OBJECTIVE To investigate the effect of prenatal dexamethasone exposure (PDE) on chondrogenesis of female fetal rats and those of dexamethasone treatment on gene expression of chondrocytes, and to explore the underlying mechanism. METHODS ?In vivo, Wistar female ratswere conceived naturally, and the PDE group was sc given dexamethasone 0.2 mg-kg"1 once a day for 9-20 d after gestation (GD9-20). Pregnant rats were sacrificed on GD20( and cartilage samples of female fetal rats were collected. Tho morphology of cartilege was observed by HE and saffranin O staining. The expressions of aggrecan, O-xylosyltransfefase I (XylT-1), pi, 3-glucuronosyl transferase I [GlcAT-1).,4-galactosyttransterase 7, (GalT-I), insulin-like growth factor-1 (IGF-1), IGF-1 receptor (IGF-1R). protein kinase B {AKT) and activator protein I (AP-1) mRNA in cartilage tissues were examined by realtime quantitative PCR (RT-PCR). The expressions of XylT-I . GlcAT-I . GalT-I . IGF-1. AKT and AP-1 were detected by immunohistochemistry. In vitro, GD20 Wistar female fetal rats were used to extract chondrocytes from fetal knee joints. Dexamethasone (100 and 500 nmol-L"'). IGF-1 (100 ug-L"'). IGF-1 R inhibitor NVP-AEW541 (1 umol-L"), AKT inhibitor MK-2206 (1 pmol-L") and AP-1 inhibitor SR-11302 (1 umol-L∗') were treated for 24 h. The content of glycosaminoglycan (GAG) in the cefl supeRNAtant was detected by DMB staining. The expressions of XylT-1 , GlcAT-1 , GalT-1 , IGF-1 R, AKT and AP-1 mRNA were detected by RT-PCR. The expressions of XylT-I , GlcAT-I and GalT-I protein were detected by Western blotting. RESULTS (J) In vivo the results of HE and saffranin O staining showed that the number of articular chondrocytes of female fetal rats in PDE group was reduced, the arrangement of surface chondrocytes was disorderty. and staining of cartilage matrix became kghter and uneven. The protein and mRNA expression of cartilage, XylT-I , GlcAT-I , GalT-I and proteins related to IGF-1/AKT/AP-1 pathway were reduced in PDE group compared with normal control group (P<0.05, P<0.01). @ In vitro compared with the normal control group, the contcnt of GAG in the supeRNAtant of chondrocytes of female fetal rats was decreased (P<0.05). and the mRNA expressions of XylT-I , GlcAT-I, GalT-I and proteins related with IGF-1/AKT/AP-1 pathways were deceased (P<0.05). Compared with the dexamethasone 500 nmol-L"1 group, IGF-1 100 pg∗L" increased the mRNA expression levels of the above proteins {P<0.05, P<0.01). Compared with the normal control group, the protein and mRNA expressions of XytT-I , GlcAT-I and GalT-| in IGF-1 treatment group were increased, while those in IGF-1R/AKT/AP-1 inhibitor treatment groups were decreased (P<0.05, F<0.01). Compared with the SR-11302 group, there was no significant change in the protein and mRNA expression levete of XylT-I, GlcAT-1 and GalT-I after co-treatment with IGF-1. CONCLUSION PDE induceds chondrodysplasia in female fetal rats, which is related to the insufficiency of cartilage matrix synthesis induced by decreasing expression of glycosyltransferases mediated by low basic activity of IGF-1/AKT/AP-1 pathway.

BACKGROUND: The purpose of this study was to identify the consistency of invasive dynamic blood pressure (BP) monitoring between the superior mesenteric artery (SMA) and the common carotid artery (CCA). METHODS: Eight male Sprague-Dawley rats were cannulated in SMA and CCA simultaneously for BP monitoring, respectively. The abdominal aorta was prepared for the induction of BP change through clamping/de-clamping by a microvascular clip. The dynamic BP monitoring was performed by a polygraph system. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) values would be recorded during different time periods: the baseline (T1), the increasing period after clamping (T2), the platform period during clamping (T3), the decreasing period after de-clamping (T4), and the final platform period (T5). Three trials were performed on each rat with 15-minute intervals between consecutive monitoring. RESULTS: Systolic BP showed no significant differences between SMA and CCA. However, significant difference was found in diastolic blood pressure except at T5 (P=0.534). Mean arterial pressure of two arteries were signifi cantly different only at T1 (P=0.015). The strength of association was significantly high between BP measurements through SMA and CCA (P<0.001). The Bland- Altman analyses showed that mean bias of MAP changed no more than 5 mmHg and standard deviation less than 8 mmHg during T2 and T4, respectively. CONCLUSION: The study indicates SMA might be an alternative site for invasive BP monitoring during abdominal aorta occlusion and release, especially in cerebrovascular-related research.

Objective To investigate the surgical diagnosis and treatment of late vitamin K deficiency intracranial hemorrhage caused by biliary atresia. Methods Clinical data of six cases of biliary atresia with late vitamin K deficiency intracranial hemorrhage were collected in the Department of Neurosurgery of Tianjin Children’s Hospital from January 2000 to December 2013. Data were analyzed to identify the biliary atresia as soon as possible in the treatment of intracranial hemorrhage and prolonged jaundice in children. Results Six cases (1 male, 5 female), mean age was (16.0±2.6) days, and were treated with external drainage of intracranial hematoma and infusion therapy. In the treatment, children were found jaundice exacerbation and doubted about biliary atresia. After consultation by general surgeons, children were transferred to the department of general surgery for further treatment at an average age of (29.1±1.2) days, and were diagnosed as biliary atresia by intraoperative cholangiography. Conclusion Pediatric neurosurgeon should have a sufficient understanding and make an early diagnosis to late vitamin K deficiency intracranial hemorrhage caused by biliary atresia, to avoid delaying the optimal treatment time of biliary atresia.

OBJECTIVE: To investigate the expression of FLIP and PTEN in laryngeal Squamous cell carcinoma (LSCC), and the relationship between FLIP and PTEN. METHOD: The protein expression of FLIP and PTEN were examined by using immunohistochemical method in 45 cases of LSCC and 15 cases of para-carcinoma tissues. RESULT: FLIP protein positive expressive rate in the laryngeal squamous cell carcinoma cases (77.8%) was higher than that in the para-carcinoma tissues cases (33.3%, P < 0.05). The protein expression of FLIP was correlated with cervical lymph node metastasis, clinical stage and prognosis. On the other hand, PTEN positive expressive rate in the laryngeal squamous cell carcinoma (65.0%) was higher than that in the para-carcinoma tissues (0%, P < 0.01). The protein expression of PTEN was associated with tumor differentiation grade, clinical stage, cervical lymph node metastasis and prognosis. There was a negative relationship between the expression of FLIP and PTEN in LSCC. CONCLUSION The protein expression of FLIP may be an important prognostic marker for LSCC. The protein expression of PTEN was correlated with clinical stage, tumor differentiation grade, and cervical lymph node metastasis . Consequently, it could be used as a valuable marker for the prognosis of LSCC.
CASP8 and FADD-Like Apoptosis Regulating Protein ; metabolism ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Humans ; Laryngeal Neoplasms ; metabolism ; pathology ; Lymphatic Metastasis ; Neoplasm Staging ; PTEN Phosphohydrolase ; metabolism ; Prognosis

OBJECTIVETo explore clinical efficacy of osteotomy and fusion in treating severe rigid equinus deformity.

METHODSFrom April 2010 to October 2015, 13 patients(16 feet) with severe rigid equinus deformity were treated with osteotomy and fusion by hollow screw, including 6 males and 7 females aged from 39 to 62 years old with an average of(49.6±5.3) years old;the courses of diseases ranged from 5 to 27 years with an average of (9.0±4.8) years. Six patients (9 feet) were treated with osteotomy and fusion for three joints, 4 patients(4 feet) were treated with osteotomy and fusion for four joints, and 3 patients (3 feet) were treated with osteotomy and fusion for tibiotalar and calcaneal-talar joints. All patients manifested as foot pain, heel could not touch floor and walking before operation. Postoperative complications were observed, AOFAS score were applied to evaluate clinical effect.

RESULTSThirteen patients were followed up from 18 to 24 months with an average of 20 months. Only one patient occurred local skin necrosis after operation and healed by dressing change and anti-infective therapy. All feet obtained fracture healing, the time ranged from 12 to 16 weeks with an average of 13.2 weeks. AOFAS score were improved from 11.85±10.66 before operation to 81.38±3.69 after operation, and had significant difference(=-25.67, <0.05);15 feet good and 1 foot moderate.

CONCLUSIONSTibiotalar and calcaneal-talar joint fusion, osteotomy and fusion for three and four joints could treat severe rigid equinus deformity according to patients' individual and could obtain satisfied clinical effects.

Adult ; Arthrodesis ; Calcaneus ; pathology ; Equinus Deformity ; surgery ; Female ; Humans ; Male ; Middle Aged ; Osteotomy ; Treatment Outcome

Objective: To explore the values of intraoperative fine-needle aspiration (IFNA) and parathyroid hormone (PTH) detection in the eluate of aspirated tissue during parathyroidectomy. Methods: Fifty-four patients with secondary hyperparathyroidism (SHPT) including 24 males and 30 females, aged 20-83 years, admitted to Zhongnan Hospital of Wuhan University from January 2019 to October 2019, were included. All patients received subtotal parathyroidectomy with autologous transplantation, during surgery, IFNA and PTH detection in the eluate of aspirated tissue were performed, and also routine postoperative pathological examination was performed. The results of PTH detection in the eluate of aspirated tissue and postoperative pathological examinations were compared and analyzed by SPSS and R software for evaluating of the sensitivity, specificity, positive predictive value, negative predictive value, misdiagnosis rate, missed diagnosis and accuracy. Results: Surgery was completed successfully in all patients. After surgery, the symptoms were improved in the patients except two who were asymptomatic. None had any serious postoperative complications such as hypocalcaemia or hoarseness. A total of 231 aspirated tissue samples were tested, of which 216 were identified as parathyroid and 15 non-parathyroid based on intraoperative PTH detection in tissue eluate; while 217 were confirmed as parathyroid tissues and 14 non-parathyroid tissues with postoperative pathological examinations. The specificity and sensitivity of intraoperative IFNA and PTH detection in tissue eluate for identifying parathyroid tissues were 99.5% and 100.0%, respectively. Conclusion: The IFNA and PTH detection in tissue eluate is a rapid, simple, and accurate procedure, which helps the surgeon to identify parathyroid tissue and to ensure the endocrine activity of preserved or autografted parathyroid tissue during parathyroidectomy.
Female ; Humans ; Hyperparathyroidism, Secondary/surgery* ; Male ; Parathyroid Glands/surgery* ; Parathyroid Hormone ; Parathyroidectomy ; Predictive Value of Tests

Objective: To investigate the application efficacy of the "classification of external branch of superior laryngeal nerve (EBSLN)" combined with intraoperative neuromonitoring (IONM) in the dissection of EBSLN for protecting the nerve from injuery, compared with ligation of branches of the superior thyroid vessels without attempts to visually identify the nerve. Methods: A prospective randomized controled study was performed in our center. Patients subjected to thyroidectomy from January 2017 to June 2019 were randomly divided into 2 groups, patients in experimental group underwent thyroidectomy and "classification of EBSLN" with IONM to dissect EBSLN, and patients in control group received synchronous surgery without attempts to visually identify the nerve. The anatomical subtypes of EBSLN in experimental group were recorded. The voice handicap index 10 (VHI-10) score was evaluated and the movement of bilateral vocal cords was examined by laryngoscope before surgery, 1 month, 3 months, and 6 months after surgery, respectively. SPSS 26.0 statistical software was used for statistical analysis. Results: Among the 1 377 EBSLN from 827 patients (317 males and 510 females, aged 24-58 years old), 691 EBSLNs in experimental group and 686 EBSLNs in control group. Totally 98.3% of EBSLNs in experimental group were identified by IONM including 16.4% (113/691) for type Ⅰ, 21.3% (147/691) for type Ⅱa, 31.4% (217/691) for type Ⅱb, 10.4% (72/691) for type Ⅲa, 3.9% (27/691) for type Ⅲb, 16.6% (115/691) for type Ⅲc. There was no statistical significance difference in baseline data between 2 groups (all P>0.05). All patients were followed up for more than 6 months. The postoperative nerve injury rate of experimental group was significantly lower than that of control group (1.2% vs. 7.5%, χ²=12.659, P<0.001), and the VHI-10 scores and laryngoscope results of experimental group were better than those of control group in three follow-up visits (P<0.001). With postoperative laryngoscope examination, 3 patients in the experimental group and 23 patients in the control group showed vocal cord relaxation, bilateral oblique asymmetry and other phenomena, which were considered as the results of permanent injury. Other patients with symptoms were relieved to varying degrees during the follow-up, and their symptoms were considered as the results of temporary injury. Conclusion: IONM combined with "classification of EBSLN" can reduce significantly the risk of EBSLN injury in thyroidectomy, which is better than direct ligation of branches without attempts to visually identify the nerve.
Adult ; Female ; Humans ; Laryngeal Nerve Injuries ; Laryngeal Nerves ; Male ; Middle Aged ; Monitoring, Intraoperative ; Prospective Studies ; Thyroid Gland ; Thyroidectomy ; Young Adult

Objective:To investigate the effect of PhysioTouch on upper limb lymphedema after breast cancer surgery. Methods:From September, 2017 to August, 2018, 42 patients with upper limb lymphedema after breast cancer operation were randomly divided into control group (n = 21) and experimental group (n = 21). Both groups accepted complex decongestion therapy, while the experimental group accepted PhysioTouch in addition, for four weeks. They were assessed with difference of upper limb volume, Disabilities of the Arm, Shoulder and Hand (DASH), and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire of Breast Cancer (EORTC QLQ‐BR23) before and after treatment. Results:All the indexes significantly improved in both groups after treatment (t > 17.925, P < 0.001), and improved more in the experimental group than in the control group (t > 2.407, P < 0.05). Conclusion:Combination of PhysioTouch can further relieve upper limb edema after breast cancer operation, and improve their shoulder-hand function and quality of life.

ObjectiveTo sort out and analyze the current situation of research related to patient privacy protection in China in the context of healthcare data sharing， with a view to providing a reference for future research in related fields. MethodsJournal articles related to patient privacy protection were retrieved from China National Knowledge Infrastructure and Wanfang databases from 2018 to 2023. The Cite Space 6.2. R 5 software was used to conduct analysis of keyword cluster and keyword burst. Combined with the specific contents of literature， the current situation of research on patient privacy protection in China was sorted out. ResultsA total of 1，590 articles were included for analysis. The core journal with the most publications was China Medical Ethics （54 articles， 3.40%）. The current situation of research in the field of patient privacy protection in China can be summarized as the privacy issues related to medical care activities， privacy issues caused by new technologies of medical services， and privacy issues in special situations. The results of keyword burst analysis showed that “personal information” and “data sharing” were current hot research topics. ConclusionIn the context of healthcare data sharing， patient privacy protection is still a research hot focus. The current research on the definition of patient privacy protection is relatively limited. It is recommended to deeply explore the understanding of multiple parties on privacy protection and enrich the connotation of patient privacy protection from multiple perspectives in the future. In addition， it is necessary to strengthen medical staff’s awareness and behavioral practice of patient privacy protection， continuously practice the safety and effectiveness of patient privacy protection technology， and further improve legislation related to personal privacy protection in special periods and in the context of health data sharing.