Objective To observe the effect of buspirone on ataxia symptom after stroke.Methods 30 patients with ataxia after stroke were treated with buspirone,other 30 patients without buspirone as controls.Before and after treatment,they were assessed with ataxia-scale.Results The buspirone can significantly improve the ataxia of patients with stroke compared with the controls(P<0.01).Conclusion Short-term treatment with buspirone can improve the ataxia symtoms after stroke.

Objective To investigate the expression and significance of glucogen synthase kinase-3β (GSK-3β) in the pathogenesis of chronic allograft nephropathy (CAN) in rats.Methods Kidneys of Fisher (F344) rats as donors were orthotopically transplanted into Lewis (LEW) rats as recipients.The renal function and histopathological changes were observed at 4,8,12,16,and 24week post-transplantation.Phosphorylated GSK-3β (p-GSK-3β) protein and mRNA expression was determined by using immunohistological assays and RT-PCR respectively.Results Our data showed that 24-h urinary protein excretion in CAN rats was increased significantly at week 16 as compared with F344/LEW controls.Allografts showed markedly increased mononuclear cells infiltration and presented with severe interstitial fibrosis and tubular atrophy at 16 and 24 week post-transplantation.p-GSK-3β expression (protein/mRNA) was down-regulated in rat kidneys with CAN,and the decrease became more significant over time after transplantation.p-GSK-3β expression was correlated significantly with 24-h urinary protein excretion,serum creatinine levels,tubulointerstitial mononuclear cells infiltration,smooth muscle cells migration in vascular wall,and interstitial fibrosis.Conclusion It was concluded that GSK-3β down-regulation was the key event that may be involved in mononuclear cells infiltration and vascular SMCs migration at early stage,and interstitial fibrosis and allograft nephroangiosclerosis at later stage of CAN pathogenesis in rats.

Objective To investigate the therapeutic effect of the meso-cavo-atrial shunt (MCAS) in the treatment of combined Budd-Chiari syndrome (BCS). Methods The clinical data of 17 cases of combined BCS with all or bilateral hepatic vein occlusion and long range occlusion or obstruction of inferior vena cava (IVC) were admitted to the Qilu Hospital from February 2000 to May 2004. All patients were treated by MCAS with artificial blood vessels. The pre- and postoperative clinical symptoms, the IVC and portal venous (PV) pressures, the incidence of postoperative complications and the patency rate of the artificial vessels were analyzed. The survival of patients was analyzed using the Kaplan-Meier analysis, and the data were analyzed using the chi-square test and t test. Results No patient died during the perioperative period, and the symptoms of 15 patients disappeared or were relieved after operation, with a significant difference compared with those before operation (χ2 =9.78, P <0. 05 ). Three patients had complications after the operation. The postoperative PV and IVC pressures were decreased by 1.2 cm H2O (1 cm H2O =0.098 kPa) and 18.5 cm H2O, respectively. There were significant differences in the decrease of IVC and PV pressures ( t = 2.38, 3.06, P < 0.05 ). The 1-, 3-, 5-year survival rates were 16/17, 15/17 and 14/17, respectively, and the 5-year patency rate of the artificial vessels was 14/17.Conclusions MCAS can simultaneously relieve IVC and PV hypertension for patients with combined BCS. The postoperative complication rate was decreased, the 5-year survival rate and the patency rate of the artificial vessels were improved after the treatment, so MCAS is an optional surgical method for treating combined BCS.

Objective Our study was performed to design a drug-sustained capsular tension ring (CTR) to evaluate its potentiality on prevention of PCO in the swine capsular bag model in vitro.Methods Following the continuous capsule curvilinear capsulorhexis ( CCCC),Phacomulsification with capsular tension ring implantation was pedormed.CTR-supported swine capsular bag models were prepared and divided into two groups,group CTR ( n =13 ) implanted with the original CTR without any modification and group CTR-PLGA-MG132 ( n =13) implanted with the CTR covered with PLGA and MG132.The CTRsupported capsular bags were cultured in vitro for up to 3 weeks.The area of lens epithelial cells (LEC) coverage over the posterior capsule surface was quantified every day under microscope.The capsules were treated for histological examination.The change of fibronectin was assessed by ELISA assay kit.Results After 2 ～ 3 days,outgrowth of LEC across the posterior capsule was observed,and the posterior capsule was totally covered by a confluent monolayer of cell after (9.06 ± 1.61 ) days in group CTR.Capsular wrinkles became increasingly apparent as time progressed.An increase in capsular thickness was also observed.In contrast,there was less LEC deposition in group CTR-PLGA-MG132.Histological examination showed LEC layers were closely arranged on the posterior capsular surface in group CTR.In group CTR-PLGA-MG132,there was comparatively looser cell arrangement.Compared with group CTR,the mean fibronectin level of posterior capsule by week 3 in group CTR-PLGA-MG132 was 25.14 μg/ml and 106.09 μg/ml respectively.Statistical analysis showed a significant difference ( P ＜ 0.01 ).Conclusions LEC migration,proliferation,and synthesis of EMT markers were inhibited in Group CTR-PLGA-MG132,compared with Group CTR.Drug-sustained capsular tension rings can effectively inhibit the migration,proliferation of LEC and the change of EMT ( epithelial-to-mesenchymal transition) in swine capsular bag models.Drug-sustained capsular tension rings might be a potential therapy to prevent the posterior capsular opacification in the future.

Objective:To investigate the prognostic value of gastroepiploic lymph node (GLN) metastasis in transverse colon cancer.Methods:The propensity score matching and retrospective cohort study was conducted. The clinicopathological data of 371 patients with transverse colon cancer who were admitted to Fujian Medical University Union Hospital from November 2010 to November 2017 were collected. There were 202 males and 169 females, aged from 21 to 92 years, with a median age of 58 years. Patients were performed complete mesocolic excision combined with GLN dissection by one group of surgeons. Of the 371 patients with transverse colon cancer, 15 cases had positive GLN metastasis (GLN+), and 356 cases had negative GLN metastasis (GLN-). Observation indicators: (1) the propensity score matching conditions and comparison of baseline data between GLN- patients and GLN+patients with transverse colon cancer after propensity score matching; (2) follow-up and survival of GLN- patients and GLN+patients with transverse colon cancer; (3) influencing factors for prognosis of patients with transverse colon cancer. Patients were followed up by outpatient examination or telephone interview to detect tumor metastasis and survival. Follow-up was conducted once every 3 months within postoperative 2 years, once every 6 months within postoperative 2-5 years and once a year thereafter up to January 2020. The propensity score matching was conducted by 1∶4 matching using the nearest neighbor method. Measurement data with skewed distribution were described as M (range), and comparison between groups was analyzed using the rank sum test. Count data were represented as absolute numbers, and comparison between groups was analyzed using the chi-square test or Fisher exact probability. The Kaplan-Meier method was used to calculate survival rates and draw survival curves, and Log-rank test was used for survival analysis. Univariate and multivariate analyses were performed using the COX proportional hazard regression model. The variables with P<0.10 in the univariate analysis were included for multivariate analysis. Results:(1) The propensity score matching conditions and comparison of baseline data between GLN- patients and GLN+ patients with transverse colon cancer after propensity score matching: 55 of 371 patients had successful matching, including 44 GLN- patients and 11 GLN+ patients. Before propensity score matching, the age, cases in stage 0 or stage 1 of M staging, preoperative carcinoembryonic antigen were 60 years(range, 24-92 years), 328, 22, 4.1 μg/L(range, 0.2-343.7 μg/L) for GLN- patients, respectively, versus 67 years(range, 21-79 years), 11, 4, 5.0 μg/L(range, 0.7-952.4 μg/L) for GLN+ patients, showing significant differences in the above indicators between the two groups ( Z=-1.440, χ2=9.031, Z=-2.086, P<0.05). After propensity score matching, the above indicators were 58 years(range, 45-67 years), 40, 4, 4.0 μg/L(range, 2.0-10.0 μg/L) for GLN- patients, respectively, versus 67 years(range, 59-71 years), 9, 2, 5.0 μg/L(range, 8.0-19.0 μg/L) for GLN+ patients, showing no significant difference between the two groups ( Z=-1.580, χ2=0.105, Z=-0.821, P>0.05). (2) Follow-up and survival of GLN- patients and GLN+ patients with transverse colon cancer: GLN- patients and GLN+ patients with transverse colon cancer were followed-up for 12-92 months and 1-70 months, with a median time of 53 months and 30 months respectively. Three cases of GLN- patients and 2 cases of GLN+patients had postoperative liver metastasis, respectively, showing no significant difference between the two groups ( χ2 =0.344, P>0.05). One case of GLN- patients and 3 cases of GLN+ patients had heterochronous lung metastasis, respectively, showing a significant difference between the two groups ( χ2 =4.870, P<0.05). The 5-year disease progression-free survival rates were 82.3% and 33.9% for GLN- patients and GLN+ patients, respectively, showing a significant difference between the two groups ( χ2 =13.366, P<0.05). (3) Influencing factors for prognosis of patients with transverse colon cancer: results of univariate analysis showed that pT staging, pN staging, M staging and GLN metastasis were related factors for prognosis of patients with transverse colon cancer ( hazard ratio=1.599, 5.107, 4.511, 6.273, 95% confidence interval as 0.467-5.471, 1.867-13.971, 1.385-14.694, 2.052-19.176, P<0.05). Results of multivariate analysis showed that pN staging, M staging and GLN metastasis were independent influencing factors for prognosis of patients with transverse colon cancer ( hazard ratio=6.399, 6.163, 4.024, 95% confidence interval as 2.028-20.189, 1.666-22.800, 1.177-13.752, P<0.05). Conclusion:For the patients with transverse colon cancer, GLN metastasis is associated with high postoperative heterochronous lung metastasis rate and poor prognosis. GLN metastasis is an independent prognostic factor for patients with transverse colon cancer.

Objective: To determine the effect of polygona-polysaccharose (PP) on learning and memory ability in rats with Alzheimer’s disease (AD). Methods: Forty ifve Sprague-Dawley rats were assigned into 3 groups. Rats in the sham-operated group were injected with normal saline. Rats in the Aβ group were injected with Aβ1-42. Rats in the PP group were injected with 16% PP solution for 45 days consecutively. hTe Morris water maze was used to investigate the ability of learning and memory in the rats. hTe effect of Aβ and PP on the hippocampus cells was observed by HE and Congo red staining of methanol. Results: Rats in the sham-operated group had no obvious morphological change; and morphology of rats in the PP group was basicaly normal. The layer of pyramidal cells in the Aβ group was decreased. hTe cells appeared sparse and irregular and became smaller. Karyopyknosis and vacuolardegeneration cells were also found. More positive staining materials aggradated in the Aβ group compared with the PP group by Congo red staining (P<0.05). Conclusion: Aβ infusion into the hippocampus results in the impairment of the neuronal degeneration in the rats, which shows similar characterizations of AD. PP can reduce the deposition of Aβ in the hippocampus.

OBJECTIVE To elucidate the mechanisms responsible for the inhibitory effects of limonene on the proliferation of non-small cell lung cancer(NSCLC) by non-targeted metabolomics and additional approaches. METHODS The CCK-8 assay was utilized to evaluate the inhibitory effects of limonene on NSCLC A549 cell viability and to ascertain the IC50. In vitro experiments, encompassing colony formation, flow cytometry, iron content assessment, and mitochondrial staining, were conducted to assess the anti-lung cancer and iron-induced cell death effects of limonene. Metabolomic analysis was employed to identify potential pathways influenced by limonene, and Western blotting was carried out to validate pivotal proteins within these pathways. RESULTS In comparison to the control group, the limonene-treated group demonstrated a significant, dose-dependent reduction in A549 cell proliferation and colony formation. Optical microscopy revealed cellular detachment and pronounced changes in cellular morphology following exposure to limonene. Limonene induced apoptosis in A549 cells and arrested them in the G0-G1 phase of the cell cycle. Confocal microscopy unveiled diminished mitochondrial fluorescence and an augmented intracellular iron content, indicative of the classical phenomenon of ferroptosis. Metabolomic investigations unveiled divergent metabolic pathways, including glutathione(GSH) metabolism, arginine biosynthesis, D-glutamine and D-glutamate metabolism, as well as cysteine and methionine metabolism, with many of them intricately linked to intracellular GSH synthesis. Western blotting experiments underscored a marked reduction in the levels of SLC40A1, SLC7A11(xCT), and GPX4 proteins within the cells post-limonene treatment. CONCLUSION Limonene may induce ferroptosis in lung cancer cells by reducing GSH synthesis and increasing Fe2+ levels.

OBJECTIVETo evaluate the result of surgical treatment of the middle and upper-middle esophageal carcinoma with a new operation, performing the anastomosis posterior to the aortic arch at the apex of the thoracic cavity.

METHODSFrom April 1996 to May. 2000, 179 patients with esophageal carcinoma were treated. Sixty-eight of these patients (49 in the middle and 19 in the upper-middle segment) were treated by esophogogastrostomy at the top of the chest, posterior to the aortic arch. There were squamous cell carcinoma 50, adenocarcinoma 16, undifferentiated carcinoma 2, including 8 double-primaries. The lesions were stage I 9 and stage II-III 59.

RESULTSAll patients have been alive after follow-up of 2 months to 3 years. Without any positive margins, anastomotic leak or perioperative death, this new method has merits: 1. Length of esophagus resected was maximal through one single incision. It would be especially useful for some of the upper-middle lesions. 2. This new method requires a shorter transposed stomach than that required by the combined triple cervico-thoraco-abdominal approach. 3. As the site of thoracic stomach was on the bed of esophagus, there was less chance of post-operative embarrassment in respiration due to the dilatation of the transpositioned stomach and pylorostenosis, etc. 4. There would be less chance of reflux esophagitis because of the "blocking" by the aortic arch, thereby, the patients life is improved.

CONCLUSIONThis radical operation for esophageal carcinoma with anastomosis at top of the thoracic cavity posterior to the aortic arch, being a newly designed surgical method, is especially useful for carcinoma in the middle and upper-middle esophageal segment.

Anastomosis, Surgical ; methods ; Aorta, Thoracic ; surgery ; Esophageal Neoplasms ; surgery ; Follow-Up Studies ; Humans ; Thoracic Surgical Procedures ; methods ; Treatment Outcome

Objective To investigate the association between chewing ability and frailty in elder-ly adults in communities of China.Methods A total of 12,678 elderly people in community were selected from data of Chinese Longitudinal Healthy Longevity and Happy Family Study(CLHLS-HF)as the study subjects.Multivariate Logistic regression analysis was used to explore the relationship be-tween chewing ability and frailty of elderly people in community,and restricted cubic spline(RCS)based on Logistic regression analysis was used to analyze the dose-response relationship between the number of teeth and frailty risk in elderly people in community of China.Results Of the 12,678 community-dwelling older adults,the mean age was(83.62±11.16)years,with an age ranging from 65 to 117 years;there were 5,848(46.1％)men and 6,830(53.9％)women.The results of the multifactorial Logistic regression analysis showed that after adjusting for the covariates including gender,age,marital status,place of residence,ethnicity,living arrangement,years of education,healthcare availability and occupation before age of 60,self-rated economic status,body mass index(BMI),smoking status,alcohol consumption status,exercise status,self-rating health status varia-bles,and participation in the annual medical check-ups or not,the results showed that the chewing a-bility of community-dwelling older adults was associated with the risk of frailty(P＜0.05).The RCS plot showed a linear correlation between the number of natural teeth and the risk of frailty,with the risk of frailty increasing when the number of natural teeth was less than 10,and the risk of frailty gradually increased as the number of teeth decreased.Conclusion Chewing ability is associated with the risk of frailty in Chinese older adults,and the number of natural teeth and the use of dentures are impor-tant for the development of frailty in older adults.

Taking the reform of DRG payment methods as the background,it discusses how the medical in-surance department uses information technology to achieve refined monitoring and management of medical institu-tions,so as to improve the quality and efficiency of medical services and control the unreasonable growth of medical expenses.The three stages of"precision monitoring-refined supervision-precision governance"of medical insurance DRG based on"refined theory"are proposed;taking Nanjing's"medical insurance high-speed railway"as an example,a DRG refined supervision and governance model framework is constructed,and its analysis is carried out monitoring elements and governance elements,and finally put forward implementation suggestions,including hori-zontal collaboration led by medical insurance,establishing a service and cost evaluation mechanism that combines in-ternal and external services.