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.

To investigate the mechanism of moxibustion in regulating cellular apoptosis in rat's precancerous lesion of primary hepatocellular carcinoma (HCC). Methods:Seventy-four rats were randomly allocated to normal group,model group and moxibustion group,and the diethylic nitrosamine (DEN) was used to establish HCC model. Moxibustion with moxa cone which is as big as a grain of wheat was performed on acupoint Zusanli (ST 36),3 cones for each acupoint and 0.5 mg for each cone,the treatment was given once a day,totally 16 weeks. Then the changes in the body weight,liver weight and thymus weight,a morphological change in the liver tissue and changes in γ-GT and GST were observed;Immunohistochemical staining method was adopted to observe the tendency of changes in relevant apoptosis genes such as C-myc,N-ras and mutant type P53,and the influence of moxibustion on cell cycle modulation genes such as cyclinD1,CDK4 and p16. Results:Moxibustion could reduce the activities of γ-GT and GST in the blood,obviously decrease the protein expression of relevant apoptosis genes such as C-myc,N-ras and mutant type P53 and markedly inhibit the over-expression of relevant cell cycle modulation genes such as cyclinD1 and CDK4 and the mutation of cell cycle modulation gene p16. Conclusion:Moxibustion might play a certain role in relieving HCC precancerous lesion and its action mechanism might be related to the regulation on partial apoptosis genes.

Objective To investigate behavior and hippocampal cytoskeletal alterations following re-exposure to chronic unpredictable mild stress(CUMS) and acute swimming stress,and explore the possible mechanism.Methods 40 Male Sprague-Dawley (SD) rats were divided into five groups,with 8 exposed to 21 consecutive days of chronic unpredicted mild stresses (CUMS) and treated with vehicle,8 exposed to CUMS and treated with fluoxetine,8 exposed to CUMS and treated with fluoxetine and re-exposed to acute swimming stress after washout,8 exposed to CUMS and treated with fluoxetine and re-exposed to CUMS after washout,and 8 as normal controls treated with vehicle.Behavioral changes in these rats were analyzed.The expressions of hippocampal cytoskeletal microtubulin were analyzed using Western Blot.Results ( 1 ) Compared with the control and CUMS group,sucrose preference (43.38 ± 7.84 ) ％,total traveling distance ( 859.21 ± 653.62 ) cm,velocity ( 2.05 ± 0.60 ) cm/s and frequencies of rearing(0.12 ±0.30) were reduced (P＜0.01 ) in the re-exposure to CUMS group.After re-exposed to acute stress,these behaviors did not differ from control rats.(2)Compared with the control and CUMS group,the Acet-Tub expression (244.24 ± 8.90 )％ of re-exposure to CUMS group showed a significant increase (P＜ 0.01 ) in rats submitted to re-exposure to CUMS and Tyr-Tub expression (30.92 ± 11.01 )％ was significantly decreased following re-exposure to CUMS (P＜0.01).At the same time,MAP-2 expression did not change while phospho-MAP-2 expression (24.75 ± 8.83 )％ decreased significantly.After re-exposed to acute stress,these prorein expressions did not differ from control rats.Conclusion These findings provide evidence that rats re-exposed to CUMS showed more impairment of cytoskeletal microtubular dynamic and structural neuronal plasticity,this effect appears to be mediated by the degree of phosphorylation of MAP-2.

Objective To evaluate the value of volume measured by multi-slice spiral CT in preoperative N staging of gastric canc-er.Methods CT data of 1 93 cases of gastric cancer proven pathologically were collected and analyzed.Volume of the tumor was cal-culated in the portal phase,and the correlation between the results and N staging was evaluated.ROC curve was used to get diagnos-tic value to differentiate N stages.Results Intra-observer Kappa value was 0.77 (P < 0.05 ),0.72 (P < 0.05 ),Inter-observer Kappa value was 0.69 (P <0.05).The tumor volume data was positively correlated with different N stages (r=0.568,P <0.05). ROC curve showed that the volume could help differentiate between stage N0 and stage N1 - N3 (cutoff 12.06 cm3 ,sensitivity 55%,specificity 95%),stage N0-N1 and stage N2-N3 (cutoff 22.35 cm3 ,sensitivity 66%,specificity 86%),stage N0-N2 and stage N3 (cutoff 25.95 cm3 ,sensitivity 62%,specificity 89%)respectively.Conclusion The volume of gastric cancer measured by CT plays an important part in predicting lymph node metastasis staging and optimizing individualized clinical strategy for patients.

Nephrotic syndrome (NS) is associated with cerebral venous sinus thrombosis (CVST), which is a rare cerebrovascular disorder in children. Systemic anticoagulation with heparin is the standard therapy for CVST, and mechanical thrombectomy (MT) has been described as a salvage treatment for adult anticoagulant refractory CVST, However, it has never been reported in children. We describe a case of MT for refractory CVST in a child with NS. A 13-year-old boy with newly diagnosed NS presented to an emergency department with acute headache. A head computed tomography showed acute thrombus in the superior sagittal sinus, straight sinus and transverse sinus. The child was started on heparin therapy, but clinically deteriorated and became unresponsive. In view of the rapid deterioration of the condition after anticoagulation treatment, the patient received intravascular treatment. Several endovascular technologies, such as stent retriever and large bore suction catheter have been adopted. After endovascular treatment, the patient’s neurological condition was improved within 24 hours, and magnetic resonance venography of the head demonstrated that the CVST was reduced. The child recovered with normal neurological function at discharge. This case highlights the importance of considering MT for refractory CVST, and we suggest that MT may be considered for refractory CVST with NS in children.

Objective To understand the health-related quality of life (HRQOL) of migrant workers with pneumoconiosis who received basic medical treatment in Hunan Province. Methods A total of 613 migrant workers with pneumoconiosis who received basic medical treatment and assistance in Hunan Province was selected as the study subjects using stratified random sampling method. The European Quality of Life-5 Dimensions (EQ-5D) questionnaire was used to assess their HRQOL. Results The abnormality of the five dimensions of the EQ-5D health description system, from high to low, were as follows： daily activities, mobility, pain/discomfort, anxiety/depression, and self-care, with the abnormal rates of 50.9%, 46.8%, 41.1%, 21.0%, and 14.5%, respectively. The visual analogue scale (VAS) score of EQ-5D was (63.5±18.6) points. Patients with stage Ⅲ pneumoconiosis had high abnormality in mobility, daily activities, and pain/discomfort compared with those with stage Ⅰ and Ⅱ disease (all P<0.02). Patients in stage Ⅱ and Ⅲ of pneumoconiosis had higher incidence of anxiety/depression compared with those with stage I disease (all P<0.02). Patients with complications in addition to pneumoconiosis had higher abnormality in mobility, self-care, and pain/discomfort compared to those with simple pneumoconiosis or those eligible for lung lavage treatment (all P<0.02). Patients with simple pneumoconiosis had a higher incidence of anxiety/depression compared with those eligible for lung lavage treatment (P<0.02). Patients with stage Ⅲ pneumoconiosis had lower average VAS scores compared with stage Ⅰ and Ⅱ patients (all P<0.02). Patients with simple pneumoconiosis or those with complications had lower average VAS scores compared with those eligible for lung lavage treatment (all P<0.05). Conclusion The HRQOL of pneumoconiosis patients among migrant workers needs improvement, especially for patients with stage Ⅲ disease and those with complications. This study indicates the need of optimizing policies, raising the hospitalization expense limit for critically ill patients with stage Ⅲ pneumoconiosis or with complications, and improving their HRQOL.

Objective To optimize the ways of extubation after tracheotomy.Methods From August, 2016 to April, 2018, 118 patients after tracheotomy for brain injury were divided into early extubation group (n=74) and conventional extubation group (n=44). The success rate and tolerance of extubation were compared, and the biochemical markers of blood were tested before and seven days after extubation. The early extubation group was divided into disposable extubation group (n=37) and occlusion tube-extubation group (n=37), and their success rates of extubation were compared.Results There was no significant difference in success rate between the early extubation group and the conventional extubation group (χ2=0.016, P>0.05). The tolerance was less in the early extubation group on the first day of extubation (χ2=4.909, P<0.05), and it was not different seven days and 15 days after extubation (χ2<1.995, P>0.05). The procalcitonin, hypersensitive C reactive protein and white blood cell count decreased (t>2.680, P<0.05), and hemoglobin and albumin increased seven days after extubation (t>11.620, P<0.001). There was no significant difference in the success rate between the disposable extubation group and the occlusion tube-extubation group (χ2<2.902, P>0.05).Conclusion Satisfactory cough and deglutition reflex are the core indexes of successful extubation, other indications may not influence on the success of extubation but on tolerance. Extubation may benefit to control the complications of tracheotomy. The disposable extubation is more recommended.