OBJECTIVES: To study the molecular mechanisms of LDH-loaded si-NEAT1 for regulating paclitaxel resistance and tumor-associated macrophage (TAM) polarization in breast cancer. METHODS: qRT-PCR and Western blotting were used to detect the expression of lncRNA NEAT1, miR-133b, and PD-L1 in breast cancer SKBR3 cells and paclitaxel-resistant SKBR3 cells (SKBR3-PR). The effects of transfection with si-NEAT1 and miR-133b mimics on MRP, MCRP and PD-L1 expressions and cell proliferation, migration and apoptosis were investigated using qRT-PCR, Western blotting, scratch and Transwell assays, and flow cytometry. Rescue experiments were conducted using si-NEAT1 and miR-133b inhibitor. Human THP-1 macrophages were cultured in the presence of conditioned media (CM) derived from SKBR3 and SKBR3-PR cells with or with si-NEAT1 transfection for comparison of IL-4-induced macrophage polarization by detecting the surface markers. LDH@si-NEAT1 nanocarriers were constructed, and their effects on MRP, MCRP and PD-L1 expressions and cell behaviors of the tumor cells were examined. THP-1 cells were treated with the CM from LDH@si-NEAT1-treated tumor cells, and the changes in their polarization were assessed. RESULTS: SKBR3-PR cells showered significantly upregulated NEAT1 and PD-L1 expressions and lowered miR-133b expression as compared with their parental cells. Transfection with si-NEAT1 and miR-133b mimics inhibited viability, promoted apoptosis and enhanced MRP and BCRP expressions in SKBR3-PR cells. NEAT1 knockdown obvious upregulated miR-133b and downregulated PD-L1, MRP and BCRP expressions. The CM from SKBR3-PR cells obviously promoted M2 polarization of THP-1 macrophages, which was significantly inhibited by CM from si-NEAT1-transfected cells. Treatment with LDH@si-NEAT1 effectively inhibited migration and invasion, promoted apoptosis, and reduced MRP, BCRP and PD-L1 expressions in the tumor cells. The CM from LDH@si-NEAT1-treated SKBR3-PR cells significantly downregulated Arg-1, CD163, IL-10, and PD-L1 and upregulated miR-133b expression in THP-1 macrophages. CONCLUSIONS LDH@si-NEAT1 reduces paclitaxel resistance of breast cancer cells and inhibits TAM polarization by targeting the miR-133b/PD-L1 axis.
Humans ; MicroRNAs/genetics* ; RNA, Long Noncoding/genetics* ; Paclitaxel/pharmacology* ; Breast Neoplasms/metabolism* ; Drug Resistance, Neoplasm ; B7-H1 Antigen/metabolism* ; Cell Line, Tumor ; Female ; Tumor-Associated Macrophages ; Apoptosis ; Cell Proliferation ; Macrophages ; Cell Movement

Since the outbreak of corona virus disease 2019(COVID 19), the epidemic has spread rapidly, which brings great challenge to the surgical diagnosis, treatment and management of lung neoplasm Sichuan International Medical Exchange &Promotion Association organized thoracic surgery experts to sum up experiences from experts in major hospital, and formulated the Guidance suggestion on surgical diagnosis, treatment and management of lung neoplasm during the outbreak of COVID-19 to provide references for thoracic surgeons.

Objective To investigate the effects of mild thalassemia on hypoxia tolerance of civil aviation student pilots ,and provide the basis for aviation medical identification of thalassemia in civil aviation pilots. Methods The parameters of red blood cells and hemoglobin were analyzed in 1 711 subjects including the student candidates who were checked in the physical examination for recruitment and the student pilots of flight college.The thalassemia gene tests were performed for the subjects with small cell and low pigmented anemia to diagnose if they were with thalassemia.Twenty-five mild thalassemia cases and 19 healthy cases were chosen for the comparison according to the principles of proximity and phone call reachable.The hypoxia test was conducted at 7.5 km simulated altitude by Model 2007 anti-G/anti-hypoxia Detector.SaO2, heart rate and blood pressure were respectively recorded at 20 s ,60s and 120 s of the test.In case of the test did not reach to 120 s but the SaO2had been lower than 60% the test was terminated and the SaO2,heart rate and blood pressure were marked at the moment.The subjects were tested by writing digits with down sequence before and after hypoxia test.In 7.5 km simulated altitude test if the SaO 2level had decreased to 60% within 120 s the test would be terminated and the actual test duration was recorded. Results ①Ninety-seven cases of thalassemia were found in 1 711 students (5.67%) and all cases were mild thalassemia.The highest detection rate was found in the students of Hainan Province ,accounting for 20%.②The difference of test duration was statistically significant between mild thalassemia group and health group under simulated 7.5 km altitude hypoxia environment (Z＝3.630 ,P＜0.01).The difference of SaO2at 60 s was not statistically significant between two groups (P＞0.05) ,but the difference at the end of test was statistically significant (t＝5.248 ,P＜0.01).The differences of heart rate at 60 s and at the end of test were not statistically significant between two groups (P＞ 0.05).The difference of systolic pressure at 60 s and the difference of diastolic pressure at the end of test were statistically significant between two groups [(t＝ 2.215 , P＝ 0.029) and (t＝ 2.518 , P＝ 0.018)].The difference on the number of correctly writing digits with down sequence was insignificant between two groups before the hypoxia test (P＞0.05) ,but was significant after the test (t＝3.489 , P＜0.01). Conclusions The hypoxia tolerance of the patients with mild thalassemia is lower than that of the healthy population.It is suggested that more attention should be paid to the candidates with mild thalassemia in the physical examination for recruiting student pilots.The pilots with mild thalassemia should minimize the flying on plateau.

Objective To investigate the effects of mild thalassemia on hypoxia tolerance of civil aviation student pilots ,and provide the basis for aviation medical identification of thalassemia in civil aviation pilots. Methods The parameters of red blood cells and hemoglobin were analyzed in 1 711 subjects including the student candidates who were checked in the physical examination for recruitment and the student pilots of flight college.The thalassemia gene tests were performed for the subjects with small cell and low pigmented anemia to diagnose if they were with thalassemia.Twenty-five mild thalassemia cases and 19 healthy cases were chosen for the comparison according to the principles of proximity and phone call reachable.The hypoxia test was conducted at 7.5 km simulated altitude by Model 2007 anti-G/anti-hypoxia Detector.SaO2, heart rate and blood pressure were respectively recorded at 20 s ,60s and 120 s of the test.In case of the test did not reach to 120 s but the SaO2had been lower than 60% the test was terminated and the SaO2,heart rate and blood pressure were marked at the moment.The subjects were tested by writing digits with down sequence before and after hypoxia test.In 7.5 km simulated altitude test if the SaO 2level had decreased to 60% within 120 s the test would be terminated and the actual test duration was recorded. Results ①Ninety-seven cases of thalassemia were found in 1 711 students (5.67%) and all cases were mild thalassemia.The highest detection rate was found in the students of Hainan Province ,accounting for 20%.②The difference of test duration was statistically significant between mild thalassemia group and health group under simulated 7.5 km altitude hypoxia environment (Z＝3.630 ,P＜0.01).The difference of SaO2at 60 s was not statistically significant between two groups (P＞0.05) ,but the difference at the end of test was statistically significant (t＝5.248 ,P＜0.01).The differences of heart rate at 60 s and at the end of test were not statistically significant between two groups (P＞ 0.05).The difference of systolic pressure at 60 s and the difference of diastolic pressure at the end of test were statistically significant between two groups [(t＝ 2.215 , P＝ 0.029) and (t＝ 2.518 , P＝ 0.018)].The difference on the number of correctly writing digits with down sequence was insignificant between two groups before the hypoxia test (P＞0.05) ,but was significant after the test (t＝3.489 , P＜0.01). Conclusions The hypoxia tolerance of the patients with mild thalassemia is lower than that of the healthy population.It is suggested that more attention should be paid to the candidates with mild thalassemia in the physical examination for recruiting student pilots.The pilots with mild thalassemia should minimize the flying on plateau.

Objective To understand the early experiences of acute ischemic stroke (AIS) patients after intravenous thrombolysis. Methods By purposive sampling method, and according to principle of sample saturation, semi-structure interview was conducted to inpatients who had undergone acute ischemic stroke and were treated with intravenous thrombolysis in Neurology Department in a comprehensive class Ⅲ grade A hospital in Shenzhen from March to September 2016. Colaizzi method was used for the analysis of interview content. Results Early experiences of acute ischemic stroke patients after intravenous thrombolysis can be concluded as four subjects: perceived body difference, heavy psychological burden, adaptation to new roles, and expectation of support from medical staff and family members. Conclusions For AIS patients, different experiences and needs appeared from the attack to the recovery period after thrombolysis, according to which, individualized nursing measures should be adopted by doctors and nurses.

Objective To analyze the clinical manifestation of cerebrovascular stenosis and relevant risk factors for aircrews,and to discuss the aviation medical appraisal.Methods One hundred and thirty four aircrews were assigned to stenosis group according to the MRA diagnosis.The location and severity of stenosis were analyzed.Two hundred and two aircrews,who were without cerebral vascular abnormalities,were randomly selected as the control group.The age,blood lipids,SBP,DBP,FBG,and BMI were compared between 2 groups.Logistic regression analysis was used to analyze the correlativity between risk factors and cerebral vascular stenosis.Results ①In 134cerebral artery stenosis aircrews,the middle cerebral artery stenosis accounted most for 36.57％ (49cases),the anterior cerebral artery stenosis accounted least for 6.72％ (9 cases).There was a significant difference between the incidences of unilateral cerebral vascular stenosis and bilateral cerebral vascular stenosis (x2 =25.40,7.82,P＜0.05).The unilateral cerebral vascular stenosis was most frequent despite the stenosis location (x2 =9.00-22.20,P＜0.01).②The stenosis severity showed significant difference among all locations of the cerebral vascular stenosis (x2 =27.00-155.70,P＜ 0.01).The incidence of mild cerebral vascular stenosis was significantly higher than that of moderate,severe cerebral vascular stenosis and cerebral vascular occlusion (x2=230.00,P＜0.01).③There were significant differences on SBP,DBP,TG,HDL-C and LDL-C between stenosis group and control group (t=1.99-2.89,P＜0.05),but no significant difference on age,blood glucose and BMI (P＞0.95).Age,DBP and LDL-C were the independent risk factors of cerebral vascular stenosis (z=2.43-3.55,P＜0.05).Conclusions Most of the cerebral vascular stenosis of aircrews is located at middle cerebral artery and cerebral internal carotid artery and the main manifestation is unilateral,mild and asymptomatic.For the aircrew with unilateral and asymptomatic stenosis,qualification and follow-up are suggested.But the aircrews who have severe cerebral vascular stenosis or any symptoms should be disqualified.The risk factors of cardiovascular and cerebrovascular should be closely supervised.

Objective To analyze the clinical manifestation of cerebrovascular stenosis and relevant risk factors for aircrews,and to discuss the aviation medical appraisal.Methods One hundred and thirty four aircrews were assigned to stenosis group according to the MRA diagnosis.The location and severity of stenosis were analyzed.Two hundred and two aircrews,who were without cerebral vascular abnormalities,were randomly selected as the control group.The age,blood lipids,SBP,DBP,FBG,and BMI were compared between 2 groups.Logistic regression analysis was used to analyze the correlativity between risk factors and cerebral vascular stenosis.Results ①In 134cerebral artery stenosis aircrews,the middle cerebral artery stenosis accounted most for 36.57％ (49cases),the anterior cerebral artery stenosis accounted least for 6.72％ (9 cases).There was a significant difference between the incidences of unilateral cerebral vascular stenosis and bilateral cerebral vascular stenosis (x2 =25.40,7.82,P＜0.05).The unilateral cerebral vascular stenosis was most frequent despite the stenosis location (x2 =9.00-22.20,P＜0.01).②The stenosis severity showed significant difference among all locations of the cerebral vascular stenosis (x2 =27.00-155.70,P＜ 0.01).The incidence of mild cerebral vascular stenosis was significantly higher than that of moderate,severe cerebral vascular stenosis and cerebral vascular occlusion (x2=230.00,P＜0.01).③There were significant differences on SBP,DBP,TG,HDL-C and LDL-C between stenosis group and control group (t=1.99-2.89,P＜0.05),but no significant difference on age,blood glucose and BMI (P＞0.95).Age,DBP and LDL-C were the independent risk factors of cerebral vascular stenosis (z=2.43-3.55,P＜0.05).Conclusions Most of the cerebral vascular stenosis of aircrews is located at middle cerebral artery and cerebral internal carotid artery and the main manifestation is unilateral,mild and asymptomatic.For the aircrew with unilateral and asymptomatic stenosis,qualification and follow-up are suggested.But the aircrews who have severe cerebral vascular stenosis or any symptoms should be disqualified.The risk factors of cardiovascular and cerebrovascular should be closely supervised.

Humans ; Liver Cirrhosis ; Renin-Angiotensin System ; Self-Control

Objective To explore targeted time management to shorten the time from arriving hospital to thrombolysis ( DNT ) . Methods A total of 42 suspected acute ischemic stroke ( AIS ) patients were underwent the targeted time management from pre-hospital until emergency thrombolysis while other 24 cases from 120 to hospital started from the time arriving Emergency Department. The complete rate of targeted time management and DNT compared with before management. Results In the control group, the hospital received 42 pre-hospital patients suspected with AIS in 3 hrs, and completed all targets 31 cases with pass rate of 73. 8%; the experimental group acquired 38 cases and achieved targets 35 cases with pass rate of 92. 1% (χ2 =4. 625,P<0. 05). In the experimental group, the pass rate of pre-hospital Emergency Department, CT detection, thrombolysis preparation were 100% (38/38), 94. 7% (18/19), 94. 7%(18/19) higher than 61. 9% (26/42), 55. 6% (10/18), 58. 8% (10/17) (χ2 =18. 095,5. 727,4. 779;P <0. 05). A total of 17 cases underwent thrombolysis with DNT of ( 68. 65 ± 23. 75 ) min while 19 cases in the experimental group with DNT of (35.50±2.98)min(Z=5.106,P<0.01),and4casescomingfrom120withDNTof(46.40±5.68) min (Z= -4. 092,P <0. 05). Conclusions To utilize pre-hospital time reasonable, we make the thrombolysis process early, regulate the process, manage each segment time targeted, find out and improve the reasons for overdue segment, make clear individual responsibility, which can shorten the DNT and be benefit patients.

ObjectiveTo investigate the clinical effects of posterior atlantoaxial fusion fixation in treatment of old atlantoaxial injury secondary to atlantoaxial dislocation.MethodsA retrospective analysis was carried out on 16 patients ( 14 males and 2 females) with old atlantoaxial injuries secondary to atlantoaxial dislocations managed with posterior atlantoaxial fusion fixation from March 2008 to March 2012.The time from injury to operation lasted for 3-36 months ( average 10.5 months).Posterior atlantoaxial transpedicular fixation was performed in 13 patients including 10 patients with old odontoid fractures and three with old traumatic transverse ligament disruptions of the atlas combined with atlantoaxial dislocations.Also,posterior atlantal arch transpediclar fixation combined with axial pedicle screw fixation was performed in three patients who had old odontoid fractures combined with atlantoaxial dislocations.All patients had simultaneous autogenous bone grafting between atlas and axis during reduction and fixation.The preoperative and postoperative Japanese Orthopaedic Association (JOA) scores were compared.Follow-up X-ray films and CT was performed to evaluate the atlantoaxial reduction and fusion.ResultsAll the patients were followed up for 9-18 months ( mean 13 months).None of the patients had spinal cord or vertebral artery injuries.Follow-up CT showed that two patients had partial penetration of one side axial pedicle screws into transverse foramen without nerve and blood vessel injuries.Clinical symptoms obtained different degree of improvement.The postoperative JOA scores ranged from 13 to 16 points ( mean 14.8 points) and the improvement rate of JOA was 71％-92％ ( mean 82％ ).The X-ray films and CT showed sound bone fusion,with good location of screws but with no signs of atlantoaxial instability or loss of reduction,or loosening or breakage of the screws.ConclusionPosterior atlantoaxial fusion fixation can effectively reconstruct atlantoaxial stability,improves neurologic function of spinal cord and has reliable curative effects.