing maintenance hemodialysis.Methods This research was conducted as a descriptive survey by 125 patients from a hemodialysis clinic in Tianjin.The data were collected with self-management behaviors questionnaire of hemodialysis patients and self-efficacy scale for managing chronic disease.Results Regression analysis revealed sex,educational level and selfefficacy were independent predictors for self-management behaviors.Conclusions Hemodialysis patients' self-management behaviors need to be improved in the future.Healthcare professionals should recognize the factors hindering self-management behaviors from the patients' perspective while assisting them with appropriate skills in making behaviors changes possible.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carbon Monoxide Poisoning ; epidemiology ; therapy ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Inpatients ; statistics & numerical data ; Male ; Middle Aged ; Young Adult

Chlorides ; metabolism ; Diarrhea ; congenital ; Humans

Objective:To retrospectively analyze the clinical data of 73 children with non-Hodgkin′s lymphoma to determine its clinical features, pathological types and relationship with efficacy.Methods:In Shanghai Children′s Hospital from October 2014 to October 2018, 73 children with newly diagnosed non-Hodgkin′s lymphoma were enrolled for a retrospective study, with 52 males and 21 females, aged between 2 and 13 years old, so as to comprehensively assess cumulative organs, pathological diagnosis, stage of disease, surgery and efficacy.Results:Among the 73 children with non-Hodgkin′s lymphoma, 66 cases had a clear pathological diagnosis, including 38 cases of surgical pathology and 20 cases of biopsy pathology.All of them were confirmed by immunohistochemisty, and 8 cases were determined by flow cytometry.Meanwhile, 6 cases of the rest 7 cases obtained approximate pathological classification.Only 1 case was unknown.Among the 66 cases, Burkitt lymphoma was the most common in 31 cases, followed by 14 cases of T-lymphocyte type, 7 cases of enlarged lymphoma, 6 cases of B-lymphocyte type, 5 cases of diffuse large B lymphoma, 1 case of extranodal natural killer/T cell lymphoma-nasal type, 1 case of blastic plasmacytoid dendritic cell neoplasm, and 1 case of panniculitis-like T lymphoma.The initial site or cumulative organ involved multiple organs, with most common in neck(20 cases), abdominal cavity(15 cases), and mediastinum(6 cases). In view of outcomes and efficacy, the complete remission rates of stage Ⅱ, Ⅲ, and Ⅳ in clinical were 100.0%, 85.1%, and 72.2%, respectively.The event-free survival rates in stage Ⅲ and Ⅳ were lower than those in stage Ⅱ(80.9% vs. 66.7% vs. 100.0%). From the perspective of the main pathological types grouping, the results revealed that lymphoblastic lymphoma had a lower event-free survival rate than Burkitt′s lymphoma (73.7% vs.90.3%), while there was no statistical significance(all P>0.05). Conclusions:Non-Hodgkin′s lymphoma in children is more common in men, and less common in infants and young children.Pathological type is simpler than adults, Burkitt lymphoma is the most common type, and clinical stage and pathological type may be related to prognosis.

OBJECTIVE To investigate the permeability of gap junction composed of connexin 43 (Cx43) for microRNAs (miRNAs) and the impact of gap junction-mediated transfer of miRNAs in glioma U87 cells. METHODS Co-culture assay demonstrated the transmission of miRNAs through gap junction channel into adjacent cells. U87 cells were labeled with green fluorescein protein (GFP) as receivers and cells were transfected miRNAs as donors. Receiver cells and donor cells were mixed together in a ratio of 1:1. After 12 h co-culture, cells were separated using a BD influx flow cytometer based on the GFP labeled. Quantitative real-time polymerase chain reaction (qRT-PCR) was applied detect to the expressions of miRNAs and Cx43 mRNA. Western blotting was performed to detect the protein expressions of Cx43 and GFP in U87 cells. CCK-8 assay is used to detect cell growth. RESULTS Co-culture assays demonstrated miR-34a could transfer between U87 cells. The role of the contact independent could also transfer of miR-34a. Gap junctions inhibitor (CBX and 18-α-GA) showed lower miR-34a expression than co-culture group, whereas gap junctions enhancer (RA and Galanglin) enhanced miR-34a expression. Knockdown of Cx43 could significantly decrease the transferring of miR-34a between U87 cells. Different length of miRNAs (miR-1827, miR-144, miR-203a and miR-1183) were similar to the expression of miR-34a between U87 cells. Additionally, we demonstrated that gap junctions mediate the effect of antiproliferation mediated by miR- 34a in U87 cells. The functional inhibition of gap junctions using either siRNA or inhibition eliminated the miR- 34a mediated antiproliferation, whereas the enhancement of gap junctions treatment augmented this miR34a-mediated antiproliferation. CONCLUSION Our study demonstrates that gap junction composed of Cx43-mediated transfer miRNAs in different length of nucleotides and gap junction-mediated transfer of miR-34a enhance the antiproliferative effect in glioma U87 cells.

This study examined the neuroprotective effect of cluster of differentiation molecule 200 (CD200) against methamphetamine (METH)-induced neurotoxicity. In the in vitro experiment, neuron-microglia cultures were treated with METH (20 μmol/L), METH (20 μmol/L)+CD200-Fc (10 μg/mL) or CD200-Fc (10 μg/mL). Those untreated served as control. Microglia activation expressed as the ratio of MHC-II/CD11b was assessed by flow cytometry. The cytokines (IL-1β, TNF-α) secreted by activated microglia were detected by enzyme-linked immunosorbent assay (ELISA). In the in vivo experiment, 40 SD rats were divided into control, METH, METH+CD200-Fc and CD200-Fc groups at random. Rats were intraperitoneally injected with METH (15 mg/kg 8 times at 12 h interval) in METH group, with METH (administered as the same dose and time as the METH group) and CD200-Fc (1 mg/kg at day 0, 2, 4 after METH injection) in METH+CD200-Fc group, with CD200-Fc (1 mg/kg injected as the same time as the METH+CD200-Fc group) or with physiological saline solution in the control group. The level of striatal dopamine (DA) in rats was measured by high-performance liquid chromatography (HPLC). The microglial cells were immunohistochemically detected for the expression of Iba-1, a marker for microglial activation. The results showed that METH could increase the microglia activation in the neuron-microglia cultures and elevate the secretion of IL-1β and TNF-α, which could be attenuated by CD200-Fc. Moreover, CD200-Fc could partially reverse the striatal DA depletion induced by METH and reduce the number of activated microglia, i.e. Iba-1-positive cells. It was concluded that CD200 may have neuroprotective effects against METH-induced neurotoxicity by inhibiting microglial activation and reversing DA depletion in striatum.

Abstract: Objective　To explore the correlation between monocyte to high-density lipoprotein cholesterol ratio (MHR) and insulin resistance (IR) in male patients with type 2 diabetes mellitus (T2DM) combined with metabolic-related fatty liver disease (MAFLD). Methods A total of 454 male patients with T2DM combined with MAFLD in National Metabolic Management Center (MMC) of the Affiliated Hospital of Jiangsu University from May 2018 to July 2020 were enrolled. The general clinical data of subjects were collected, blood routine and biochemical indexes were tested, homeostasis model insulin resistance index (HOMA-IR) was calculated, visceral fat area (VFA) and subcutaneous fat area (SFA) were measured. Accordingtothe MHR quartile, patients were divided into group Q1 (MHR≤0.38), group Q2 (0.380.64) to compare the differences in measured indicators above. In addition, patients were divided into two groups according to HOMA-IR, HOMA-IR<2.5 and HOMA-IR≥2.5, and the differences in MHR were compared. Results The patients were divided into four groups according to MHR:group Q1 (n=115), group Q2 (n=110), group Q3 (n=120) and group Q4 (n=109). Fasting insulin (FINS) were respectively 6.17(4.20,9.76), 7.73(4.94,10.66), 8.92(5.32,11.33) and 9.13(5.25,12.27) mU/L, 2-hour postprandial insulin were 22.75(12.87,39.59), 27.55(16.44,39.77), 30.98(17.46,43.11) and 31.28(18.54,45.92) U/L. HOMA-IR were 3.12(1.63,4.25), 3.72(2.26,4.66), 3.87(2.48,5.44) and 3.95(2.42,5.31). Neutrophil (Neu) were 3.10(2.60,3.70), 3.20(2.50,3.93), 3.60(2.80,4.28), 4.20(3.30,5.00)×109/L. Subcutaneous fat area (SFA) were (181.27±53.60), (192.64±62.41), (199.53±61.40) and (203.69±71.51) cm2. They all increased gradually. However, the levels of high-density lipoprotein cholesterol (HDL-c) [1.18(1.06,1.35), 1.02(0.86,1.17), 0.96(0.80,1.03) and 0.80(0.69,0.92) mmol/L] and low-density lipoprotein cholesterol (LDL-c) [(3.00±0.79), (2.76±0.83), (2.67±0.85) and (2.59±0.92) mmol/L] decreased gradually. Pearson's or Spearman's correlation analysis showed that MHR was positively correlated with FINS, 2-hour postprandial insulin (2hINS), HOMA-IR, VFA and SFA (r=0.190, 0.153, 0.184, 0.114, 0.127, P<0.05). The coronary heart disease history, systolic blood pressure,diastolic blood pressure,fasting plasmaglucose (FPG), FINS, alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood uric acid (Ur), body mass index (BMI), VFA, SFA and MHR of patients in group HOMA-IR≥2.5 were higher than group HOMA-IR<2.5 (P<0.05). Conclusion　MHR is positively correlated with IR in male patients with T2DM combined with MAFLD, and as MHR increases, the degree of IR is higher.