Objective To investigate the biocompatibility and safety of nanoscale brain-targeting-carrier micelles [poly (ethylene)-b-poly (lactic acid)/OX26 conjugate micells (copolymer/OX26)],and to explore its possibility as brain-targeted-drug carrier for brain glioma.Methods The C6 glioma cells were cultured in vitro and divided into experimental groups with different concentrations (10, 20, 40, 80 mg · L-1 )of nano micelle, and the medium without micelle was used as control group.The inhibitory effect of nano-micelles on the rat brain glioma C6 cells was examined by Trypan blue cell counting assay.Flow cytometry (FCM)was used to detect the changes of apoptosis and cell cycle of C6 cells,and confocal laser scanning microscope (CLSM)was performed to analyze the distribution of copolymer/OX26 into C6 cells. Results The results of Trypan blue cell counting assay showed copolymer/OX26 didn’t affect the growth of C6 cells,and there were no significant differences in the number of C6 cells between control group and expreimental groups (P >0.05).The results of FCM showed that the cell cycle and and the apoptotic rates of C6 cells had no changes compared with control group (P > 0.05).The results of CLSM showed that the fluorescence intensities in experimental groups were higher than those in blank micelles group and blank control group (P < 0.05 ), and they were increased in dose- and time-dependent manner (P <0.05).Conclusion Copolymer/OX26 has no effect on the growth and apoptosis of glioma cells.By bonding OX26,copolymer/OX26 can significantly increase the intake of C6 cells on the nano micelles.

Objective: To explore relationship among bullying victimization, psychological traits and suicide ideation of middle school students, and to provide suggestions for school bullying and suicide prevention for adolescents. Methods: A total of 3 635 students of 7-9th grade from 5 junior middle schools were enrolled and investigated with the Olweus Bully/Victim Questionnaire (OBVQ), psychological traits questionnaire for middle school students and suicide ideation questionnaire. Results: Prevalence of bullying victimization was 28.34% of middle school students, while the prevalence of verbal, relational and physical bullying were 22.59%, 12.05% and 7.54%, respectively. Boys had significantly higher rates of bullying victimization than girls (χ2=88.92，94.29，7.69，P<0.01). Bullying victimization was positively associated with suicidal ideation (r=0.21, P<0.01), while associated with psychological traits (r=-0.17, -0.22, P<0.01). Psychological traits had a moderating effect on the relationship between bullying victimization and suicidal ideation (β=-0.04, P<0.05). Conclusion Psychological traits can buffer the adverse effects of bullying victimization on suicidal ideation, and the critical role of psychological traits in the maintenance and development of adolescent mental health should be emphasized.

Objective:To investigate the relationship between childhood psychological abuse and dark triad with suicide ideation, and to provide references for suicide prevention in college students.Methods:A total of 2 995 college students from 6 universities including Guangxi, Sichuan, Henan, Guizhou and Chongqing were enrolled, and were investigated with the child psychological maltreatment scale (CPMS), dirty dozen(DD), and suicide ideation questionnaire.SPSS 26.0 software was used for correlation analysis and macro program-PROCESS was used to analyze the mediating effect.Results:The prevalence of childhood psychological maltreatment among college students was 29.32%, which in male students and students with left-behind experience (33.38%, 34.60%) were higher than that in female students and students without left-behind experience (25.65%, 25.98%)(χ 2=21.53, 25.47, both P<0.01) respectively.There was positive correlation between childhood psychological maltreatment, dark triad and suicidal ideation( r=0.32-0.41, all P<0.001). Dark triad had a partial mediating effect between childhood psychological maltreatment and suicidal ideation(effect size=0.08, 95% CI=0.06-0.10). An analysis of multiple mediating effects on the three dimensions of dark triad found that Machiavellianism and psychopathy had significant mediating effects between childhood psychological maltreatment and suicidal ideation(effect size=0.05, 95% CI=0.02-0.07; effect size=0.07, 95% CI=0.04-0.10), while narcissism had no significant mediating effect(effect size=-0.01, 95% CI=-0.01-0.01). Conclusion:Childhood psychological maltreatment can not only directly affect the suicide ideation of college students, but also further affect the suicide ideation through dark triad.

Objectives To explore the association between the single nucleotide polymorphism (SNP) rs2239669 in makorin ring-finger protein 3 (MKRN3) gene and the susceptibility to central precocious puberty (CPP). Methods A case-control study including 246 children with CPP and 269 healthy children was performed.The genotype and MKRN3 expression levels of patients were analyzed by PCR-HRM and RT-PCR,respectively. Results SNP rs2239669 genotype (TT,TC,CC) and allele frequencies (T and C) were different between cases and controls,with higher CC genotype in CPP patients. Under recessive model (CC/TT+TC),CC genotype was higher in CPP group and associated with higher risk of CPP (95%CI:1.062-2.143,P=0.021). MKRN3 expression levels were different among patients with different genotypes,of which TT genotype had the highest level followed by TC and CC (0.376±0.094, 0.330±0.068, 0.250±0.072, P=0.041). Conclusions MKRN3 SNP rs2239669 was associated with increased risk of CPP, and patients with TT genotype had higher MKRN3 levels.

Objective:To investigate the expression of coxsackievirus-adenovirus receptor (CAR) in thymic carcinoma and the relationship between CAR and the antitumor activity of oncolytic adenovirus H101.Methods:The expression of CAR in thymic carcinoma tissues and cells were detected by RT-qPCR and Western blot. H101 expression and virus titers in Bcap-37, MP59 and T1889 cells after infection were detected by RT-qPCR and 50% tissue culture infectious dose (TCID 50). The proliferation activity and apoptosis rates of T1889 cells infected with H101 at different multiplicity of infection (MOI) were detected by CCK-8 and flow cytometry. CAR expression in T1889 cells treated with different concentrations of trichostatin A (TSA), a histone deacetylase inhibitor, was detected. H101 expression and virus titers in the TSA-treated and H101-infected cells were detected. Cell activity was detected by CCK-8. The phosphorylation levels of MARK and ERK1/2 and the expression of CAR at protein level in TSA-treated or TSA+ TBHQ (ERK activator) treated cells were detected. Results:CAR expression at both mRNA and protein levels were significantly lower in thymic carcinoma tissues than in adjacent normal tissues ( P<0.01), and lower in MP59 and T1889 cells than in thymic epithelial cells (TEC) and Bcap-37 cells ( P<0.01). H101 expression in MP59 and T1889 cells and the titers of H101 in culture supernatants were significantly lower than those in Bcap-37 cells ( P<0.01). Compared with Bcap-37 cell, the activity of MP59 and T1889 cells was significantly increased and the apoptosis rates were significantly decreased 48 h after H101 infection ( P<0.01). The expression of CAR at both mRNA and protein levels in T1889 cells treated with different concentrations of TSA increased in a dose-dependent manner. When T1889 cells were treated with 0.25 μmol/L of TSA, the expression of H101 at mRNA level and H101 titers were significantly increased ( P<0.05); the phosphorylation levels of MAPK and ERK1/2 proteins were continuously decreased; the expression of CAR was continuously increased. Compared with the TSA treatment group, the expression of CAR at protein level in the TSA+ TBHQ treatment group decreased significantly ( P<0.01), and the p-ERK1/2/ERK1/2 ratio increased significantly ( P<0.01). Conclusions:TSA could up-regulate CAR expression in thymic carcinoma by inhibiting the MARK/ERK1/2 pathway, thereby enhancing the antitumor activity of H101.

Objective:To explore the safety and short-term and long-term efficacy of robot-assisted radical esophageal cancer surgery.Methods:A prospective randomized controlled trial was conducted. Patients who were preoperatively diagnosed as stage 0-IIIB esophageal squamous cell carcinoma and suitable for minimally invasive surgery in our hospital from January 1, 2014 to June 30, 2018 were prospectively enrolled. Those of age ≥75 years having received preoperative neoadjuvant therapy, contradicted to anesthesia or operation due to severe complications, with history of thoracotomy or laparotomy, with concurrent malignant tumors, without complete informations or refusing to participate in this study were excluded. Participants were randomly divided into the thoracoscopy-laparoscopy group and the robot group using a random number table in ratio of 1:1. Preoperative clinicopathological data, surgical data and postoperative outcomes were recorded. The patients were followed up mainly by telephone. Follow-up endpoint was recurrence of esophageal cancer and death. Kaplan-Meier method was used to estimate survival rate. The survival difference between the two groups was analyzed using the log-rank test.Results:According to above criteria, a total of 192 esophageal cancer patients were enrolled finally, including 144 males and 48 females with mean age of (61.9±8.6) years. The robot group had 94 cases, including 72 males and 22 females with mean age of (61.3±8.2) years, and the thoracoscopy-laparoscopy group had 98 cases, including 72 males and 26 females with mean age of (62.4±9.1) years. There were no significant differences in baseline data between the two groups (all P>0.05). Operation was abandoned in one case in each group due to extensive pleural cavity metastasis and one case in each group was converted to thoracotomy. The success rate of operation was 97.9% (92/94) in the robot group and 98.0% (96/98) in the thoracoscopy-laparoscopy group (χ 2=0.002, P=0.996). The number of lymph nodes dissected in the robot group was significantly higher than that in the thoracoscopy-laparoscopy group (29.2±12.5 vs. 22.8±13.3, t=3.433, P=0.001), while there were no significant differences in operative time, intraoperative blood loss, R0 resection rate, postoperative 30-day mortality, postoperative hospital stay, ICU stay, time to withdrawal of chest drainage tube, ICU readmission, and postoperative morbidity of complications between the two groups (all P>0.05). The median follow-up time was 21 (3 to 57) months. During the follow-up, 3 cases and 4 cases were lost, and 2 cases and 3 cases died of other diseases in the robot group and in the thoracoscopy-laparoscopy group respectively. Recurrence occurred in 39 cases during follow-up, including 14 recurrences in the robotic group with 1- and 3-year recurrence-free survival rates of 92.4% and 87.6% respectively and the median recurrence time of 15 (9 to 42) months. There were 25 recurrences in the thoracoscopy-laparoscopy group with 1- and 3-year recurrence-free survival rates of 81.7% and 67.9% respectively and the median recurrence time of 9 (3 to 42) months. There was significant difference in recurrence-free survival between the two groups (χ 2=4.193, P=0.041). Conclusions:The robotic surgical system has good oncology effect and surgical safety in the radical operation of esophageal cancer, which deserves further research and promotion.

Objective:To explore the clinic effects of the head of second metatarsal bone and flap for bone and skin defect at lateral malleolus in children.Methods:Between July 2009 and May 2018, 4 children with ankle bone and skin and soft tissue defects in the Jizhong Energy Xingtai Mig General Hospital were selected, including 3 boys and 1 girl aged 4-13 years old. All cases were lateral malleolus defect with adjacent skin defect, the range of skin defect was 2.0 cm×2.0 cm -4.0 cm×5.0 cm, and the range of bone defect was 1.0-3.0 cm. The area of the flap was 2.5 cm×2.5 cm-4.5 cm × 5.5 cm, and the length of the second metatarsal head was 1.0-3.0 cm. The donor site was closed directly. After the operation, X-rays was performed to evaluate whether the ankle space and lateral malleolus longitudinal development was synchronized with the uninjured limb. Ankle joint function recovery was evaluated according to the American Orthopaedic Foot and Ankle Society (AOFAS). The outcomes of donor foot range of motion, weight-bearing, and walking were observed.Results:All the composite tissue flap survived with good blood circulation, and all the donor sites healed well. All the child patients were followed up for 0.5-2.0 years. The color and elasticity of the flaps were good, without cicatricial contracture. The patients had no inversion of ankle joint, with satisfying loading and walking function. Imaging evaluation showed that the space between ankle points and the longitudinal development of lateral malleolus were roughly synchronous with the healthy side. Two cases were graded as excellent and 2 as good according to the standard of the AOFAS.The donor's foot had normal flexion and extension function, without instability.Conclusions:The head of second metatarsal bone and flap can repair the epiphysis and soft tissue defect of lateral malleolus in children at one stage, and the reconstructed lateral malleolus can develop with the growth of children. It is a satisfactory method of reconstructing the traumatic defect of lateral malleolus in children.

Objective:To explore the clinic effects of the head of second metatarsal bone and flap for bone and skin defect at lateral malleolus in children.Methods:Between July 2009 and May 2018, 4 children with ankle bone and skin and soft tissue defects in the Jizhong Energy Xingtai Mig General Hospital were selected, including 3 boys and 1 girl aged 4-13 years old. All cases were lateral malleolus defect with adjacent skin defect, the range of skin defect was 2.0 cm×2.0 cm -4.0 cm×5.0 cm, and the range of bone defect was 1.0-3.0 cm. The area of the flap was 2.5 cm×2.5 cm-4.5 cm × 5.5 cm, and the length of the second metatarsal head was 1.0-3.0 cm. The donor site was closed directly. After the operation, X-rays was performed to evaluate whether the ankle space and lateral malleolus longitudinal development was synchronized with the uninjured limb. Ankle joint function recovery was evaluated according to the American Orthopaedic Foot and Ankle Society (AOFAS). The outcomes of donor foot range of motion, weight-bearing, and walking were observed.Results:All the composite tissue flap survived with good blood circulation, and all the donor sites healed well. All the child patients were followed up for 0.5-2.0 years. The color and elasticity of the flaps were good, without cicatricial contracture. The patients had no inversion of ankle joint, with satisfying loading and walking function. Imaging evaluation showed that the space between ankle points and the longitudinal development of lateral malleolus were roughly synchronous with the healthy side. Two cases were graded as excellent and 2 as good according to the standard of the AOFAS.The donor's foot had normal flexion and extension function, without instability.Conclusions:The head of second metatarsal bone and flap can repair the epiphysis and soft tissue defect of lateral malleolus in children at one stage, and the reconstructed lateral malleolus can develop with the growth of children. It is a satisfactory method of reconstructing the traumatic defect of lateral malleolus in children.

Objective:To explore the safety and short-term and long-term efficacy of robot-assisted radical esophageal cancer surgery.Methods:A prospective randomized controlled trial was conducted. Patients who were preoperatively diagnosed as stage 0-IIIB esophageal squamous cell carcinoma and suitable for minimally invasive surgery in our hospital from January 1, 2014 to June 30, 2018 were prospectively enrolled. Those of age ≥75 years having received preoperative neoadjuvant therapy, contradicted to anesthesia or operation due to severe complications, with history of thoracotomy or laparotomy, with concurrent malignant tumors, without complete informations or refusing to participate in this study were excluded. Participants were randomly divided into the thoracoscopy-laparoscopy group and the robot group using a random number table in ratio of 1:1. Preoperative clinicopathological data, surgical data and postoperative outcomes were recorded. The patients were followed up mainly by telephone. Follow-up endpoint was recurrence of esophageal cancer and death. Kaplan-Meier method was used to estimate survival rate. The survival difference between the two groups was analyzed using the log-rank test.Results:According to above criteria, a total of 192 esophageal cancer patients were enrolled finally, including 144 males and 48 females with mean age of (61.9±8.6) years. The robot group had 94 cases, including 72 males and 22 females with mean age of (61.3±8.2) years, and the thoracoscopy-laparoscopy group had 98 cases, including 72 males and 26 females with mean age of (62.4±9.1) years. There were no significant differences in baseline data between the two groups (all P>0.05). Operation was abandoned in one case in each group due to extensive pleural cavity metastasis and one case in each group was converted to thoracotomy. The success rate of operation was 97.9% (92/94) in the robot group and 98.0% (96/98) in the thoracoscopy-laparoscopy group (χ 2=0.002, P=0.996). The number of lymph nodes dissected in the robot group was significantly higher than that in the thoracoscopy-laparoscopy group (29.2±12.5 vs. 22.8±13.3, t=3.433, P=0.001), while there were no significant differences in operative time, intraoperative blood loss, R0 resection rate, postoperative 30-day mortality, postoperative hospital stay, ICU stay, time to withdrawal of chest drainage tube, ICU readmission, and postoperative morbidity of complications between the two groups (all P>0.05). The median follow-up time was 21 (3 to 57) months. During the follow-up, 3 cases and 4 cases were lost, and 2 cases and 3 cases died of other diseases in the robot group and in the thoracoscopy-laparoscopy group respectively. Recurrence occurred in 39 cases during follow-up, including 14 recurrences in the robotic group with 1- and 3-year recurrence-free survival rates of 92.4% and 87.6% respectively and the median recurrence time of 15 (9 to 42) months. There were 25 recurrences in the thoracoscopy-laparoscopy group with 1- and 3-year recurrence-free survival rates of 81.7% and 67.9% respectively and the median recurrence time of 9 (3 to 42) months. There was significant difference in recurrence-free survival between the two groups (χ 2=4.193, P=0.041). Conclusions:The robotic surgical system has good oncology effect and surgical safety in the radical operation of esophageal cancer, which deserves further research and promotion.

Objective:To investigate the clinical effects of retrograde anterolateral thigh perforator flaps assisted with computed tomography angiography (CTA) in repairing skin and soft tissue defects around the knee or in proximal lower leg.Methods:A retrospective cohort study was conducted. From May 2015 to October 2019, 17 patients with skin and soft tissue defects around the knee or in proximal lower leg were admitted to the Department of Orthopedics of Jizhong Energy Xingtai Mig General Hospital, including 12 males and 5 females, aged 16-65 years, with an average age of 35 years. The areas of skin and soft tissue defects after debridement ranged from 6.0 cm×3.0 cm to 15.0 cm×9.0 cm. The retrograde anterolateral thigh perforator flaps were designed according to the origin and distribution of the perforating branches in flaps and the length of the vascular pedicle examined with CTA and the condition of the wound to repair the wounds. The areas of resected flaps ranged from 6.5 cm×3.5 cm to 15.5 cm×9.5 cm. The wounds in donor sites of flaps were sutured directly or covered with medium-thickness skin grafts from healthy upper leg. The sources of the perforating branches in flaps were recorded. The lateral circumflex femoral artery, its branches, and the relative length of the vascular pedicle were compared between preoperative CTA detection and intraoperative observation. The survivals of the flaps were observed. At the last follow-up, the effects of flaps in repairing wounds were evaluated according to evaluation standard of efficacy satisfaction; the motion ranges of flexion and extension of the knee joint were measured, and the knee joint function was evaluated according to the Hohl knee joint function evaluation standard; the sensory function in the flap area was evaluated according to the sensory function evaluation standard formulated by the British Medical Research Council; the wound healing and the occurrence of complication affecting motor function of limb of flap donor sites was observed. Data were statistically analyzed with paired sample t test. Results:The perforating branches in flaps originated from descending branches, oblique branches, and rectus femoris branches of lateral circumflex femoral artery in 7, 6, and 4 patients, respectively. The flaps with blood supply from descending branches, oblique branches, and rectus femoris branches of lateral circumflex femoral artery were type 1, 2, and 3 retrograde anterolateral thigh perforator flaps, respectively. The preoperative CTA examination of lateral circumflex femoral artery and its branches were consistent with those observed during operation. The relative lengths of vascular pedicles of type 1, 2, and 3 retrograde anterolateral thigh perforator flaps calculated after CTA examination were 0.32±0.13, 0.56±0.07, and 0.56±0.15, which were close to 0.35±0.12, 0.52±0.10, and 0.53±0.12 measured and calculated during operation, respectively ( t=0.45, 0.80, 0.31, P>0.05). All flaps survived in 17 cases without vascular crisis. At the last follow-up, 16 patients were satisfied with effects of flaps in wound repair, with 1 patient feeling average about the effect; the flexion range of knee joint was 100-120°, and the extension range of knee joint was -2-0°; knee joint function was evaluated as excellent in 9 cases, good in 7 cases, and poor in 1 case; the sensory function of the flap area reached S 4 level in 2 cases, S 3 level in 8 cases, and S 2 level in 7 cases; the wounds in flap donor sites healed well; there was no adverse effect in motor function of limbs. Conclusions:Retrograde anterolateral thigh perforator flap is an effective method for repairing skin and soft tissue defects around the knee or in proximal lower leg. Preoperative CTA examination can fully show the anatomical characteristics of the branches of the lateral circumflex femoral artery and the perforating vessels of each branch, which can guide preoperative flap design and operation, thus shortening operation time and improving flap survival rate, with good clinical effects.