BACKGROUND:Steroid-induced femoral head necrosis is mostly caused by long-term and extensive use of hormones,but its specific pathogenesis is not yet clear and needs further study. OBJECTIVE:To screen out the differential miRNAs in osteoclast exosomes after the intervention of Panax notoginseng saponins,and on this basis,to further construct an osteogenic-related ferroptosis regulatory network to explore the potential mechanism and research direction of steroid-induced osteonecrosis of the femoral head. METHODS:MTT assay was used to detect the toxic effects of different concentrations of dexamethasone and different mass concentrations of Panax notoginseng saponins on Raw264.7 cell line.Tartrate resistant acid phosphatase staining and TUNEL assay were used to detect the effects of Panax notoginseng saponins on osteoclast inhibition and apoptosis.Exosomes were extracted from cultured osteoclasts with Panax notoginseng saponins intervention.Exosomes from different groups were sequenced to identify differentially expressed miRNAs.CytoScape 3.9.1 was used to construct and visualize the regulatory network between differentially expressed miRNAs and mRNAs.Candidate mRNAs were screened by GO analysis and KEGG analysis.Finally,the differential genes related to ferroptosis were screened out,and the regulatory network of ferroptosis-related genes was constructed. RESULTS AND CONCLUSION:(1)The concentration of dexamethasone(0.1 μmol/L)and Panax notoginseng saponins(1 736.85 μg/mL)suitable for intervention of Raw264.7 cells was determined by MTT assay.(2)Panax notoginseng saponins had an inhibitory effect on osteoclasts and could promote their apoptosis.(3)Totally 20 differentially expressed miRNAs were identified from osteoclast-derived exosome samples,and 11 differentially expressed miRNAs related to osteogenesis were predicted by target mRNAs.The regulatory networks of 4 up-regulated differentially expressed miRNAs corresponding to 155 down-regulated candidate mRNAs and 7 down-regulated differentially expressed miRNAs corresponding to 238 up-regulated candidate mRNAs were constructed.(4)Twenty-four genes related to ferroptosis were screened out from the differential genes.Finally,12 networks were constructed(miR-98-5p/PTGS2,miR-23b-3p/PTGS2,miR-425-5p/TFRC,miR-133a-3p/TFRC,miR-185-5p/TFRC,miR-23b-3p/NFE2L2,miR-23b-3p/LAMP2,miR-98-5p/LAMP2,miR-182-5p/LAMP2,miR-182-5p/TLR4,miR-23b-3p/ZFP36,and miR-182-5p/ZFP36).These results indicate that Panax notoginseng saponins may regulate osteoblast ferroptosis by regulating the expression of miRNAs derived from osteoclast exosomes,thus providing a new idea for the study of the mechanism of steroid-induced femoral head necrosis.

Objective To investigate the clinical efficacy of dot matrix laser combined with subcutaneous separation in the treatment of depressed acne scar.Methods A total of 86 patients with depressed acne scar admitted to the Second Affiliated Hospital of Nanchang University from February 2022 to August 2023 were selected and divided into dot matrix group and combined group according to random number table method,with 43 cases in each group.The patients in dot matrix group were treated with dot matrix laser,and the patients in combined group were treated with dot matrix laser combined with subcutaneous separation.The visual analogue scale(VAS)score,echelle d'evaluation clinique des cicatrices d'acne(ECCA)score,pigmentation area,scar area,treatment satisfaction and adverse reactions were compared between two groups.Results There was no significant difference in VAS scores between two groups after the first treatment and the second treatment(P>0.05).Three months after treatment,the ECCA score of combined group was significantly lower than that of dot matrix group,and the pigmentation area and scar area were significantly smaller than those of dot matrix group(P<0.05).The total satisfaction of patients in combined group was significantly higher than that in dot matrix group(χ2=4.746,P=0.029).There was no significant difference in the occurrence of adverse reactions between two groups(χ2=0.453,P=0.501).Conclusion Dot matrix laser combined with subcutaneous separation in the treatment of depressed acne scar can effectively promote scar repair,reduce skin pigmentation area and scar area,and do not increase pain,with good safety and high patient satisfaction.

As a source of traffic-related air pollution, diesel particulate matter (DPM) associate with a variety of lung-related diseases, but there is no systematic review of the relationship between DPM and the development and progression of asthma. This article reviewed the relationship between DPM and asthma, the effect and mechanism of DPM on airway inflammation and remodeling in asthma, and illustrated that DPM exposure may participate in airway inflammation and remodeling through oxidative stress, immune regulation and regulation of lung and intestinal microecology, so as to promote the development and progression of asthma.

Objective:To investigate the preoperative and intraoperative risk factors of clinical pancreatic fistula after laparoscopic pancreaticoduodenectomy (LPD).Methods:Clinical data of 100 patients undergoing LPD at the Second Department of Hepatobiliary and Pancreatic Surgery of the First Hospital of Jilin University from Jan 2019 to May 2019 were studied.Results:The total incidence of pancreatic fistula was 8%, and the incidence of clinical pancreatic fistula (grade B, C) was 6%. Univariate analysis found that gender (male), preoperative pancreatic plain CT value <33HU, soft texture of the pancreas, long operation time, alcoholic consuming history may be risk factors for pancreatic fistula after LPD( P<0.05), and further multivariate analysis found gender (male), preoperative pancreatic plain CT value <33 HU, soft texture of the pancreas were independent risk factors for clinical pancreatic fistula after LPD( P<0.05). Conclusions:Male patients, preoperative pancreatic plain CT value <33HU, soft texture of the pancreas were respectively independent risk factors predicting post-LPD clinical pancreatic fistula.

Objective? To compare the effects of constant pressure urination and timed urination during indwelling catheterization in elderly patients with coma in the emergency intensive care unit (EICU). Methods? Totally 100 elderly patients with coma admitted in EICU, the First Affiliated Hospital of Huzhou University from January 2015 to June 2017 were selected by convenient sampling. The 49 patients admitted from January 2015 to March 2016 were included into the control group, while the 51 patients admitted between April 2016 and June 2017 were included into the treatment group. Patients in the control group were allowed urination every 3-4 hours, while patients in the treatment group were monitored for continuous bladder pressure using a

BACKGROUND: The morbidity of lung cancer has long been the highest in cancer. Stage I, stage II and partly of stage III non-small cell lung cancer (NSCLC) are mainly treated by surgery. Lobectomy and segmentectomy both are common lung resection methods. Video-assisted thoracoscopic surgery (VATS) has been widely used in clinical, and the application of single-portvideo-assisted thoracoscopic surgery (SP VATS) has gradually been recognized and accepted by professors. With increasing degree of eldly in society, eldly patients already have become inceasingly difficulties in the diagnosis and treatment of NSCLC. The aim of this study is to explore and analyze clinical value of SP VATS lobectomy and segmentectomy in elderly patients with NSCLC. METHODS: In this retrospective observational study, the outcomes of 417 consecutive patients who had undergone SP VATS anatomic segmentectomy or lobectomy for NSCLC from May 2014 to December 2016 on department of thoracic surgery in Fujian Medical University Affiliated Union Hospital were examined, including 139 elderly-case (lobectomy vs segmentectomy: 124 vs 15) and 278 nonelderly-case (lobectomy vs segmentectomy: 248 vs 30). The condition of perioperative period and postoperative short-time recovery could be compared with lobectomy and segmentectomy between elderly and nonelderly cases and lobectomy and segmentectomy in elderly cases. RESULTS: The morbidty of preoperative complications was significant difference (P<0.05) in comparing with elderly and non-elderly patients with NSCLC either in SP VATS anatomic segmentectomy orlobectomy, except others is no significant difference (P>0.05). Numbers of dissected lymph nodes and mediastinal nodal stations of SP VATS lobectomy in elderly patients with NSCLC were more than segmentectomy (P<0.05), which were (7.61±0.21) vs (20.39±0.97) and (5.60±0.35) vs (15.40±2.64). But there was not significant difference between two elderly groups of SP VATS lobectomy and anatomic segmentectomy in age, morbidty of preoperative complications, average operation time and intraoperative blood loss (P>0.05). Postoperative drainage volume [(1,150.15±140.02) mL vs (853.53±177.04) mL] and duration [(7.00±1.31) d vs (5.00±0.74) d], duration of postoperative hospital stay [(3.18±1.32) d vs (5.04±1.30) d], costs [(70.06±5.23) thousands yuan vs (61.20±5.22) thousands yuan ] or postoperative complications (5.97% vs 20.00%)(P>0.05). Notwithstanding, group of SP VATS anatomic segmentectomy found more postoperative atrialfibrillation and the vein thrombosis of lower limbs (P<0.05). CONCLUSIONS Elderly patients having more basic diseases and taking increasely risk of postoperative complications. SP VATS anatomic segmentectomy andlobectomy do not increase the risk of elderly patients with surgery. SP VATS segmentectomy is as safe and effective as SP VATS lobectomy in elderly patients, who fit to undergo SP VATS segmentectomy seem to get as same short-time effect as SP VATS lobectomy.
Aged ; Carcinoma, Non-Small-Cell Lung ; pathology ; surgery ; Female ; Humans ; Length of Stay ; Lung Neoplasms ; pathology ; surgery ; Lymph Node Excision ; Male ; Mastectomy, Segmental ; methods ; Middle Aged ; Pneumonectomy ; methods ; Postoperative Complications ; etiology ; Retrospective Studies ; Thoracic Surgery, Video-Assisted ; methods

The cardiovascular disease, accompanied by psychological disorder frequently, often re-quiresphysical and mental (double heart) treatment. The clinical teaching of cardiovascular graduate stu-dents is very important for cultivating qualified cardiovascular doctors. According to present situation, we improved the diagnosis rate and the doctor-patient communication skills by the strengthening of learning thedouble heart theory, the analysis ofdouble heart typical cases, and the clinical practice of double heart medical model. Accordingly, we enhanced the consciousness of double heart, which is helpful to reducing the conflicts between doctors and patients, promoted the rational use of medical resources, and fi-nally promoted the application ofdouble heartmedical model in clinical practice.

This study was aimed to observe the effects ofTian-ShuDripping Pills (TSDP) on cerebral hemodynamics among anesthetized dogs, in order to demonstrate its clinical treatment functional correlation on angioneurotic headache. A total of 25 hybrid dogs were randomly divided into the normal saline (NS) group, TS capsule (positive control: 0.4 g·kg-1 crude medicine) group, low-dose TSDP (0.2 g·kg-1 crude medicine) group, middle-dose TSDP (0.4 g·kg-1 crude medicine) group, and high-dose TSDP (0.8 g·kg-1 crude medicine) group.Intraduodenal administration was given once under anesthesia. Changes of mean arterial blood pressure, blood flow of vertebral artery and internal carotid artery blood flow were detected and the cerebral blood flow and cerebral vascular resistance were calculated. The results showed that TSDP of low-dose, middle-dose and high-dose group can significantly reduce the cerebral vascular resistance and increase the cerebral blood flow within 180 min after medication. It was concluded that TSDP can improve the cerebral blood circulation of anesthetized dogs. Its mechanism may be through the reduction on cerebral vascular resistance and increasing of cerebral blood flow.

Objective By the designing and clinical application of score table and focus nursing sheet to brain trauma patients,paramedics can observe state of illness individually,optimize the nursing care in a further performance,and ensure the security of brain trauma patients more profitably.Methods To design the score table and focus nursing sheet according to the disease species and symptoms,contrast to the previous nurse observing table in noting time,error rate,exam results and surgeon satisfaction degree.Results By evaluating 130 cases in this test,the score table and focus nursing sheet were superior to the previous nurse observing table.Conclusions With the score table and focus nursing sheet,nurses can observe the illness and note the progress more scientifically and conveniently,the concept of individuation and specialization are worthy of recommending.

ObjectiveTo investigate clinical application of intraoperative intraperitoneal hyperthermic chemotherapy using sustained-release fluorouracil in radical gastrectomy for advanced gastric cancer.MethodsThe clinical data of 280 advanced gastric cancer patients admitted from September,2002 to September,2010 were analyzed retrospectively.They were divided into three groups randomly and followed up.The postoperative morbidity,the mortality and the overall survival rates were evaluated.ResultsThere were no significant differences in these three groups with respect to postoperative morbidity ( P ＞ 0.05 ).The incidence of recurrence in intraperitoneal chemotherapy using sustained-release fluorouracil ( treatment group) was significantly lower than those of intraperitoneal chemotherapy and operative treatment( 16.18％,37.61％ and 41.28％,P ＜0.05).The 1,3- and 5-year overall survival rates of treatment group were 85.51％,61.28％ and 53.67％,respectively,and the 1-,3- and 5-year overall survival rates were 84.11％,39.98％ and 28.12％,and 81.28％,29.88％ and 25.21％ respectively in intrapeitoneal chemotherapy group and operative group.1-year overall survival rate had no significant differences among three groups with respect to ( P＞0.05).3-and 5-year overall survival rates in treatment group were higher signfficantly than those of intraperitoneal chemotherapy and operative treatment( P＜0.05).Conclusions Intraoperative intrapeitoneal hyperthermic chemotherapy using sustained-release fluorouracil is a kind of convenient,safe,and highly effective comprehensive treatment method,and it can kill isolated intraperitoneal cancer cells.It may reduce postoperative recurrence and improve survival rates.