Objective To assess the clinical value of a novel surgical technique—Tubeless subxiphoid uniportal video-assisted thoracoscopic surgery with percutaneous suspension technique via balance-shaped sternal elevation device in the resection of anterior mediastinal masses. Methods Patients who underwent tubeless subxiphoid uniportal video-assisted thoracoscopic surgery via balance-shaped sternal elevation device in anterior mediastinal masses process at the Department of Thoracic Surgery, West China Hospital, Sichuan University from March to April 2025 were included, and their clinical data were analyzed. Results A total of 4 patients were included, with 2 males and 2 females, aged 58-75 years. The diameter of the tumor was 2.5-3.0 cm. The operation time was 60.0-150.0 min, intraoperative blood loss was 5-10 mL, pain score on the 3rd day after surgery was 0 points, and postoperative hospital stay was 2-3 days. All patients achieved complete resection of the masses and thymus without perioperative complications. Conclusion The tubeless subxiphoid uniportal video-assisted thoracoscopic surgery with percutaneous suspension technique via balance-shaped sternal elevation device technique optimizes surgical visualization and instrument maneuverability while avoiding complications related to conventional anesthesia and tubing, thereby markedly enhancing the minimally invasive profile of anterior mediastinal masses resections. In addition to maintaining procedural safety, this approach effectively reduces postoperative pain and accelerates patient recovery, highlighting its potential for widespread clinical adoption.

Objective:To explore the clinical characteristics and risk factors of the severe delayed encephalopathy after acute carbon monoxide poisoning (s-DEACMP).Methods:A retrospective analysis of 170 acute carbon monoxide poisoning (ACMP) patients treated in the Hyperbaric Oxygen (HBO) Department of Beijing Chao-yang Hospital, Capital Medical University from January 1st, 2017 to December 31st, 2020 was conducted. According to the occurrence of delayed encephalopathy, the ACMP patients were divided into DEACMP group and non-DEACMP (n-DEACMP) group. The DEACMP patients were stratified by the activities of daily living scale when they were most severely ill. The patients with total score≤60 were classified as s-DEACMP and the patients with total score >60 were classified as mild to moderate DEACMP (m-DEACMP). Their clinical characteristics were compared and the risk factors of s-DEACMP were analyzed.Results:There were 70 s-DEACMP patients, 49 m-DEACMP patients, and 51 n-DEACMP patients. Compared with the n-DEACMP group, the s-DEACMP group was older (average age: 59.0 vs. 49.0, P=0.005), had a higher proportion of patients over 40 years old (97.1% vs. 66.7%, P<0.001), lower Glasgow coma scale scores [(4.0±3.0) vs.(6.0±5.0), P=0.024] on admission to the hospital, longer consciousness disturbance [(32.0±31.8) h vs.(20.5±26.4) h, P=0.017], a higher proportion of patients with consciousness disturbance over 48 hours (24.3% vs. 9.8%, P=0.041), a lower proportion of patients receiving HBO therapy (70.0% vs. 86.3%, P=0.036), a higher proportion of patients with hypertension (38.6% vs. 17.6%, P=0.013), a higher proportion of patients with hyperhomocysteinemia (40.0% vs. 19.6%, P=0.017), and a higher proportion of patients with smoking index over 400 (24.3% vs. 9.8%, P=0.041). Compared with the m-DEACMP group, the s-DEACMP group had a higher proportion of patients with hyperhomocysteinemia (40.0% vs. 20.4%, P=0.024). Multivariate Logistic regression showed that age over 40 years old, consciousness disturbance over 48 hours, hypertension, and hyperhomocysteinemia were independent risk factors of s-DEACMP( P<0.05). Conclusion:The clinical characteristics of s-DEACMP patients are that the patients are older, have a deeper and longer consciousness disturbance, a lower proportion of early HBO intervention, a higher proportion of hypertension, hyperhomocysteinemia, and smoking index over 400. Among them, the age over 40 years old, disturbance consciousness over 48 hours, and hypertension were the independent risk factors of the occurrence of s-DEACMP.In additon hyperhomocysteinemia was also an idependent risk factor for s-DEAMP, which special worth attention.

Objective:To explore the clinical characteristics and risk factors of the severe delayed encephalopathy after acute carbon monoxide poisoning (s-DEACMP).Methods:A retrospective analysis of 170 acute carbon monoxide poisoning (ACMP) patients treated in the Hyperbaric Oxygen (HBO) Department of Beijing Chao-yang Hospital, Capital Medical University from January 1st, 2017 to December 31st, 2020 was conducted. According to the occurrence of delayed encephalopathy, the ACMP patients were divided into DEACMP group and non-DEACMP (n-DEACMP) group. The DEACMP patients were stratified by the activities of daily living scale when they were most severely ill. The patients with total score≤60 were classified as s-DEACMP and the patients with total score >60 were classified as mild to moderate DEACMP (m-DEACMP). Their clinical characteristics were compared and the risk factors of s-DEACMP were analyzed.Results:There were 70 s-DEACMP patients, 49 m-DEACMP patients, and 51 n-DEACMP patients. Compared with the n-DEACMP group, the s-DEACMP group was older (average age: 59.0 vs. 49.0, P=0.005), had a higher proportion of patients over 40 years old (97.1% vs. 66.7%, P<0.001), lower Glasgow coma scale scores [(4.0±3.0) vs.(6.0±5.0), P=0.024] on admission to the hospital, longer consciousness disturbance [(32.0±31.8) h vs.(20.5±26.4) h, P=0.017], a higher proportion of patients with consciousness disturbance over 48 hours (24.3% vs. 9.8%, P=0.041), a lower proportion of patients receiving HBO therapy (70.0% vs. 86.3%, P=0.036), a higher proportion of patients with hypertension (38.6% vs. 17.6%, P=0.013), a higher proportion of patients with hyperhomocysteinemia (40.0% vs. 19.6%, P=0.017), and a higher proportion of patients with smoking index over 400 (24.3% vs. 9.8%, P=0.041). Compared with the m-DEACMP group, the s-DEACMP group had a higher proportion of patients with hyperhomocysteinemia (40.0% vs. 20.4%, P=0.024). Multivariate Logistic regression showed that age over 40 years old, consciousness disturbance over 48 hours, hypertension, and hyperhomocysteinemia were independent risk factors of s-DEACMP( P<0.05). Conclusion:The clinical characteristics of s-DEACMP patients are that the patients are older, have a deeper and longer consciousness disturbance, a lower proportion of early HBO intervention, a higher proportion of hypertension, hyperhomocysteinemia, and smoking index over 400. Among them, the age over 40 years old, disturbance consciousness over 48 hours, and hypertension were the independent risk factors of the occurrence of s-DEACMP.In additon hyperhomocysteinemia was also an idependent risk factor for s-DEAMP, which special worth attention.

Objective:To study the effectiveness and safety of combined intraoral and cutaneous using of long pulsed 1064 nm Nd∶YAG and 2940 nm Er∶YAG lasers in facial rejuvenation.Methods:Twenty-one female patients with different grades of nasolabial fold were treated with 6 sessions of the combination lasers therapy once a month. Standardized photographs of VISIA were taken before and after treatment to record any changes of facial contour and nasolabial folds. The efficacy assessment was judged by two non-group experienced dermatologists using modified Fitzpatrick Wrinkle Scale (MFWS), based on the VISIA photos at base line, twelve-week and six-month after treatment. Self-scoring of 5-level satisfaction from patients was also collected and analyzed. Any side effects and complications were recorded.Results:At 12 weeks, mild and moderate nasolabial folds were improved notably, the mean value of MFWS decreased from 1.59 to 0.90, whereas severe nasolabial folds had no remarkable improvement. Six-month after treatment, 18 patients had notable improved, among them: five out of 7 mild cases, 9 out of 10 moderate cases and 2 out of 4 severe cases, and the mean value of MFWS significantly decreased to 0.57 ( P<0.001). The general satisfactory rate of self-scoring was 86%. Two patients had tolerable light burning pain during treatment and two patients got temporary pigmentation that vanished in three months. There were no other adverse reactions and complications. Conclusion:Combined intraoral and cutaneous using oflong pulse 1064 nm Nd∶YAG laser and 2940 nm Er∶YAG laser is a safe and effective therapy for facial rejuvenation.

PURPOSE: Prolactinoma (prolactin-secreting pituitary adenoma) is one of the most common estrogen-related functional pituitary tumors. As an agonist of the dopamine D2 receptor, bromocriptine is used widely to inhibit prolactinoma progression. On the other hand, it is not always effective in clinical application. Although a dopamine D2 receptor deficiency contributes to the impaired efficiency of bromocriptine therapy to some extent, it is unknown whether there some other underlying mechanisms leading to bromocriptine resistance in prolactinoma treatment. That is the main point addressed in this project. MATERIALS AND METHODS: Human prolactinoma samples were used to analyze the S-phase kinase associated protein 2 (SKP2) expression level. Nutlin-3/adriamycin/cisplatin-treated GH3 and MMQ cells were used to analyze apoptosis in SKP2 overexpression or knockdown cells. SKP2 expression and the interaction partners of SKP2 were also detected after a bromocriptine treatment in 293T. Apoptosis was analyzed in C25 and bromocriptine-treated GH3 cells. RESULTS: Compared to normal pituitary samples, most prolactinoma samples exhibit higher levels of SKP2 expression, which could inhibit apoptosis in a p53-dependent manner. In addition, the bromocriptine treatment prolonged the half-life of SKP2 and resulted in SKP2 overexpression to a greater extent, which in turn compromised its pro-apoptotic effect. As a result, the bromocriptine treatment combined with C25 (a SKP2 inhibitor) led to the maximal apoptosis of human prolactinoma cells. CONCLUSION: These findings indicated that SKP2 inhibition sensitized the prolactinoma cells to bromocriptine and helped promote apoptosis. Moreover, a combined treatment of bromocriptine and C25 may contribute to the maximal apoptosis of human prolactinoma cells.
Apoptosis* ; Bromocriptine ; Half-Life ; Hand ; Humans* ; Pituitary Neoplasms ; Prolactinoma* ; Receptors, Dopamine D2 ; S-Phase Kinase-Associated Proteins

Objective To explore the effect of posterior debridement, grafting and internal fixation for treatment of non-specific lumbar intervertebral infection. Methods Clinical data of 20 patients with non-specific lumbar intervertebral infection treated in General Hospital of Ningxia Medical University from October 2013 to June 2013 were retrospectively analyzed. There were 15 males and 5 females with an average age of 41 years (range, 36-51 years). All patients suffered from single lumbar inter-vertebral infection, including 3 cases at L2/3,4 at L3/4,10 at L4/5 and 3 at L5/S1. All 20 cases underwent one-stage posterior debride-ment, autogenous bone grafting and internal fixation, tissue samples in focus were collected for bacterial culture and pathological examination. The disease controlling statues were evaluated based on laboratory results of ESR and CRP. Imaging examinations were taken to evaluate the fusion of vertebral body. Clinical effects were evaluated using the visual analog scale (VAS) and the Jap-anese Orthopaedic Association scores (JOA) score of lumbar fumction. Results All patients underwent the surgery successfully. The surgery duration time was 90-160 min, average 125 min, and the blood loss was 200-700 ml, average 360 ml. Cerebrospinal fluid leakage occurred in one case. Postoperatively, all patients experienced significant reliefof back pain, improving in the func-tion of movement, and no fever. The lower back VAS score: average (5.35 ± 1.15) points before operation , average (2.76 ± 0.34) points one week after operation, and an average score of (0.85±0.65) points by the last follow-up time. JOA lumbar function score:all patients were effective after operation, the improvement rate was excellent in 65%(13cases), good in 25%(5 cases), and pass-able in 10%(2cases). Comparing with preoperation, the excellent and good rate was 90%. All patients ESR and CRP returned to normal levels at the last follow-up. Ordinary bacterial culture was positive in 8 cases and negative in 12 cases. The pathogens iden-tified were staphylococcus aureus (6 cases), Escherichia coli (2 cases) and staphylococcus epidermidis (2cases). All incisions achieved primary healing. All patients were followed up from 6-18 months (average,12 months), and the symptom of pain relieved significantly. No recurrent infection had happened. A solid bony fusion was found in all patients at 6-14 months (average, 8.5 months) after the surgery. Conclusion Posterior debridement, grafting and internal fixation are effective treatments for non-spe-cific lumbar intervertebral infection, can reduce the time of staying in hospital, this operation is safe and reliable.

Objective To explore the value of time-invariant CTA in assessing collateral circulation of patients with acute ischemic stroke and assisting clinicians in predicting clinical outcomes.Methods The score of collateral circulation was compared between single-phase and time-invariant CTA.NIHSS score was calculated at admission and two weeks after admission.A 50% or greater decrease in NIHSS score over two weeks was considered as major neurologic improvement,which showed good clinical outcome;otherwise,it indicated bad outcome.The predictive ability of time-invariant CTA for clinical outcomes was assessed based on ROC curves.Results Compared with single-phase CTA,more collateral vessels could be viewed on time-invariant CTA.The average score of collateral circulation on time-invariant and single-phase CTA was 1.50±0.69 and 1.15±0.49 respectively (P=0.006<0.05 ).Time-invariant CTA had the moderate predictive ability for clinical outcomes in patients with acute ischemic stroke (AUC=0.810;P=0.032<0.05). Conclusion The time-invariant CTA showed potential value in assessing collateral circulation of patients with acute ischemic stroke and assisting clinicians in predicting clinical outcomes.

OBJECTIVE: To explore the changes of the serum immune cytokines in medical radiation workers exposure to low dose ionizing radiation. METHODS: Totally 244 medical professionals working with radiation(61 diagnosis radiology,51 nuclear medicine,74 radio therapeutics and 58 interventional radiology) from 7 hospitals of Guangdong Province were selected as study subjects by using the typical sampling method; 51 administration workers who did not expose to radiation were selected as control group. The radiation dose of these individuals was monitored by thermoluminescent measurement instrument for one year. Venous blood was collected and the levels of interferon γ(IFN-γ),interleukin 10(IL-10),transforming growth factor-β1(TGF-β1) in serum were examined by enzyme-linked immuno sorbent assay. RESULTS: The maximum annual average dose of radiation per person of the medical radiation workers was 0. 41 mSv/a. It was smaller than the occupational exposure limit(20. 00 mSv/a). The annual average dose of radiation per person in the group of nuclear medicine was significantly higher than those of diagnosis radiology,radio therapeutics and interventional radiology(P <0. 01). Among the male staffs,the expression of IL-10 in the diagnosis radiology group,radio therapeutics group and interventional radiology group was lower than that in the control group(P < 0. 05); the expression of IL-10 in radio therapeutics group was lower than those in nuclear medicine group and interventional radiology group(P < 0. 05); the ratio of IFN-γ/IL-10 in radio therapeutics group was higher than those in diagnosis radiology group,nuclear medicine group,interventional radiology group and control group(P < 0. 05). These individuals were divided into 3 different dose group(0. 03-,0. 06-and > 0. 15 m Sv/a) based on their average radiation dose. The expression of IL-10 in male staffs of these3 dose groups was lower than that of the male control group(P < 0. 05). CONCLUSION: Long-term low dose ionizing radiation may restrain the expression level of IL-10 in the male staffs.

Gene ADAM10 (a disintegrin and metalloproteinase 10) is a member of ADAMs gene family. The corresponding membrane protein contains a disintegrin domain and a metalloproteinase domain. It is involved in various biological events such as cell adhesion, cell fusion, cell migration, and membrane protein shedding and proteolysis. ADAM10 protein is overexpressed in many tumors, which interacts with adhesion molecules and critical signaling molecules associated with cancer development and tumor progression, and promotes tumor invasion and metastasis. Regulating the expression of ADAM 10 can inhibit tumor invasion and metastasis , which may become a new strategy for anticancer therapy.

OBJECTIVE: To evaluate the clinical outcomes of single-balloon kyphoplasty in the treatment of thoracic osteoporotic compression fractures via extrapedicular approach METHODS: From July 2004 to May 2008, 38 cases (52 vertebra) of thoracic osteoporotic fractures were treated by balloon kyphoplasty via unilateral extrapedicular approach, including 12 males and 26 females with an average age of 60.3 years (range 55-72 years). There were 34 cases of primary osteoporosis, and 4 had administrated hormone due to other diseases for over 6 months. Symptomatic levels ranged from T_4 to T_(12) confirmed by physical examination, MRI and X-ray. The pain relief, restoration of vertebral height and kyphosis correction were compared before and after operation by using visual analogue scale (VAS) and radiograph, respectively. In addition, bone cement leakage location and complications were recorded. RESULTS: Operation were successfully performed in 38 cases with an average injection of bone cement volume of (3.2+ 1.4) mL (2.25-4.60 mL in unilateral infusion). The mean time of surgery was 25-55 minutes, and that of follow-up was 9.5 months (6-24 months). Back pain of 36 cases was improved, and the VAS 3 days postoperatively and the final follow-up was significantly reduced (P < 0.05). The vertebral anterior margin and median height following surgery were significantly improved detected by X-ray (P < 0.05), and average median height restoration was (50.90+34.60)%, but no significant change was found in posterior height (P > 0.05). No lateral wedging or changes in the coronal alignment was found. Three cases (5 vertebra) had cement leakage: the bone cement of 1 case leaked to posterior margin through the puncture channel, and 2 cases leaked to lateral vertebra through vertebral venous system without any adverse event. The patients could move the second day after surgery, discharged from the hospital at days 3-4, and restored to normal life at 1 month postoperatively. No blood vessel or spinal cord puncture injury or pulmonary embolism, or blood vessel embolism was found. CONCLUSION: Unilateral extrapedicular kyphoplasty is safe and effective in treating thoracic osteoporotic fractures. It rapidly releases backache, restores the body height of fractured thoracic vertebrae and improves quality of life of the patients.