Objective To explore the clinical and aesthetic results of single axillary approach reverse sequence endoscopic nipple-sparing mastectomy of breast cancer combined with subpectoral implant-based breast reconstruction (IBBR) for breast cancer patients. Methods The clinical data of consecutive female patients who underwent single axillary approach reverse sequence endoscopic nipple-sparing mastectomy of breast cancer combined with subpectoral IBBR from May 2020 to December 2022 were retrospectively analyzed. The patient demographics, perioperative parameters, complications and aesthetic results were collected. Results A total of 62 patients (74 breasts) were included. The mean age of patients was (39.0±7.8) years. The total mean operation time was (185.2±45.5) minutes. Five (8.1%) patients suffered from surgical complications. Two (3.2%) patients experienced major complications, and 3 (4.8%) suffered from minor complications. No patient experienced partial nipple-areola complex necrosis. Seventeen (27.4%) patients experienced implant related complications, of which 11 (17.7%) experienced capsular contracture. During a median follow-up time of 30 months ranging from 11 to 42 months, no patient experienced locoregional recurrence, distant metastasis or death. Thirty-seven (88.1%) patients evaluated their breasts as good or excellent. In the surgeon-reported cosmetic results, 40 (95.2%) patients achieved excellent or good results. Conclusion This surgical technique is characterized by minimal trauma, short operation time, high safety, and excellent cosmetic outcomes for patients with small breasts and mild ptosis, making it worthy of further promotion.

Depression (Dep) is one of the most common concomitant symptoms of Parkinson's disease (PD), but there is a lack of detailed pathologic evidence for the occurrence of PD-Dep. Currently, the management of symptoms from both conditions using conventional pharmacological interventions remains a formidable task. In this study, we found impaired activation of extracellular signal-related kinase (ERK), reduced levels of transcription and translation, and decreased expression of brain-derived neurotrophic factor (BDNF) in the medial prefrontal cortex (mPFC) of PD-Dep rats. We demonstrated that the abnormal phosphorylation of α-synuclein (pS129) induced tropomyosin-related kinase receptor type B (TrkB) retention at the neuronal cell membrane, leading to BDNF/TrkB signaling dysfunction. We chose SEW2871 as an ameliorator to upregulate ERK phosphorylation. The results showed that PD-Dep rats exhibited improvement in behavioral manifestations of PD and depression. In addition, a reduction in pS129 was accompanied by a restoration of the function of the BDNF/ERK signaling loop in the mPFC of PD-Dep rats.
Animals ; Brain-Derived Neurotrophic Factor/metabolism* ; alpha-Synuclein/metabolism* ; Male ; Prefrontal Cortex/drug effects* ; Rats, Sprague-Dawley ; Depression/metabolism* ; MAP Kinase Signaling System/drug effects* ; Rats ; Parkinson Disease/metabolism* ; Receptor, trkB/metabolism* ; Phosphorylation ; Disease Models, Animal ; Signal Transduction

Numerous neurodegenerative diseases,such as Alzheimer's disease,Parkinson's disease,and amyotrophic lateral sclerosis,exhibit a common pathophysiological hallmark of aberrant protein aggregation and organelle mislocalization.These pathological manifestations are hypothesized to stem from disruptions in axonal transport within neurons,resulting in the im-paired targeting of pathological proteins for degradation and the misplacement of organelles crucial for normal cellular func-tions.This review aims to illustrate the mechanisms responsible for axonal transport deficits in various prevalent neurodegenera-tive diseases,suggesting that these deficits are typically early pathological occurrences that ultimately result in the deterioration of axonal integrity and degenerative alterations.The review may offer novel insights for future fundamental research endeavors.

Objective:To observe the effect of early mechanical ventilation on the expression of inflammatory factors and prognosis of patients with severe traumatic brain injury (sTBI).Methods:From January 2017 to December 2020, 138 patients with sTBI admitted to the department of the emergency of Xinhua Hospital Chongming Branch were enrolled. Although some patients were admitted to hospital without acute respiratory failure, their Glasgow coma score (GCS) were less than 8, they bad risk of hypoxia, so early mechanical ventilation was required. According to the patient's condition and the willingness of family members, patients were divided into mechanical ventilation group (tracheal intubation mechanical ventilation) and conventional oxygen inhalation group (nasal catheter or mask oxygen inhalation) in the end. The arterial partial pressure of oxygen (PaO 2), arterial partial pressure of carbon dioxide (PaCO 2), oxygenation index (PaO 2/FiO 2), tumor necrosis factor-α (TNF-α), and interleukin (IL-6, IL-10) levels at admission, preoperation and 72 hours postoperation, as well as GCS before operation and 1 week after operation, the duration and number of patients successfully evacuated from the ventilator within 1 week after surgery were observed and analyzed. Results:A total of 138 sTBI patients were enrolled in the study, including 72 cases in the mechanical ventilation group and 66 cases in the routine oxygen inhalation group. In the two groups, PaO 2, PaO 2/FiO 2 and IL-10 were higher, and PaCO 2, TNF-αand IL-6 were lower at 72 hours post operation than that before operation. Moreover, the changes in the mechanical ventilation group were more significant than those in the conventional oxygen inhalation group [PaO 2 (1 mmHg = 0.133 kPa): 94.6±7.7 vs. 92.5±6.8, PaO 2/FiO 2 (mmHg): 351±94 vs. 319±89, IL-10 (ng/L): 8.2±2.7 vs. 7.4±1.8, PaCO 2 (mmHg): 35.6±1.8 vs. 37.5±2.7, TNF-α(ng/L): 71.5±6.3 vs. 96.8±15.5, IL-6 (ng/L): 10.8±3.9 vs. 14.4±6.5, all P < 0.05]. There were 17 patients with severe respiratory insufficiency or failure in the conventional oxygen inhalation group before operation. Compared with the conventional oxygen inhalation group, the GCS score (11.7±3.1 vs. 9.1±4.6) and the proportion of successful weaning [62.5% (45/72) vs. 44.0% (29/66)] were significantly higher, and the duration of successful weaning (hours: 63.5±28.6 vs. 88.1±33.9) was significantly shorter in the mechanical ventilation group 1 week after operation. Conclusion:Early mechanical ventilation in sTBI patients can significantly improve oxygen supply, inhibit the release of pro-inflammatory factors, reduce secondary brain damage, and effectively improve the prognosis.

Objective: To investigate the use of diabetes medications and their effects on the community diabetic patients in Shanghai, China, and provide the evidence for the use of antidiabetic drugs in diabetic patients in the region. Methods: The data were from a database of a 2018 Survey on Community Diabetes Mellitus in Shanghai, China. There were 4 612 subjects included in this cross-sectional study in 2018. According to the use of antidiabetic drugs, the population was divided into untreated group, single drug group, double drugs combination group and multi-drugs combination group, to compare the fasting blood glucose, glycosylated hemoglobin, BMI and prevalence of diabetic complications in different groups. Results: About 70.9% of the 4 612 patients used hypoglycemic agents, 34.8% used metformin, 35.1% used sulfonylureas, 22.9% used alpha glycosidase inhibitors, and 13.8% used insulin. The prevalence of diabetic nephropathy, retinopathy, neuropathy, stroke, and diabetic foot was higher in the combination than in the untreated and single-drug users (P<0.01). Only 41.3% subjects had HbA_1C<7%. The fasting blood glucose and HbA_1C values were lower in the untreated group than in other three medication groups, and the rate of the HbA_1C reaching target in the untreated group was higher than the other medication groups (P<0.01). As the types of drug increased, HbA_1C was less likely to reach the target (P<0.01). There were 42.2% of patients with BMI<24 kg/m², and there was no significant difference in the proportion of BMI reaching target among the four groups (P>0.05). Conclusion The most common used antidiabetic drugs in diabetic patients in Shanghai are metformin, sulfonylureas, α-glycosides inbibitor, and insulin. The blood glucose control in diabetic patients in Shanghai community is not good enough. Patients with a longer duration of diabetes, a lower rate of HbA_1C at goal, and a higher prevalence of diabetic complications may be more prone to use multiple hypoglycemic drugs.

Objective: To investigate the effects of cadmium exposure on cardiovascular system of occupational workers. Methods: Cross-sectional study was applied to 992 workers in a nickel-cadmium battery plant in November, 2011, of which 749 were cadmium exposed workers and 243 were controls without cadmium and other expose. Urinary cadmium、electrocardiogram (ECG) and blood pressure were examined simultaneously among 992 workers. The risk factors of ECG abnormality rate and hypertension rate were analyzed by Logistic regression. Results: The level of urinary cadmium in cadmium exposed workers was significantly higher than controls (8.89±4.00 vs 1.34±1.18 μg/g creatinine, P<0.01) . Urinary cadmium level in women was significantly higher than men in both exposure and control group (P<0.05) . According to the group of working years, Urinary cadmium level raised with the increase of working years (F=28.272, P<0.001) . The ECG abnormality rate and hypertension rate of cadmium exposed workers were higher than that of control group, the differences were all statistically significant (P<0.01) . The abnormal rate of ECG and the hypertension rate increased with the prolonging of working years and demonstrated dose-response relationship. With the increase of urinary cadmium level, the abnormal rate of ECG and hypertension rate raised (OR=1.11, P<0.01) and (OR=1.15, P<0.01) respectively. Conclusion Occupational cadmium exposure increased the abnormal rate of ECG and blood pressure and therefore damaged cardiovascular system of workers. This study provided base data for protecting health of cadmium exposed workers.

Objective To investigate the relationship between matrix metalloproteinase-9 (MMP-9) gene-1562 C/T polymorphism and hemorrhagic transformation (HT) from (IS) in Chinese Han population in Henan province.Methods The promoter-1562 C/T gene polymorphism in 84 IS patients with HT and 138 age-and sex-matched IS patients without HT were tested by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).The genotypes and alleles frequencies of-1562 C/T polymorphism were analyzed.Results The frequency of CT and TT genotype and T allele was lower in IS patients with HT than in IS patients without HT (17.86％ (15cases) vs.30.43％ (42 cases),8.93％ (15 cases) vs.15.94％ (44 cases),x2=4.326 and 4.458,P=0.037 and 0.035).The relative risk for HT from IS was decreased in patients with T allele than those withCTandTTgenotype[0.517 (95％CI:0.278-0.961) vs.0.497 (95％CI:0.255-0.967)].Conclusions The MMP-9 gene-1562C/T polymorphism may be related to hemorrhagic transformation of in Chinese Han population in Henan province.The T allele is a protective factor for hemorrhagic transformation of in the population.

Objective To express the VP8 * protein of the rotavirus vaccine strain LLR in the E.coli with the pGEX4T-1 vector,which is important for the further research of the VP8 * protein functions.Methods The LLR VP8 * gene was obtained by virus RNA extraction and RT-PCR.Then it was cloned in the expression vectors pGEX4T-1.The recombinant plasmid pGEX4T-1-VP8 * was transformed to the E.coli BL21.Then the VP8 *-GST fusion protein was expressed and purified by the affinity chromatograph.The protein of interest was validated by SDS-PAGE and Western Blot.Results The molecular weight of the VP8 *-GST fusion protein was about 52 000 according to the SDS-PAGE.The bands of both 52 000 and 26 000 were shown in the Western Blot with the antibody against GST.Conclusions The LLR VP8 * gene was obtained and cloned to the pGEX4T-1 vector.Moreover,the solvable VP8 *-GST fusion protein was successfully expressed and purified.

To study the regulating effect of Astragalus Polysaccharides ( APS) to the mice infected by Brucella suis S2.Methods:120 BALB/c mice were randomly divided into 4 groups:experimental mice were injected APS 1 ml ( 0.4,1.2,3 mg/ml) via peritoneal cavity respectively once a day and the control group was injected with the same volume of saline for 3 days,then infected with Brucella suis S2 1 ml (1×107 L-1 ) by ip.Five mice of each group were killed through eye bloodletting at 1,6,12,24,48, 72 h respectively post-infection with Brucella suis S 2 and the peritoneal macrophage were obtained respectively to make smear.Phagocytic rate and phagocytic index were calculated by the Wright Giemsa staining after infected 1 h.TNF-α,IL-12 and IFN-γlevels of serum at different time points were measured by ELISA.The bacterial load of MΦand spleen were measured by coating method.Results:The phagocytic rate and phagocytic index of MΦin APS 3 dose groups were higher than those of the control group ( P<0.05 ).The microbial load of MΦin APS 3 dose groups at 1 h infected by Brucella suis S 2 were significantly higher than those of control,but significantly lower than those of control at 6,12,24,48,72 h after infected by Brucella suis S2.The microbial load of spleen in APS 3 dose groups at 6 h infected by Brucella suis S 2 were significantly higher than those of control ,but significantly lower than those of control at 12,24,48,72h after infected by Brucella suis S2.The concentrations of TNF-α,IL-12 and IFN-γin the serum of APS groups had significantly been improved ( P<0.05 ).Conclusion: APS can promote the activation of MΦin vivo and strengthen the activity of phagocytosis and killing to Brucella suis S 2.APS can promote the secretion of TNF-α,IL-12 and IFN-γof mice,strengthen the cellular immune response of mice to Brucella suis S 2.