Objective:To compare the short-term clinical outcomes of thoracoscopy-assisted minimally invasive mitral valve surgery(minimally invasive cardiac surgery MICS group)versus conven-tional median sternotomy mitral valve surgery(conventional surgery group),including surgical metrics,postoperative complications,transfusion volume,and in-hospital mortality rate.Methods:A ret-rospective analysis was performed for 141 patients who underwent mitral valve surgery in Chongqing General Hospital from January 2021 to June 2022,and these patients were divided into MICS group with 42 patients and conventional surgery group with 99 patients.Propensity score matching at a ratio of 1∶1 was performed to ob-tain 82 patients,with 41 patients in each group,and related data were collected and compared,including surgical procedure,cardiopul-monary bypass time,postoperative ventilation time,transfusion volume,and in-hospital mortality.Results:There were no significant differences between the MICS group and the conventional surgery group in sex,age,cardiac functional grading,and comorbidity with diabetes or hypertension,and as for the surgical procedure,there was no significant difference between the two groups in the number of patients undergoing atrial fibrillation radiofrequency ablation(11/42 vs.26/99,P=0.583)or tricuspid valvuloplasty(14/42 vs.39/99,P=0.310).Compared with the conventional surgery group,the MICS group had significantly longer aortic cross-clamp time[(122±48)min vs.(91±50)min,P=0.031]and cardiopulmonary bypass time[(180±73)min vs.(136±72)min,P=0.033],while there was no significant difference in postoperative ventilation time between the two groups after surgery[18.6(12.0,36.2)h vs.24.0(15.5,33.1)h,P=0.265].There was no significant difference in the number of patients with acute renal failure after surgery between the MICS group and the conventional surgery group[grade 1:3(42)vs.7(99);grade 2:0(42)vs.2(99);grade 3:1(42)vs.9(99);P=0.398].There was also no significant difference in the number of patients receiving hemodialysis after surgery between the two groups[1(42)vs.4(99),P=0.531].The MICS group had a significantly lower postoperative transfusion volume than the conventional surgery group[120(80,240)mL vs.400(200,600)mL,P=0.002],and there was no significant difference in in-hospital mortality rate between the two groups[1(42)vs.2(99),P=0.665].After propensity score matching,there were no significant differences between the two groups in general characteristics(sex,age,and comorbidities).Compared with the conventional surgery group,the MICS group had longer cardiopulmonary bypass time[(165±73)min vs.(122±74)min,P=0.053]and aortic cross-clamp time[(119±48)min vs.(98±52)min,P=0.073]and a significantly lower postoperative transfusion volume[120(80,240)mL vs.400(200,600)mL,P<0.001].There were no significant differences between the two groups in 30-day in-hospital mortality rate and postoperative compli-cations(including acute renal failure and requirement for hemodialysis).Conclusion:Thoracoscopy-assisted minimally invasive mitral valve surgery has comparable short-term clinical outcomes and safety to conventional sternotomy.Although MICS requires longer cardiopulmonary bypass time and aortic cross-clamp time,it has relatively low requirements for postoperative transfusion and shows favorable clinical outcomes.

Objective To construct the machine learning models based on the radiomic features of non-contrast and enhanced CT and to evaluate the predictive value in the risk stratification of gastrointestinal stromal tumor(GIST).Methods A total of 182 patients with pathologically confirmed GIST were randomly divided into a training set and a validation set at a ratio of 7∶3.The volume of interest(VOI)was outlined in the non-contrast phase,arterial phase and venous phase,and its radiomic features were extracted.The most valuable radiomic features were selected using the least absolute shrinkage and selection operator(LASSO)algorithm.The logistic regression(LR)classifier was used to construct the prediction models based on single-phase or multi-phase images.The predictive efficacy of the different models was compared by using receiver operating characteristic(ROC)curves.Results Four,three,and four radiomic features were selected in the non-contrast phase,arterial phase and venous phase,and 4 models were constructed in total.Among the single-phase models,the venous phase had better predictive efficacy,with the area under the curve(AUC)of 0.932[95％confidence interval(CI)0.873-0.969]and 0.924(95％CI 0.819-0.979)in the training and validation sets.The predictive efficacy of the combined model was improved,with the AUC of 0.946(95％CI 0.891-0.978)and 0.938(95％CI 0.838-0.986).Conclusion The venous phase model can predict the risk stratification of GIST accurately,and the prediction efficacy can be improved by combining the non-contrast and arterial phases.

Objective:To analyze the clinical application value of serum heme oxygenase (HO)-1expression level in non-alcoholic fatty liver disease (NAFLD) and, based on that, establish a diagnostic model combined with glucose regulatory protein 78 (GRP78) so as to clarify its diagnostic effectiveness and application value.Methods:A total of 210 NAFLD patients diagnosed by abdominal B-ultrasound and liver elastography were included, and at the same time, 170 healthy controls were enrolled. The general clinical data, peripheral blood cell counts, and biochemical indicators of the research subjects were collected. The expression levels of HO-1 and GRP78 were detected using an enzyme-linked immunosorbent assay. Multivariate analysis was used to screen independent risk factors for NAFLD. Visual output was performed through nomogram diagrams, and the diagnostic model was constructed. Receiver operating characteristic curve (ROC), calibration curve, and decision curve analysis (DCA) were used to evaluate the diagnostic effectiveness of NAFLD. Measurement data were analyzed using a t-test or Mann-Whitney U rank sum test to detect data differences between groups. Enumeration data were analyzed using the Fisher's exact probability test or the Pearson χ2 test. Results:Compared with the healthy control group, the white blood cell count, aspartate aminotransferase (AST), alanine aminotransferase, gamma-glutamyl transferase (GTT), fasting blood glucose (Glu), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), serum HO-1, and GRP78 levels were significantly increased in the NAFLD group patients ( P ?

Endodontic diseases are a kind of chronic infectious oral disease.Common endodontic treatment concepts are based on the removal of inflamed or necrotic pulp tissue and the replacement by gutta-percha.However,it is very essential for endodontic treatment to debride the root canal system and prevent the root canal system from bacterial reinfection after root canal therapy(RCT).Recent research,encompassing bacterial etiology and advanced imaging techniques,contributes to our understanding of the root canal system's anatomy intricacies and the technique sensitivity of RCT.Success in RCT hinges on factors like patients,infection severity,root canal anatomy,and treatment techniques.Therefore,improving disease management is a key issue to combat endodontic diseases and cure periapical lesions.The clinical difficulty assessment system of RCT is established based on patient conditions,tooth conditions,root canal configuration,and root canal needing retreatment,and emphasizes pre-treatment risk assessment for optimal outcomes.The findings suggest that the presence of risk factors may correlate with the challenge of achieving the high standard required for RCT.These insights contribute not only to improve education but also aid practitioners in treatment planning and referral decision-making within the field of endodontics.

The overall health condition of patients significantly affects the diagnosis,treatment,and prognosis of endodontic diseases.A systemic consideration of the patient's overall health along with oral conditions holds the utmost importance in determining the necessity and feasibility of endodontic therapy,as well as selecting appropriate therapeutic approaches.This expert consensus is a collaborative effort by specialists from endodontics and clinical physicians across the nation based on the current clinical evidence,aiming to provide general guidance on clinical procedures,improve patient safety and enhance clinical outcomes of endodontic therapy in patients with compromised overall health.

Gap junction is a necessary channel structure composed of connexin proteins, which can form direct communication to exchange material and information between mammal cells. Connexin 43(Cx43)is the most abundant connexin protein expressed in the central nervous system. There is emerging evidence that Cx43 has a wide regulatory effect on the occurrence and development of glioma and play an important role in malignant biological behaviors of glioma. Temozolomide is a currently first-line chemotherapeutic drug for glioma. However, with the prolong of treatment period, the therapy effect of temozolomide is attenuated in some patients because of drug resistance. And the abnormal expression of Cx43 in glioma may be one of the important reasons for temozolomide resistance. In this review, we summarized the structure and function of Cx43, several mechanism of temozolomide resistance and the research progress of Cx43-mediated temozolomide resistance, as well as anti-tumor compounds targeting Cx43 in recent years, in order to provide new evidence for glioma therapy.

Objective: To evaluate recent prognosis of patients with acute ST elevation myocardial infarction (STEMI) treated by primary percutaneous coronary intervention (PCI), and explore related risk factors.Methods: Clinical data of 168 STEMI patients undergoing primary PCI were retrospectively analyzed.According to occurrence of major adverse cardiovascular events (MACE) within 30d or not, they were divided into poor prognosis group (n=40) and good prognosis group (n=128).Clinical data were compared between two groups.Logistic regression analysis was used to analyze independent risk factors for MACE.Results: Incidence rate of MACE was 23.81% among the 168 STEMI patients.Logistic regression analysis indicated that age (OR=1.326, 95%CI 1.168~1.505), family history of coronary heart disease (OR=1.852, 95%CI 1.369~2.505), number of diseased vessels ≥2 (OR=1.682, 95%CI 1.382~2.047), Killip′s class Ⅲ~Ⅳ (OR=1.693, 95%CI 1.428~2.007) and onset-to-PCI time (OR=1.785, 95%CI 1.425~2.236) were the independent risk factors, P<0.01 all;TIMI grade 3 (OR=0.623, 95%CI 0.518~0.749) and tirofiban application (OR=0.452, 95%CI 0.367~0.557) were independent protective factors for MACE, P<0.01 both.Conclusion: Advanced aged, family history of coronary heart disease, number of diseased vessels ≥2, poor cardiac function and long onset-to-PCI time are independent risk factors, while TIMI grade 3 and tirofiban application are independent protective factors for MACE.

Objective To compare the differences in the blood pressure values by 3 types of noninvasive blood pressure meas-urement instruments , so as to provide evidence for the selection of noninvasive blood pressure measurement instruments applied to the o -cean-going ship.Methods The blood pressure values of 50 afloat personnel were measured 3 times consecutively with desktop mercuri-al sphygmomanometer (Group A), spring type sphygmomanometer (Group B) and multifunctional monitor (Group C), before and dur-ing deployment.Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were detected and recorded.Then, differences in the mean blood pressure values detected both before and after deployment at sea and the percentage of the 3 detected mean SBP values (>5 mmHg) were analyzed statistically .Results There were significant statistical differences in the mean SBP values of group A de-tected before and after deployment (P <0.001), but no statistical significance could be noted in the mean DBP values , when compar-isons were made between the pre and post deployment values (P>0.05).Nevertheless, there were no significant statistical differences in the mean SBP and DBP values of group B and group C detected before and after deployment (P>0.05).The percentage of the 3 SBP and DBP data (>5 mmHg) detected before deployment was 6%/4%, 10%/6%and 42%/23%in groups A, B and C, and that of the SBP and DBP data detected during deployment was 36%/19%,16%/10%and 46%/27%, respectively .Conclusion Ship de-ployment had certain effects on the accuracy and repeatability of the 3 types of blood pressure measurement instruments , the mercurial sphygmomanometer in particular .It was suggested that the spring sphygmomanometer calibrated just recently was the first choice of blood pressure measurement instrument applied to the ocean-going ship.

The lentiviral vector was used for construction of a recombinant mediating RNA interference (RNAi) against Beclin1 gene in this study. Recombinant vector plasmid was transfected into non small cell lung cancer (NSCLC) A549 cells by liposome. PCR results showed that three amplified positive fragments were inserted into pRNAT-U6. 2/Lenti vectors. DNA sequencing results showed that the three recombinant lentivirus plasmids, pRNAT-U6. 2/Lenti-si356, pRNAT-U6. 2/Lenti-si423 and pRNAT-U6. 2/ Lenti-si684 were constructed successfully. After transfection with liposome, RT-PCR and Western blot analysis confirmed that the expression of Beclin1 mRNA and protein was inhibited in the three recombinant lentivirus plasmids transfected groups, and gene silencing efficacy was 35.56%, 89.22% and 66.78%, respectively. The results demonstrated that the lentiviral vectors of RNAi targeting Beclin1 gene were successfully constructed, and NSCLC A549 stable cell line with Beclin1 gene knockdown was established. This study finally provided a new cell model to explore the biological behavior of the Beclin1 gene in NSCLC A549 cells.
Apoptosis Regulatory Proteins ; genetics ; Autophagy ; genetics ; Base Sequence ; Beclin-1 ; Carcinoma, Non-Small-Cell Lung ; genetics ; pathology ; Cell Line, Tumor ; Genetic Vectors ; genetics ; Humans ; Lentivirus ; genetics ; Lung Neoplasms ; genetics ; pathology ; Membrane Proteins ; genetics ; Molecular Sequence Data ; RNA Interference ; RNA, Small Interfering ; genetics ; Transfection

Objective To investigate the expression of Dysadherin and analyze its role in renal clear cell carcinoma (RCCC).Methods RT-PCR and immunohistochemical were used to detect the expression of Dysadherin in 60 cases of fresh RCCC and 60 adjacent normal renal tissues(male 35,female 25; age 37-78,median age 61; ＞7 cm 24,≤7 cm 36; Ⅰ/Ⅱ 39,Ⅲ/Ⅳ 21).Results Dysadherin mRNA expression in RCCC tissues (2.0043±0.2890) was higher than that in adjacent normal renal tissues (0.8461 ±0.2479) (t =6.8020,P ＜ 0.05).Dysadherin expression was associated with nuclear grade.The expression of Dysadherin in nucleus grade Ⅲ and Ⅳ tumors were significantly higher than that in nucleus grade Ⅰ and Ⅱ tumors [the mRNA expression were 4.6224±0.3194,2.7780±0.2288,the positive rates of protein were 64.1％ (25/39),95.2 ％ (20/21) (t =6.5750,x2 =5.495,P ＜ 0.05)].There was no association between the expression of Dysadherin with sex (t =1.0530,x2 =0.023),age(t =0.0511,x2 =0.089) and tumor size (t =1.0330,x2 =0.370) (P ＞ 0.05).Conclusion In RCCC,Dysadherin expression is positively associated with tumor aggressiveness based on grading.It seems that Dysadherin may be a valuable prognostic marker in RCCC.