1.Linarin inhibits microglia activation-mediated neuroinflammation and neuronal apoptosis in mouse spinal cord injury by inhibiting the TLR4/NF-κB pathway
Linyu XIAO ; Ting DUAN ; Yongsheng XIA ; Yue CHEN ; Yang SUN ; Yibo XU ; Lei XU ; Xingzhou YAN ; Jianguo HU
Journal of Southern Medical University 2024;44(8):1589-1598
Objective To investigate the mechanism underlying the neuroprotective effect of linarin(LIN)against microglia activation-mediated inflammation and neuronal apoptosis following spinal cord injury(SCI).Methods Fifty C57BL/6J mice(8-10 weeks old)were randomized to receive sham operation,SCI and linarin treatment at 12.5,25,and 50 mg/kg following SCI(n=10).Locomotor function recovery of the SCI mice was assessed using the Basso Mouse Scale,inclined plane test,and footprint analysis,and spinal cord tissue damage and myelination were evaluated using HE and LFB staining.Nissl staining,immunofluorescence assay and Western blotting were used to observe surviving anterior horn motor neurons in injured spinal cord tissue.In cultured BV2 cells,the effects of linarin against lipopolysaccharide(LPS)-induced microglia activation,inflammatory factor release and signaling pathway changes were assessed with immunofluorescence staining,Western blotting,RT-qPCR,and ELISA.In a BV2 and HT22 cell co-culture system,Western blotting was performed to examine the effect of linarin against HT22 cell apoptosis mediated by LPS-induced microglia activation.Results Linarin treatment significantly improved locomotor function(P<0.05),reduced spinal cord damage area,increased spinal cord myelination,and increased the number of motor neurons in the anterior horn of the SCI mice(P<0.05).In both SCI mice and cultured BV2 cells,linarin effectively inhibited glial cell activation and suppressed the release of iNOS,COX-2,TNF-α,IL-6,and IL-1β,resulting also in reduced neuronal apoptosis in SCI mice(P<0.05).Western blotting suggested that linarin-induced microglial activation inhibition was mediated by inhibition of the TLR4/NF-κB signaling pathway.In the cell co-culture experiments,linarin treatment significantly decreased inflammation-mediated apoptosis of HT22 cells(P<0.05).Conclusion The neuroprotective effect of linarin is medicated by inhibition of microglia activation via suppressing the TLR4/NF-κB signaling pathway,which mitigates neural inflammation and reduce neuronal apoptosis to enhance motor function of the SCI mice.
2.Linarin inhibits microglia activation-mediated neuroinflammation and neuronal apoptosis in mouse spinal cord injury by inhibiting the TLR4/NF-κB pathway
Linyu XIAO ; Ting DUAN ; Yongsheng XIA ; Yue CHEN ; Yang SUN ; Yibo XU ; Lei XU ; Xingzhou YAN ; Jianguo HU
Journal of Southern Medical University 2024;44(8):1589-1598
Objective To investigate the mechanism underlying the neuroprotective effect of linarin(LIN)against microglia activation-mediated inflammation and neuronal apoptosis following spinal cord injury(SCI).Methods Fifty C57BL/6J mice(8-10 weeks old)were randomized to receive sham operation,SCI and linarin treatment at 12.5,25,and 50 mg/kg following SCI(n=10).Locomotor function recovery of the SCI mice was assessed using the Basso Mouse Scale,inclined plane test,and footprint analysis,and spinal cord tissue damage and myelination were evaluated using HE and LFB staining.Nissl staining,immunofluorescence assay and Western blotting were used to observe surviving anterior horn motor neurons in injured spinal cord tissue.In cultured BV2 cells,the effects of linarin against lipopolysaccharide(LPS)-induced microglia activation,inflammatory factor release and signaling pathway changes were assessed with immunofluorescence staining,Western blotting,RT-qPCR,and ELISA.In a BV2 and HT22 cell co-culture system,Western blotting was performed to examine the effect of linarin against HT22 cell apoptosis mediated by LPS-induced microglia activation.Results Linarin treatment significantly improved locomotor function(P<0.05),reduced spinal cord damage area,increased spinal cord myelination,and increased the number of motor neurons in the anterior horn of the SCI mice(P<0.05).In both SCI mice and cultured BV2 cells,linarin effectively inhibited glial cell activation and suppressed the release of iNOS,COX-2,TNF-α,IL-6,and IL-1β,resulting also in reduced neuronal apoptosis in SCI mice(P<0.05).Western blotting suggested that linarin-induced microglial activation inhibition was mediated by inhibition of the TLR4/NF-κB signaling pathway.In the cell co-culture experiments,linarin treatment significantly decreased inflammation-mediated apoptosis of HT22 cells(P<0.05).Conclusion The neuroprotective effect of linarin is medicated by inhibition of microglia activation via suppressing the TLR4/NF-κB signaling pathway,which mitigates neural inflammation and reduce neuronal apoptosis to enhance motor function of the SCI mice.
3.Establishment and evaluation of risk prediction model for the esophageal cancer via whole transcriptome analysis
Yangbo FENG ; Yanlu XIONG ; Jinbo ZHAO ; Jie LEI ; Shaowei XIN ; Tianyun QIAO ; Yongsheng ZHOU ; Xiao ZHANG ; Tao JIANG ; Yong HAN
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2023;30(04):578-585
Objective To establish the gene-based esophageal cancer (ESCA) risk score prediction models via whole transcriptome analysis to provide ideas and basis for improving ESCA treatment strategies and patient prognosis. Methods RNA sequencing data of esophageal squamous cell carcinoma (ESCC), esophageal adenocarcinoma (EAC) and adjacent tissues were obtained from The Cancer Genome Atlas database. The edgeR method was used to screen out the differential genes between ESCA tissue and normal tissue, and the key genes affecting the survival status of ESCC and EAC patients were initially identified through univariate Cox regression analysis. The least absolute shrinkage and selection operator regression analysis and multivariate Cox regression analysis were used to further screen genes and establish ESCC and EAC risk score prediction models. Results The risk score prediction models were the independent prognostic factors for ESCA, and the risk score was significantly related to the survival status of patients. In ESCC, the risk score was related to T stage. In EAC, the risk score was related to lymph node metastasis, distant metastasis and clinical stage. The constructed nomogram based on risk score showed good predictive ability. In ESCC, the risk score was related to tumor immune cell infiltration and the expression of immune checkpoint genes. However, this feature was not obvious in EAC. Conclusion 聽 聽The ESCC and EAC risk score prediction models have shown good predictive capabilities, which provide certain inspiration and basis for optimizing the management of ESCA and improving the prognosis of patients.
4.Research progress of LI-RADS categories and imaging features in predicting the prognosis of liver tumors
Jinkui LI ; Lili WANG ; Yongsheng XU ; Junqiang LEI
Chinese Journal of Hepatology 2022;30(6):676-680
The liver imaging reporting and data system (LI-RADS) is an imaging assessment system that standardizes the diagnosis of hepatocellular carcinoma (HCC), indicating the benign and malignant tumor through categories as well as major and ancillary features. The higher the LI-RADS category ranking, the higher the corresponding HCC likelihood and malignancy risk. Therefore, early diagnosis and prediction of the prognostic risk factors of liver tumors by preoperative imaging have important clinical significance for improving the survival rate and prognosis of patients. This article reviews the research progress of LI-RADS categories and related imaging features in predicting the prognosis of liver tumors.
5.Epidemiological characteristics, diagnosis, treatment and prognosis of gallbladder cancer in China: a report of 6 159 cases
Xuheng SUN ; Yijun WANG ; Wei ZHANG ; Yajun GENG ; Yongsheng LI ; Tai REN ; Maolan LI ; Xu'an WANG ; Xiangsong WU ; Wenguang WU ; Wei CHEN ; Tao CHEN ; Min HE ; Hui WANG ; Linhua YANG ; Lu ZOU ; Peng PU ; Mingjie YANG ; Zhaonan LIU ; Wenqi TAO ; Jiayi FENG ; Ziheng JIA ; Zhiyuan ZHENG ; Lijing ZHONG ; Yuanying QIAN ; Ping DONG ; Xuefeng WANG ; Jun GU ; Lianxin LIU ; Yeben QIAN ; Jianfeng GU ; Yong LIU ; Yunfu CUI ; Bei SUN ; Bing LI ; Chenghao SHAO ; Xiaoqing JIANG ; Qiang MA ; Jinfang ZHENG ; Changjun LIU ; Hong CAO ; Xiaoliang CHEN ; Qiyun LI ; Lin WANG ; Kunhua WANG ; Lei ZHANG ; Linhui ZHENG ; Chunfu ZHU ; Hongyu CAI ; Jingyu CAO ; Haihong ZHU ; Jun LIU ; Xueyi DANG ; Jiansheng LIU ; Xueli ZHANG ; Junming XU ; Zhewei FEI ; Xiaoping YANG ; Jiahua YANG ; Zaiyang ZHANG ; Xulin WANG ; Yi WANG ; Jihui HAO ; Qiyu ZHANG ; Huihan JIN ; Chang LIU ; Wei HAN ; Jun YAN ; Buqiang WU ; Chaoliu DAI ; Wencai LYU ; Zhiwei QUAN ; Shuyou PENG ; Wei GONG ; Yingbin LIU
Chinese Journal of Digestive Surgery 2022;21(1):114-128
Objective:To investigate the epidemiological characteristics, diagnosis, treat-ment and prognosis of gallbladder cancer in China from 2010 to 2017.Methods:The single disease retrospective registration cohort study was conducted. Based on the concept of the real world study, the clinicopathological data, from multicenter retrospective clinical data database of gallbladder cancer of Chinese Research Group of Gallbladder Cancer (CRGGC), of 6 159 patients with gallbladder cancer who were admitted to 42 hospitals from January 2010 to December 2017 were collected. Observation indicators: (1) case resources; (2) age and sex distribution; (3) diagnosis; (4) surgical treatment and prognosis; (5) multimodality therapy and prognosis. The follow-up data of the 42 hospitals were collected and analyzed by the CRGGC. The main outcome indicator was the overall survival time from date of operation for surgical patients or date of diagnosis for non-surgical patients to the end of outcome event or the last follow-up. Measurement data with normal distribu-tion were represented as Mean±SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M( Q1, Q3) or M(range), and com-parison between groups was conducted using the U test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test. Univariate analysis was performed using the Logistic forced regression model, and variables with P<0.1 in the univariate analysis were included for multivariate analysis. Multivariate analysis was performed using the Logistic stepwise regression model. The life table method was used to calculate survival rates and the Kaplan-Meier method was used to draw survival curves. Log-rank test was used for survival analysis. Results:(1) Case resources: of the 42 hospitals, there were 35 class A of tertiary hospitals and 7 class B of tertiary hospitals, 16 hospitals with high admission of gallbladder cancer and 26 hospitals with low admission of gallbladder cancer, respectively. Geographical distribution of the 42 hospitals: there were 9 hospitals in central China, 5 hospitals in northeast China, 22 hospitals in eastern China and 6 hospitals in western China. Geographical distribution of the 6 159 patients: there were 2 154 cases(34.973%) from central China, 705 cases(11.447%) from northeast China, 1 969 cases(31.969%) from eastern China and 1 331 cases(21.611%) from western China. The total average number of cases undergoing diagnosis and treatment in hospitals of the 6 159 patients was 18.3±4.5 per year, in which the average number of cases undergoing diagnosis and treatment in hospitals of 4 974 patients(80.760%) from hospitals with high admission of gallbladder cancer was 38.8±8.9 per year and the average number of cases undergoing diagnosis and treatment in hospitals of 1 185 patients(19.240%) from hospitals with low admission of gallbladder cancer was 5.7±1.9 per year. (2) Age and sex distribution: the age of 6 159 patients diagnosed as gallbladder cancer was 64(56,71) years, in which the age of 2 247 male patients(36.483%) diagnosed as gallbladder cancer was 64(58,71)years and the age of 3 912 female patients(63.517%) diagnosed as gallbladder cancer was 63(55,71)years. The sex ratio of female to male was 1.74:1. Of 6 159 patients, 3 886 cases(63.095%) were diagnosed as gallbladder cancer at 56 to 75 years old. There was a significant difference on age at diagnosis between male and female patients ( Z=-3.99, P<0.001). (3) Diagnosis: of 6 159 patients, 2 503 cases(40.640%) were initially diagnosed as gallbladder cancer and 3 656 cases(59.360%) were initially diagnosed as non-gallbladder cancer. There were 2 110 patients(34.259%) not undergoing surgical treatment, of which 200 cases(9.479%) were initially diagnosed as gallbladder cancer and 1 910 cases(90.521%) were initially diagnosed as non-gallbladder cancer. There were 4 049 patients(65.741%) undergoing surgical treatment, of which 2 303 cases(56.878%) were initially diagnosed as gallbladder cancer and 1 746 cases(43.122%) were initial diagnosed as non-gallbladder cancer. Of the 1 746 patients who were initially diagnosed as non-gallbladder cancer, there were 774 cases(19.116%) diagnosed as gallbladder cancer during operation and 972 cases(24.006%) diagnosed as gallbladder cancer after operation. Of 6 159 patients, there were 2 521 cases(40.932%), 2 335 cases(37.912%) and 1 114 cases(18.087%) undergoing ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) examination before initial diagnosis, respec-tively, and there were 3 259 cases(52.914%), 3 172 cases(51.502%) and 4 016 cases(65.205%) undergoing serum carcinoembryonic antigen, CA19-9 or CA125 examination before initially diagnosis, respectively. One patient may underwent multiple examinations. Results of univariate analysis showed that geographical distribution of hospitals (eastern China or western China), age ≥72 years, gallbladder cancer annual admission of hospitals, whether undergoing ultrasound, CT, MRI, serum carcinoembryonic antigen, CA19-9 or CA125 examination before initially diagnosis were related factors influencing initial diagnosis of gallbladder cancer patients ( odds ratio=1.45, 1.98, 0.69, 0.68, 2.43, 0.41, 1.63, 0.41, 0.39, 0.42, 95% confidence interval as 1.21-1.74, 1.64-2.40, 0.59-0.80, 0.60-0.78, 2.19-2.70, 0.37-0.45, 1.43-1.86, 0.37-0.45, 0.35-0.43, 0.38-0.47, P<0.05). Results of multivariate analysis showed that geographical distribution of hospitals (eastern China or western China), sex, age ≥72 years, gallbladder cancer annual admission of hospitals and cases undergoing ultrasound, CT, serum CA19-9 examination before initially diagnosis were indepen-dent influencing factors influencing initial diagnosis of gallbladder cancer patients ( odds ratio=1.36, 1.42, 0.89, 0.67, 1.85, 1.56, 1.57, 0.39, 95% confidence interval as 1.13-1.64, 1.16-1.73, 0.79-0.99, 0.57-0.78, 1.60-2.14, 1.38-1.77, 1.38-1.79, 0.35-0.43, P<0.05). (4) Surgical treatment and prognosis. Of the 4 049 patients undergoing surgical treatment, there were 2 447 cases(60.435%) with complete pathological staging data and follow-up data. Cases with pathological staging as stage 0, stage Ⅰ, stage Ⅱ, stage Ⅲa, stage Ⅲb, stage Ⅳa and stage Ⅳb were 85(3.474%), 201(8.214%), 71(2.902%), 890(36.371%), 382(15.611%), 33(1.348%) and 785(32.080%), respectively. The median follow-up time and median postoperative overall survival time of the 2 447 cases were 55.75 months (95% confidence interval as 52.78-58.35) and 23.46 months (95% confidence interval as 21.23-25.71), respectively. There was a significant difference in the overall survival between cases with pathological staging as stage 0, stage Ⅰ, stage Ⅱ, stage Ⅲa, stage Ⅲb, stage Ⅳa and stage Ⅳb ( χ2=512.47, P<0.001). Of the 4 049 patients undergoing surgical treatment, there were 2 988 cases(73.796%) with resectable tumor, 177 cases(4.371%) with unresectable tumor and 884 cases(21.833%) with tumor unassessable for resectabi-lity. Of the 2 988 cases with resectable tumor, there were 2 036 cases(68.139%) undergoing radical resection, 504 cases(16.867%) undergoing non-radical resection and 448 cases(14.994%) with operation unassessable for curative effect. Of the 2 447 cases with complete pathological staging data and follow-up data who underwent surgical treatment, there were 53 cases(2.166%) with unresectable tumor, 300 cases(12.260%) with resectable tumor and receiving non-radical resection, 1 441 cases(58.888%) with resectable tumor and receiving radical resection, 653 cases(26.686%) with resectable tumor and receiving operation unassessable for curative effect. There were 733 cases not undergoing surgical treatment with complete pathological staging data and follow-up data. There was a significant difference in the overall survival between cases not undergoing surgical treatment, cases undergoing surgical treatment for unresectable tumor, cases undergoing non-radical resection for resectable tumor and cases undergoing radical resection for resectable tumor ( χ2=121.04, P<0.001). (5) Multimodality therapy and prognosis: of 6 159 patients, there were 541 cases(8.784%) under-going postoperative adjuvant chemotherapy and advanced chemotherapy, 76 cases(1.234%) under-going radiotherapy. There were 1 170 advanced gallbladder cancer (pathological staging ≥stage Ⅲa) patients undergoing radical resection, including 126 cases(10.769%) with post-operative adjuvant chemotherapy and 1 044 cases(89.231%) without postoperative adjuvant chemo-therapy. There was no significant difference in the overall survival between cases with post-operative adjuvant chemotherapy and cases without postoperative adjuvant chemotherapy ( χ2=0.23, P=0.629). There were 658 patients with pathological staging as stage Ⅲa who underwent radical resection, including 66 cases(10.030%) with postoperative adjuvant chemotherapy and 592 cases(89.970%) without postoperative adjuvant chemotherapy. There was no significant difference in the overall survival between cases with postoperative adjuvant chemotherapy and cases without postoperative adjuvant chemotherapy ( χ2=0.05, P=0.817). There were 512 patients with pathological staging ≥stage Ⅲb who underwent radical resection, including 60 cases(11.719%) with postoperative adjuvant chemotherapy and 452 cases(88.281%) without postoperative adjuvant chemotherapy. There was no significant difference in the overall survival between cases with postoperative adjuvant chemo-therapy and cases without post-operative adjuvant chemo-therapy ( χ2=1.50, P=0.220). Conclusions:There are more women than men with gallbladder cancer in China and more than half of patients are diagnosed at the age of 56 to 75 years. Cases undergoing ultrasound, CT, serum CA19-9 examination before initial diagnosis are independent influencing factors influencing initial diagnosis of gallbladder cancer patients. Preoperative resectability evaluation can improve the therapy strategy and patient prognosis. Adjuvant chemotherapy for gallbladder cancer is not standardized and in low proportion in China.
6.Extended trans-dome onlay graft combining nasal vestibule V-Y advancement flap for correction of alar retraction
Lei QIN ; Yongsheng ZENG ; Zhongbo HE ; Ren LI
Chinese Journal of Plastic Surgery 2022;38(10):1160-1168
Objective:To investigate the effect of using extended trans-dome onlay graft(eTDOG) made of costal cartilage combined with nasal vestibule V-Y advancement flap for correction of alar retraction.Methods:Clinical data of patients diagnosed with alar retraction at Chongqing Huamei Plastic Surgery Hospital between July 2019 and October 2020 were retrospectively analyzed. The 6th or 7th right costal cartilage was harvested, cut into pieces for grafts, including a laminar trans-dome onlay graft, made from cortex part of the rib. Then a V-shaped flap was designed on the vestibular skin. At the end of the rhinoplasty, a pocket was created along the alar rim, and the eTDOG was inserted into the pocket to push down the alar rim. Nasal vestibule V-Y advancement flap provides extra soft tissue for alar retraction correction. Splints were applied to hold the eTDOG and flap in place. Assessment of therapeutic effect was made from three aspects. First of all, therapeutic satisfaction assessment, which was made based on the visual analogue scale(VAS). VAS scoring was conducted by patients and two surgeons who were not involved in surgery. Results were divided into three categories, total satisfaction with scoring 9 or 10, partly satisfaction with scoring 7 or 8, and dissatisfaction with scoring 0-6. Subsequently, the percentage of satisfaction indeed in the total number of cases was counted. Alar symmetry assessment was also included. The percentage of cases with alar symmetry in the total number of cases. Third, the ratio (a/b) of the distance between the line defined by bilateral highest points of alar retraction and the line determined by tip-defining points (a) to that between the line determined by bilateral highest points of alar retraction and the horizontal line defined by the turning point of columella lobule (b) was calculated on frontal view. The value of a and b was measured using Image J, and a/b<1 represented absence of alar retraction. The statistical analysis was performed using SPSS version 20.0. Chi-square test was used to compare the symmetry of alae pre- and post-operation. Values of a/b were expressed as Mean±SD, and was compared using t-test. SNK were used for comparison among and between groups of different types, respectively. P-value less than 0.05 considered to be statistically significant. Results:Forty-three cases were included in this study, including 5 men and 38 women, with mean age of 27.3 years (18-45 yars). Among them, medial, central and lateral type of alar retraction was comprised of 17, 22 and 4 cases, respectively. The median follow-up time was 4 months (range, 1-24 months). During the follow-up, no complications like avascular necrosis of ala, step like deformity or alar contracture were observed, so was the recurrence of alar retraction. A total of 5 complications were observed, including 4 cases of hypertrophic scar at the incision which were improved after injection of Triamcinolone and 1 case of remaining alar asymmetry which was corrected by reoperation. The VAS score of patient was 8.93±1.12, and patients with satisfaction indeed accounted for 81.4% (35/43). The mean VAS score of the two operation-non-participated surgeons was 8.93±1.04; and cases assessed to be satisfaction indeed accounted for 81.4% (70/86). The proportion of symmetric alae significantly improved from 58.1% (25/43) to 93.0% (40/43) ( P<0.01). The ratio of a/b decreased from 0.79±0.06 pre-operation to 1.00±0.04 post-operation( P<0.01). While no significance was found among groups neither pre- nor post-operation ( P>0.05). Conclusions:eTDOG made of costal cartilage combining nasal vestibule V-Y advancement flap is an effective method for correction of all types of alar retraction and improvement of alar symmetry, with high satisfaction of patients and surgeons.
7.Extended trans-dome onlay graft combining nasal vestibule V-Y advancement flap for correction of alar retraction
Lei QIN ; Yongsheng ZENG ; Zhongbo HE ; Ren LI
Chinese Journal of Plastic Surgery 2022;38(10):1160-1168
Objective:To investigate the effect of using extended trans-dome onlay graft(eTDOG) made of costal cartilage combined with nasal vestibule V-Y advancement flap for correction of alar retraction.Methods:Clinical data of patients diagnosed with alar retraction at Chongqing Huamei Plastic Surgery Hospital between July 2019 and October 2020 were retrospectively analyzed. The 6th or 7th right costal cartilage was harvested, cut into pieces for grafts, including a laminar trans-dome onlay graft, made from cortex part of the rib. Then a V-shaped flap was designed on the vestibular skin. At the end of the rhinoplasty, a pocket was created along the alar rim, and the eTDOG was inserted into the pocket to push down the alar rim. Nasal vestibule V-Y advancement flap provides extra soft tissue for alar retraction correction. Splints were applied to hold the eTDOG and flap in place. Assessment of therapeutic effect was made from three aspects. First of all, therapeutic satisfaction assessment, which was made based on the visual analogue scale(VAS). VAS scoring was conducted by patients and two surgeons who were not involved in surgery. Results were divided into three categories, total satisfaction with scoring 9 or 10, partly satisfaction with scoring 7 or 8, and dissatisfaction with scoring 0-6. Subsequently, the percentage of satisfaction indeed in the total number of cases was counted. Alar symmetry assessment was also included. The percentage of cases with alar symmetry in the total number of cases. Third, the ratio (a/b) of the distance between the line defined by bilateral highest points of alar retraction and the line determined by tip-defining points (a) to that between the line determined by bilateral highest points of alar retraction and the horizontal line defined by the turning point of columella lobule (b) was calculated on frontal view. The value of a and b was measured using Image J, and a/b<1 represented absence of alar retraction. The statistical analysis was performed using SPSS version 20.0. Chi-square test was used to compare the symmetry of alae pre- and post-operation. Values of a/b were expressed as Mean±SD, and was compared using t-test. SNK were used for comparison among and between groups of different types, respectively. P-value less than 0.05 considered to be statistically significant. Results:Forty-three cases were included in this study, including 5 men and 38 women, with mean age of 27.3 years (18-45 yars). Among them, medial, central and lateral type of alar retraction was comprised of 17, 22 and 4 cases, respectively. The median follow-up time was 4 months (range, 1-24 months). During the follow-up, no complications like avascular necrosis of ala, step like deformity or alar contracture were observed, so was the recurrence of alar retraction. A total of 5 complications were observed, including 4 cases of hypertrophic scar at the incision which were improved after injection of Triamcinolone and 1 case of remaining alar asymmetry which was corrected by reoperation. The VAS score of patient was 8.93±1.12, and patients with satisfaction indeed accounted for 81.4% (35/43). The mean VAS score of the two operation-non-participated surgeons was 8.93±1.04; and cases assessed to be satisfaction indeed accounted for 81.4% (70/86). The proportion of symmetric alae significantly improved from 58.1% (25/43) to 93.0% (40/43) ( P<0.01). The ratio of a/b decreased from 0.79±0.06 pre-operation to 1.00±0.04 post-operation( P<0.01). While no significance was found among groups neither pre- nor post-operation ( P>0.05). Conclusions:eTDOG made of costal cartilage combining nasal vestibule V-Y advancement flap is an effective method for correction of all types of alar retraction and improvement of alar symmetry, with high satisfaction of patients and surgeons.
8.Clinical value of early gastroscopy for hypopharyngeal carcinoma
Huijun ZHUANG ; Jinzhong CHEN ; Liqing YAO ; Hong SU ; Haixing WANG ; Tianxia LEI ; Weilin YANG ; Jianhai WU ; Yongsheng ZHENG ; Jinhai CHEN ; Guoxing XU ; Yilin XIE
Chinese Journal of Digestive Endoscopy 2021;38(2):133-137
Objective:To investigate the clinical value of early gastroscopy for patients with hypopharyngeal cancer.Methods:A total of 231 cases of hypopharyngeal cancer diagnosed and treated in the First Affiliated Hospital of Xiamen University from January 2010 to December 2014 were included in the retrospective analysis. The 5-year survival rate of hypopharyngeal cancer and patients accompanied with synchronous esophageal cancer (including early and advanced esophageal cancer), as well as the detection rate of synchronous esophageal cancer by gastroscopy and systemic PET-CT examination were statistically analyzed.Results:The 5-year survival rate of hypopharyngeal cancer was 38.96% (90/231). The 5-year survival rates of 62 patients accompanied with synchronous esophageal cancer and 169 patients without were 27.42% (17/62) and 43.20% (73/169), respectively, with statistic difference ( χ2=4.747, P=0.029). The 5-year survival rate of 49 patients accompanied with synchronous early esophageal cancer was 30.69% (17/49). Among the 13 patients with synchronous progressive esophageal cancer, none had a survival period of 5 years, which was significantly different compared with the patients with synchronous early esophageal cancer ( P=0.013). The detection rates of synchronous esophageal carcinoma by gastroscopy and by systemic PET-CT were 26.84% (62/231) and 14.29% (33/231), respectively, with statistic difference ( χ2=11.14, P<0.01). The detection rates of synchronous early esophageal carcinoma by gastroscopy and by systemic PET-CT were 21.21% (49/231) and 8.66% (20/231), respectively, and the difference was also statistically significant ( χ2=14.328, P<0.01). Conclusion:Hypopharyngeal cancer accompanied with synchronous esophageal cancer is of high risk, which affects the survival rate of patients. Early gastroscopy in hypopharyngeal cancer patients can significantly improve the detection rate of synchronous esophageal cancer, which helps to design individualized regimen to improve the survival rate of patients.
9.Clinical application of a prefabricated interocclusal recording cap for making interocclusal records of implant-supported fixed prostheses
Qian DING ; Tingting PU ; Mingzhu HE ; Shimin WANG ; Wenjin LI ; Lei ZHANG ; Jianzhang LIU ; Dai TONG ; Yongsheng ZHOU
Chinese Journal of Stomatology 2021;56(12):1205-1210
Objective:To use a self-developed, prefabricated cap for making interocclusal records in implant-supported fixed prosthetic treatment, and to evaluate its effect of clinical application and accuracy of transferring intra-oral intercuspal position.Methods:Series of prefabricated caps for occlusal recording of implant-supported fixed prostheses were designed based on the healing abutments, and fabricated with three-dimensional (3D) printing. According to the inclusion and exclusion criteria, 12 partially edentulous patients who visited the Department of Prosthodontics, Peking University School and Hospital of Stomatology between November 2020 and September 2021, had lost no fewer than 2 contiguous teeth in distal extension (Kennedy Class Ⅰ or Ⅱ), and had received implant placement 3 months ago were enrolled. Self-control study design was used. Two occlusal records of each included case were obtained by the following 2methods:for the test group, appropriate prefabricated caps were used; and for the control group, polyvinyl siloxane occlusal record was directly set on the healing abutments. The working casts were mounted on the mechanical articulator using the 2 groups of occlusal records successively. Accuracy of occlusal relationship of the mounted casts was evaluated. Diagnostics test was performed to obtain the sensitivity and positive predictive value, which were determined in photographs by comparing the intra-oral occlusal contact points with those in the mounted casts, point-by-point. Virtual casts were taken by intraoral and extraoral scans in intercuspal position and imported to Geomagic Studio 2014. Then the root mean square values of occlusal clearance space between the upper and lower occlusal surfaces of remaining posterior teeth, and the deviations of the interocclusal position of the occlusal surfaces of the remaining teeth in the mandibular arches when superimposing the maxillary arches of the intraoral and extraoral scans were calculated. As a self-control design, paired t test was used. Results:Twelve participants were enrolled, including 3 men and 9 women aged (52.6±12.1) years, and 36 missing teeth. The prefabricated caps could fit on the healing abutments with good retention and stability. The sensitivity of the test group (0.73±0.14) was significantly better than that of control group (0.63±0.12, P<0.01), with no significant difference in positive predictive value between the 2 groups ( P>0.05). The deviations of the interocclusal position of the occlusal surfaces of the remaining teeth were (357.0±140.2) μm for the test group, and (399.4±206.3) μm for the control group, with no significant difference between them ( P>0.05). Conclusions:Interocclusal position record based on prefabricated cap in this study for implant-supported fixed prosthetic treatment can improve the consistency between the intra-oral occlusion and the occlusion in dental casts. This technique has good accuracy, clinical convenience and usability.
10.Effects of different doses of atorvastatin combined with valsartan on blood pressure variability and circadian rhythm in patients with hypertension
Lei LI ; Gendong ZHOU ; Sheng LI ; Peng CHENG ; Yibao SHI ; Yongsheng WANG ; Xiaohong ZHANG
Chinese Journal of Postgraduates of Medicine 2020;43(6):540-544
Objective:To study the effects of different doses of atorvastatin combined with valsartan on blood pressure variability (BPV) and circadian rhythm in patients with hypertension.Methods:Eighty patients with grade 2 and grade 3 hypertension from March 2018 to March 2019 in Hefei First People′s Hospital were divided into low-dose group (20 mg/d atorvastatin combined with valsartan) and high-dose group (40 mg/d atorvastatin combined with valsartan) according to the random number table method. The efficacy after 8 weeks of treatment was compared between the two groups. The BPV, circadian rhythm, vascular endothelial factors [nitric oxide (NO), endothelin (ET)], serum disease-related factors [human cartilage glycoprotein (YKL-40), soluble intercellular adhesion molecule-1(sICAM-1), folate] and blood lipids [total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C)] were recorded before treatment and 8 weeks after treatment, and the occurrence of adverse reactions during medicine was counted in the two group.Results:After 8 weeks of treatment, the total effective rate was 97.50%(39/40) in low-dose group and was 92.50%(37/40) in high-dose group, and there was no significant difference in the total effective rate between the two groups ( P>0.05). After 8 weeks of treatment, the 24 h SBPV, daytime SBPV, nighttime SBPV, 24 h DBPV, daytime DBPV and circadian rhythm in the two groups were significantly decreased compared with those before treatment, and the 24 h SBPV, daytime SBPV, daytime DBPV and circadian rhythm in high-dose group were significantly lower than those in low-dose group: (9.53 ± 1.73)% vs. (10.89 ± 1.98)%, (9.14 ± 1.90)% vs. (10.33 ± 2.07)%, (11.56 ± 2.78)% vs. (13.06 ± 3.16)%, (4.78 ± 1.56)% vs. (5.70 ± 1.81)%( P<0.05). After 8 weeks of treatment, the levels of NO, folate and HDL-C in the two groups were significantly increased compared with those before treatment, and the levels with in high-dose group were significantly higher than those in low-dose group: (67.16 ± 13.14) μmol/L vs.(60.53 ± 12.50) μmol/L, (14.94 ± 2.07) mmol/L vs.(13.83 ± 2.28) mmol/L, (1.42 ± 0.15) mmol/L vs. (1.31 ± 0.18)mmol/L ( P<0.05). The levels of ET, YKL-40, sICAM-1, TC, TG and LDL-C in the two groups were significantly decreased compared with those before treatment, and the levels in high-dose group were significantly lower than those in low-dose group: (33.63 ± 5.15) ng/L vs. (37.44 ± 5.13) ng/L, (32.68 ± 6.16) μg/L vs. (36.94 ± 6.03) μg/L, (203.78 ± 41.19) ng/L vs. (249.93 ± 50.81) ng/L, (6.78 ± 1.03) mmol/L vs. (7.38 ± 1.30) mmol/L, (2.88 ± 0.61) mmol/L vs. (3.39 ± 0.85) mmol/L, (3.14 ± 1.05) mmol/L vs. (3.85 ± 1.44) mmol/L ( P<0.05). Conclusions:Different doses of atorvastatin combined with valsartan are effective in the treatment of hypertension, but high dose of atorvastatin combined with valsartan has better effects on blood pressure variability and circadian rhythm, and can effectively improve vascular endothelial function.

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