Objective To explore the deafness-causing underlying mechanisms of CX26 gene recessive mutations through functional analyzing nine missense mutations (p.S19T,p.R32H,p.E47K,p.V84L,p.V95M,p.R143W,p.R165W,p.S199F,p.L214P) in exogenous expression system Hela cells.Methods The nine recessive missense mutations of CX26,which are in the different domains of CX26 protein,and the wild type CX26 were subcloned into pEGFP-N1 vector directively,following to transfect into HeLa cells by the liposome complex method.The expressions of the mutated proteins were analyzed using western blot method.The localizations of the mutated proteins and whether there were gap junction-plaques formation were observed under confocal microscopy with immunofluorescence technique.Results The nine constructs were all expressed in HeLa cells.In which,the mutated proteins of p.S19T,p.E47K,p.V84L,p.V95M and p.R165W localized at the cytoplasmic membrane of HeLa cells and formed gap junction-plaques at contact points between two cells,and the mutated proteins of p.R32H,p.R143W,p.S199F and p.L214P accumulated and localized only intracellularly and did not form gap junction-plaques on cell membrenes.Conclusion The mutations of p.S19T,p.E47K,p.V84L,p.V95M and p.R165W do not interfere the mutated connxins trafficking and inserting into the plasma membrane.The mutations of p.R32H,p.R143W,p.S199F and p.L214P impared the proteins trafficking to the cell surface.The deafness-causing mechanisms of different missense mutations might not be identical and no correlation could be observed between the mutation and the topological domain of the mutated protein.

Objective: To investigate the mechanism of improvement effect of electro-acupuncture at acupoint Neiguan (PC 6) on acute myocardial ischemia (AMI). Methods: Ninety-six rats were randomly divided into sham-operation group, myocardial ischemia model group and myocardial ischemia model plus electro-acupuncture group, the rat model of AMI was established by occlusion of the anterior descending branch of the left coronary artery, then electro-acupuncture therapy was performed at bilateral acupoint Neiguan (PC 6). The myocardial enzyme activities in plasma was detected with biochemical method, and the myocardial c-fos gene expression was detected with reverse transcription polymerase chain reaction(RT-PCR) method. Results: The myocardial enzyme activities in plasma and the myocardial c-fos gene expression in myocardial ischemia model group were obviously higher than those in sham group(P＜ 0.05), after electro-acupuncture treatment, the myocardial enzyme activities in plasma and the myocardial c-fos gene expression were decreased,there was a significant difference (P＜ 0.05). Conclusion: The mechanism of improvement effect of electro-acupuncture at acupoint Neiguan (PC 6) on AMI is related to down-regulation of the myocardial c-fos mRNA expression.

Extracellular vesicles(EV)are a group of membrane-bound structures that originate from the endosomal system or are shed from the plasma membrane of cells.EVs can carry a heterogeneous set of molecules,including proteins,lipids,nucleic acids,and membrane receptors from their cell of origin.EV can cross the blood-brain barrier,allowing brain-derived EV(BDEV)to be specifically extracted from peripheral blood using surface markers on neuronal cells.Due to the presence of signals from the central nervous system,such as proteins,lipids,and nucleic acids,BDEV has emerged as a promising tool for exploring the central nervous system.This article provided an overview of the feasibility of BDEV as biomarkers for neurological and psychiatric disorders,as well as their potential for monitoring therapeutic efficacy in the treatment process.

Objective:To study the safety and feasibility of en-bloc lymph node dissection in laparoscopic radical resection for gallbladder cancer(GBC).Methods:The clinical data of 87 patients who underwent laparoscopic radical resection for GBC at Zhejiang Provincial People's Hospital from January 2014 to February 2022 were retrospectively analyzed. There were 26 males and 61 females, aged 67.0 (59.0, 72.0) years old. The patients were divided into the en-bloc dissection group ( n=29) and the non-en-bloc dissection group ( n=58) based on whether en-bloc lymph node dissection was carried out. Differences in general data, tumor characteristics, operation, recurrence and survival were compared between the two groups. Postoperative survival status of these patients was followed-up by telephone. Results:The number of lymph nodes dissected in the en-bloc dissection group was 9.0(8.0, 12.0), which was significantly higher than the 8.0(4.8, 11.0) in the non-en-bloc dissection group ( Z=-2.39, P=0.017). There were no significant differences in age, gender, preoperative blood biochemical indexes, tumor carbohydrate antigen 19-9, tumor stage, nerve and vascular invasion, operation time, intraoperative blood loss, postoperative drainage tube retention time, postoperative hospital stay, and incidences of postoperative complications (biliary fistula, abdominal hemorrhage and abdominal infection) between the two groups (all P>0.05). The median survival was longer in the en-bloc group than in the non-en-bloc group (21 vs. 15 months), and the median relapse-free survival time was 18 months in the en-bloc group compared with 10 months in the non-en-bloc group. However, there were no significant differences in postoperative cumulative survival and recurrence-free survival between the two groups (all P>0.05). Conclusion:En-bloc lymphadenectomy was safe and feasible in laparoscopic radical GBC surgery, with more lymph nodes being removed than the non-en-bloc lymphadenectomy group.

Objective:To evaluate the feasibility of abandoning prophylactic abdominal drainage in patients undergoing minimally invasive minor hepatectomy based on a propensity score matching (PSM) study.Methods:Retrospective review of a prospectively collected database of patients undergoing minimally invasive minor hepatectomy from July 2022 to May 2023 at the Department of Hepatopancreatobiliary Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital. A total of 108 patients were enrolled, including 48 males and 60 females, aged (60.8±13.7) years old. According to whether the abdominal drainage tube was prophylactically placed intraoperatively, patients were divided into two groups: the drainage group (with prophylactic placement of abdominal drainage tubes, n=76); the no-drainage group (without prophylactic placement of abdominal drainage tubes, n=32). PSM was used to compare the perioperative data between the groups, including extent of liver resection, intraoperative blood loss, operative time, and postoperative complications. Postoperative survival status within 90 days was followed up through telephone review. Results:Before PSM, the two groups differed significantly on age and the history of hypertension (both P<0.05). After PSM, there were 23 patients in each group. Patients in the two groups showed comparable results regarding the intraoperative parameters including the surgical method, pathological types, the number and maxium diameter of hepatic lesions, the extent and complexity of liver resection, and the duration of hepatic inflow occlusion (all P>0.05). No postoperative intra-abdominal bleeding occurred in either group. The incidences of postoperative complications were comparable between the groups, including fever, bile leakage, incision infection, and abdominal acupuncture for drainage (all P>0.05). After PSM, compared to patients wothout prophylactic abdominal drainage, prophylactic abdominal drainage group showed a decreased white blood cell counts on postoperative day 1 [9.39(6.30, 10.58)×10 12/L vs. 13.19(10.15, 14.90)×10 12 /L, P=0.006] and a shorter length of postoperative hospital stay [4(3, 5) d vs. 5(4, 5) d, P=0.033]. No postoperative death within 90 days occurred in either group. Conclusion:In minimally invasive minor hepatectomy, abandoning prophylactic abdominal drainage could be feasible, which facilitates fast recovery without increasing the incidence of postoperative fever, perihepatic fluid accumulation and postoperative abdominal acupuncture for drainage.