Objective : To explore the molecular mechanism of long non-coding RNA metastasis associated lung ad- enocarcinoma transcript 1 (MALAT1) / microRNA-15b-5p (miR-15b-5p) regulating the Wnt / β-catenin pathway in lipopolysaccharide (LPS) -induced chondrocyte injury in osteoarthritis． Methods : TDC5 cells were treated with 5 mg / L LPS to establish the osteoarthritis cell injury model，and the expression levels of MALAT1 and miR-15b-5p in the cells were detected by RT-qPCR. The MTT，flow cytometry，Alizarin red staining，and ELISA were used to as- sess the effects of MALAT1 and miR-15b-5p on LPS-induced chondrocyte injury．The dual-luciferase reporter gene assay was used to examine the regulatory relationship between MALAT1 and miR-15b-5p．Western blot assay was used to evaluate the expression of relevant proteins． Results : In LPS-induced ATDC5 cells，MALAT1 expression decreased (P＜0. 05) ．Compared to the control group，the LPS group exhibited reduced cell activity，an increased apoptosis rate，elevated levels of tumor necrosis factor-α , interleukin-6，and interleukin-1 β , a higher number of calcified nodules，increased expression levels of extracellular matrix degradation-related proteins MMP13 and AD- AMTS5，decreased expression levels of Collagen Ⅱ and Aggrecan，and increased protein expression levels of Wnt1 and β-catenin (P＜0. 05) ．Overexpression of MALAT1 could mitigate the effects of LPS on chondrocyte activity， apoptosis，inflammatory response，osteogenic differentiation，extracellular matrix degradation，and the Wnt / β-cate- nin pathway (P＜0. 05) ．Additionally，the overexpression of miR-15b-5p enhanced the impact of LPS on chondro- cytes (P＜0. 05) ． Conclusion MALAT1 is lowly expressed in LPS-induced chondrocytes，and it alleviates LPS- induced chondrocyte injury by targeting miR-15b-5p to inhibit the Wnt / β-catenin pathway．

Objective:To evaluate the effects of parathyroid autotransplantation on total central lymph node dissection and postoperative parathyroid functional recovery in endoscopic radical operation for thyroid carcinoma.Method:The data of 152 patients undergoing endoscopic radical operation for thyroid carcinoma are retrospectively analyzed. The incidence of postoperative hypoparathyroidism, serum PTH and Ca 2+ concentrations at different time points, and the number of lymph nodes cleared were counted. Results:The rate of temporary hypoparathyroidism in the experimental group was higher than that in the control group, and the incidence of permanent hypoparathyroidism was lower than that in the control group, with statistically significant differences ( χ2=6.243, P=0.029). Patient's PTH in the experimental group is significantly higher than that in the control group at 1 week, 1 , 3 , 6 and 12 months after operation, and the difference is statistically significant ( F=25.193, P<0.05); Ca 2+ concentration in experimental group is higher than that in control group at 1, 3, 6 and 12 months after operation, and the difference is statistically significant ( F=3.268, P=0.005); The average number of central zone lymph node dissection and positive lymph nodes per case in the experimental group was higher than that in the control group, and the difference was statistically significant ( t=2.000, P=0.047; t=2.014, P=0.046). Conclusion:In radical lumpectomy for thyroid cancer, parathyroid autotransplantation can effectively prevent permanent postoperative hypoparathyroidism while achieving a more complete lymph node dissection in the central region.

Hiatal hernia (HH) is a prevalent medical condition characterized by the protrusion of abdominal contents into the thoracic cavity through an enlarged diaphragmatic esophageal hiatus. The most common clinical manifestations of HH include acid reflux, heartburn, belching, coughing, and chest pain. Currently, there is a lack of standardized comprehensive treatment protocols for different types of HH, presenting significant challenges in their clinical management. In light of this, individualized treatment approaches should be followed by surgical practitioners when dealing with HH, in order to formulate the most appropriate clinical treatment plan tailored to each patient′s specific circumstances.

Objective:To investigate the application value of Clavien-Dindo classification in evaluation of postoperative short-term complications of Da Vinci robotic-assisted or laparoscopic-assisted total gastrectomy with D 2 lymphadenectomy. Methods:The retrospective cohort study was conducted. The clinicopathological data of 262 patients with gastric cancer who were admitted to the 940th Hospital of Joint Logistic Support Force of Chinese People′s Liberation Army from January 2016 to January 2019 were collected. There were 214 males and 48 females, aged (58±11) years, with a range from 17 to 81 years. Of 262 patients, 120 cases undergoing Da Vinci robotic-assisted total gastrectomy + D 2 lymphadenectomy + Roux-en-Y anastomosis were divided into robotic group, and 142 cases undergoing laparoscopic-assisted total gastrectomy + D 2 lymphadenectomy + Roux-en-Y anastomosis were divided into laparoscopic group. Observation indicators: (1) intraoperative and postoperative situations; (2) postoperative pathological examination; (3)complications; (4) stratified analysis; (5) follow-up. Follow-up using outpatient examination and telephone interview was performed to detect complications, tumor recurrence and survival of patients within postoperative 2 months. The follow-up was up to May 2019. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test. Measurement data with skewed distribution were represented as M (range), and comparison between groups was analyzed using the Mann-Whitney U test. Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test or Fisher exact probability. Comparison of ranked data between groups was analyzed using the rank sum test. Results:(1) Intraoperative and postoperative situations: cases undergoing conversion to open surgery, the operation time, volume of intraoperative blood loss, the number of lymph node dissected, time to first flatus, time to initial fluid diet intake, duration of postoperative hospital stay of the robotic group were 1, (243±42)minutes, 100 mL(range, 100-150 mL), 38±15, (2.8±1.0)days, 3 days(range, 3-4 days), 11 days(range, 9-13 days), respectively. The above indicators of the laparoscopic group were 2, (244±38)minutes, 100 mL(range, 100-150 mL), 34±14, (3.2±1.0)days, 4 days(range, 3-5 days), 10 days(range, 9-13 days), respectively. There were significant differences in the number of lymph node dissected, time to first flatus, time to initial fluid diet intake between the two groups ( t=2.068, -3.030, Z=-3.370, P<0.05), and there was no significant difference in cases undergoing conversion to open surgery, the operation time, volume of intraoperative blood loss, duration of postoperative hospital stay between the two groups ( χ2=0.000, t=-0.158, Z=-1.824, -0.088, P>0.05). (2) Postoperative pathological examination: cases with well differentiated tumor, moderately differentiated tumor, poorly differentiated tumor, signet ring cell carcinoma or other types of tumor, cases in stage T1b, T2, T3 or T4a (pT staging), cases in stage N0, N1, N2, N3a or N3b (pN staging), cases in stage ⅠB, ⅡA, ⅡB, ⅢA, ⅢB or ⅢC (pTNM staging) of the robotic group were 6, 50, 55, 9, 10, 22, 63, 25, 42, 19, 19, 24, 16, 17, 22, 23, 20, 23, 15, respectively. The above indicators of the laparoscopic group were 4, 42, 84, 12, 6, 18, 81, 37, 39, 27, 32, 19, 25, 13, 19, 28, 39, 16, 27, respectively. There was no significant difference in the above indicators between the two groups ( Z=-1.880, -1.827, -0.140, -1.460, P>0.05). (3) Complications: cases with complication classified as grade Ⅰ, grade Ⅱ, grade Ⅲa, grade Ⅲb, grade Ⅳa, grade Ⅳb of Clavien-Dindo classification, cases with death, cases with overall complications, cases with severe complications of the robotic group were 9, 6, 3, 2, 2, 0, 0, 22, 7, respectively. The above indicators of the laparoscopic group were 12, 15, 9, 6, 3, 1, 1, 47, 20, respectively. There were significant differences in cases with overall complications, cases with severe complications between the two groups ( χ2=7.309, 4.790, P<0.05), and there was no significant difference in cases with complication classified as grade Ⅰ, grade Ⅱ, grade Ⅲa, grade Ⅲb, grade Ⅳa, grade Ⅳb of Clavien-Dindo classification, cases with death between the two groups ( χ2=0.080, 2.730, 1.042, 0.704, 0.000, 0.000, 0.000, P>0.05). (4) Stratified analysis: of the patients with overall complications in robotic group, cases of male or female, cases aged ≥65 years or <65 years, cases with body mass index (BMI) ≥24 kg/m 2 or <24 kg/m 2, cases with tumor diameter ≥5 cm or <5 cm, cases with or without abdominal surgery, cases with tumor located at upper stomach or middle stomach, cases in Ⅰ-Ⅱ grade or Ⅲ grade of American Society of Anesthesiologists (ASA) classification, cases with well differentiated tumor or undifferentiated tumor, cases in stage Ⅰ-Ⅱ or stage Ⅲ (pTNM staging), cases with operation time ≥250 minutes or <250 minutes, cases with volume of intraoperative blood loss ≥150 mL or <150 mL, cases with the number of lymph node dissected ≥25 or <25 were 15, 7, 14, 8, 11, 11, 16, 6, 4, 18, 19, 3, 15, 7, 7, 15, 8, 14, 12, 10, 12, 10, 14, 8, respectively. The above indicators of patients with overall complications in the laparoscopic group were 33, 14, 17, 30, 16, 31, 36, 11, 11, 36, 27, 20, 31, 16, 13, 34, 14, 33, 24, 23, respectively. Of the patients with overall complication, there were significant differences in cases of male, cases aged ≥65 years or <65 years, cases with BMI<24 kg/m 2, cases with tumor diameter≥5 cm, cases without abdominal surgery, cases with tumor located at middle stomach, cases in Ⅰ-Ⅱ grade or Ⅲ grade of ASA classification, cases with well differentiated tumor, cases in stage Ⅲ (pTNM staging), cases with operation time ≥250 minutes, cases with volume of intraoperative blood loss <150 mL, cases with the number of lymph node dissected ≥25 between the two groups ( χ2=6.683, 4.207, 6.761, 7.438, 4.297, 6.325, 9.433, 3.970, 4.850, 4.911, 3.952, 3.915, 6.865, 4.128, P<0.05) and there was no significant difference in cases of female, cases with BMI≥24 kg/m 2, cases with tumor diameter <5 cm, cases with abdominal surgery, cases with tumor located at upper stomach, cases with undifferentiated tumor, cases in stage Ⅰ-Ⅱ (pTNM staging), cases with operation time < 250 minutes, cases with volume of intraoperative blood loss ≥150 mL, cases with the number of lymph node dissected <25 between the two groups ( χ2=0.277, 1.052, 1.996, 1.552, 2.172, 2.594, 2.244, 3.771, 1.627, 3.223, P>0.05). (5) Follow-up: 262 patients were followed up postoperatively for 2 months. During the follow-up, no patient was diagnosed with tumor recurrence, and one patient in the laparoscopic group died of severe infection. Conclusions:The Clavien-Dindo classification can be used in evaluating postoperative short-term complications of Da Vinci robotic-assisted or laparoscopic-assisted total gastrectomy with D 2 lymphadenectomy. Compared with laparoscopic-assisted total gastrectomy with D 2 lymphadenectomy, Da Vinci robotic-assisted total gastrectomy with D 2 lymphadenectomy has the advantages of minimally invasiveness, low incidence of overall and severe complication.

Objective To provide a strategy for open heart surgical procedures of reducing allogeneic transfusion in the perioperative periods.Methods A comprehensive blood conservation program and new transfusion criteria[haemoglobin(Hb)were0.05).The Hct was down after operation in both groups.In the test group the Hct decreased in to 30% at day7 postoperation and regained gradually after 14 days of operation.Conclusion The dininishing allogeneic transfusion can be achieved by application of comprehensive blood conservation techniques and new transfusion criterion during the perioperative periods of open heart surgical procedures.The operative curative effect is not influence thereby.

Objective To investigated the biological procedure of allograft decalcified bone matrix(DBM)and bone cement(BC)combined with bovine bone morphogenetic protein (bBMP)used for the repair of femoral defect caused by microwave－ induced hyperthermia in dogsby 99mTc－ MDP bone scintigraphy.Method The canine femoral defect(length 25mm,width 10mm)was caused by microwave－ induced hyperthermia(50℃ ,20minutes)and the composite material was implanted .Then the canine femurs were examined by 99mTc－ MDP bone scintigraphy respectively at different postoperative time and the results were compared with that of X－ ray photography and histological observation.Bone cement was implanted in the other femur as a contrast.Results It could be observed at the first and the second month that the radioisotope was gathered in the place where the composite material was implanted and the amount of radioisotope gathered in was the most abundant at the third month and it was lasted to the fourth month. That of the sixth month was decreased to that of the second month.The radiation count of the first, the second, the third the fourth and the sixth month were 93.9± 12.7, 110.7± 16.4,222.1± 24.0,201.3± 26.9 and 111.6± 20.7 respectively,and the count of the third month and the fourth month were more than that of the first, the second and the sixth month(P<0.01).Conclusion The composite material could be remodeled easily and the new bone could be formed by the induction of bBMP. So it could be merged with the normal bone.While the 99mTc－ MDP bone scintigraphy is the object and reliable index to determine the biological procedure of the composite material in dogs.

A composite material of decalcified bone matrix (DBM) and bone cement (BC) combined with bovine bone morphogenitic protein (bBMP) was used to repair canine femoral defect caused by microwave induced hyperthermia. The composite material was examined with scan electron microscope and its biomechanical properties were assessed. Then a canine femoral defect was produced by microwave induced hyperthermia, and the composite material was implanted.Then the femurs were examined with X ray, 99m Tc MDP bone scintigraphy, histology and biomechanics at different postoperative periods. It was found that DBM and BC were tightly connected in a multipolar mode with irregular gaps in a diameter of 400?m to 800?m. Callus was formed in the first month and its amount was most abundant in the third month as shown by X ray examination. The new bone was formed in the composite material,and it was confirmed by bone scintigraphy and histology. The border of new bone was connected with the normal bone. So the composite material could merge with the normal bone finally.