Objective To investigatethe relationship between gastroesophageal reflux disease (GERD) symptoms and clinicopathological characteristics, p53 expression, and survival of Chinese patients with esophageal adenocarcinoma. Methods A total of 3882 patients with esophageal adenocarcinoma, 970 matched patients with esophageal squamous cell carcinoma, and 970 matched patients with gastric cardia adenocarcinoma were included to compare the incidence of GERD symptoms. Patients with esophageal adenocarcinoma were divided into two groups according to the presence and absence of GERD symptoms. The differences in clinicopathological characteristics and p53 expression between the two groups were compared by chi-square test, and the differences in survival between the two groups were compared by landmark analysis. Results The incidence of GERD symptoms increased successively in esophageal squamous cell carcinoma, esophageal adenocarcinoma, and gastric cardia adenocarcinoma. In patients with esophageal adenocarcinoma, the proportions of male, less than 65 years old, lower thoracic tumors, tumors without squamous cell carcinoma, poorly differentiation, early tumors (stage 0-I), and p53-positive tumors in the group with GERD symptoms were higher than those in the group without GERD symptoms; moreover, the long-term survival (≥15 years) was better. Conclusion GERD symptom is an important clinical sign of esophageal adenocarcinoma. It is closely related to specific clinicopathological characteristics, p53 overexpression, and good long-term prognosis.

Objective:To explore the classification of bilobar anterolateral thigh perforator flaps assisted by color Doppler ultrasonography and its impact on their donor sites.Methods:A retrospective analysis was conducted of the data of 67 patients with large soft tissue defects who had been repaired with anterolateral thigh perforator flaps at Department of Orthopaedics, The Hospital Affiliated to The Second Medical University of Shandong, Department of Orthopaedics, The 80th Group Army Hospital of the People's Liberation Army, and Department of Orthopaedics, Weifang Traditional Chinese Medicine Hospital. The patients were divided into 2 groups according to their flaps used: a unilobar group and a bilobar group. In the unilobar group, 36 cases [25 males and 11 females with an age of (40.3±8.3) years] were repaired with a unilobar anterolateral thigh perforator flap from March 2015 to April 2019. In the bilobar group, 31 cases [22 males and 9 females with an age of (38.9±7.4) years] were repaired with a bilobar anterolateral thigh perforator flap from May 2019 to August 2023. Color Doppler ultrasonography was used to classify the bilobar flaps into 4 types according to the different distributions of perforating vessels: common trunk type, separate trunks type, fascia dependent type, and composite mixed type. The number of perforating vessels and type of perforator flap found by preoperative color Doppler ultrasound were compared with the intraoperative findings in the bilobar group. One year after operation, recovery rate of donor muscle strength, rate of skin paresthesia, scar length at the donor site, the widest scar width and motor function were compared between the 2 groups.Results:The number of perforating vessels and type of perforator flap found by preoperative color Doppler ultrasound were consistent with the intraoperative findings ( P<0.05). There was no significant difference in the preoperative general data between the 2 groups, indicating comparability ( P>0.05). One year after operation in the bilobar group, the recovery rate of donor muscle strength was 96.8% (30/31), significantly higher than that in the unilobar group [77.8% (28/36)], the rate of skin paresthesia 6.5% (2/31), significantly lower than that in the unilobar group [27.8% (10/36)], the scar length at the donor site (22.18±5.02) cm, significantly longer than that in unilobar group [(17.35±3.11) cm], the widest scar width (7.26±1.58) mm, significantly narrower than that in the unilobar group [(43.72±9.81) mm], and the scores of Vancouver Scar Assessment Scale and Fugl-Meyer lower limb motor function scale were (1.95±0.57) points and (8.39±2.17) points, respectively, significantly lower than those in the unilobar group [(6.38±1.72) points and (14.02±3.54) points] ( P<0.05). Conclusions:Preoperative classification of bilobar anterolateral thigh perforator flaps assisted by color Doppler ultrasonography may provide guidance for flap harvesting and lobe layout of the flap. Compared to traditional unilobar flaps, bilobar ones may minimize tissue damage at a donor site.

Objective:To explore the classification of bilobar anterolateral thigh perforator flaps assisted by color Doppler ultrasonography and its impact on their donor sites.Methods:A retrospective analysis was conducted of the data of 67 patients with large soft tissue defects who had been repaired with anterolateral thigh perforator flaps at Department of Orthopaedics, The Hospital Affiliated to The Second Medical University of Shandong, Department of Orthopaedics, The 80th Group Army Hospital of the People's Liberation Army, and Department of Orthopaedics, Weifang Traditional Chinese Medicine Hospital. The patients were divided into 2 groups according to their flaps used: a unilobar group and a bilobar group. In the unilobar group, 36 cases [25 males and 11 females with an age of (40.3±8.3) years] were repaired with a unilobar anterolateral thigh perforator flap from March 2015 to April 2019. In the bilobar group, 31 cases [22 males and 9 females with an age of (38.9±7.4) years] were repaired with a bilobar anterolateral thigh perforator flap from May 2019 to August 2023. Color Doppler ultrasonography was used to classify the bilobar flaps into 4 types according to the different distributions of perforating vessels: common trunk type, separate trunks type, fascia dependent type, and composite mixed type. The number of perforating vessels and type of perforator flap found by preoperative color Doppler ultrasound were compared with the intraoperative findings in the bilobar group. One year after operation, recovery rate of donor muscle strength, rate of skin paresthesia, scar length at the donor site, the widest scar width and motor function were compared between the 2 groups.Results:The number of perforating vessels and type of perforator flap found by preoperative color Doppler ultrasound were consistent with the intraoperative findings ( P<0.05). There was no significant difference in the preoperative general data between the 2 groups, indicating comparability ( P>0.05). One year after operation in the bilobar group, the recovery rate of donor muscle strength was 96.8% (30/31), significantly higher than that in the unilobar group [77.8% (28/36)], the rate of skin paresthesia 6.5% (2/31), significantly lower than that in the unilobar group [27.8% (10/36)], the scar length at the donor site (22.18±5.02) cm, significantly longer than that in unilobar group [(17.35±3.11) cm], the widest scar width (7.26±1.58) mm, significantly narrower than that in the unilobar group [(43.72±9.81) mm], and the scores of Vancouver Scar Assessment Scale and Fugl-Meyer lower limb motor function scale were (1.95±0.57) points and (8.39±2.17) points, respectively, significantly lower than those in the unilobar group [(6.38±1.72) points and (14.02±3.54) points] ( P<0.05). Conclusions:Preoperative classification of bilobar anterolateral thigh perforator flaps assisted by color Doppler ultrasonography may provide guidance for flap harvesting and lobe layout of the flap. Compared to traditional unilobar flaps, bilobar ones may minimize tissue damage at a donor site.

Objective To explore the relationship between the serum levels of absent in melanoma 2(AIM2)and apolipoprotein J(Apo J)and the severity and prognosis of vascular dementia(VD).Methods From October 2020 to September 2022,128 patients with vascular dementia were collected as the study group in the Second People's Hospital of Binzhou.Based on the mini-mental state examination(MMSE)score,the severity of the condition was evaluated and the study group was separated into mild group(n=43),moderate group(n=54)and severe group(n=31).After 90 days of treatment,the prognosis of patients was evaluated based on the ability of daily living(ADL)scale score and grouped into grade Ⅰ group(n=66),grade Ⅱ group(n=40)and grade Ⅲgroup(n=22).Another 96 healthy individuals who underwent physical examination were selected as the control group.The expression levels of serum AIM2 and Apo J were detected by qRT-PCR and ELISA methods,and the differences between the groups were compared.Spearman method was applied to analyze the correlation between serum AIM2 and ApoJ expression levels and MMSE scores,and the relationship between serum AIM2 and Apo J expression levels and prognosis in patients with vascular dementia.Logistic regression was applied to analyze the prognostic factors of vascular dementia patients.Results The expression level of serum AIM2 mRNA(3.11±0.57 vs 1.06±0.23)in the study group was higher than those in the control group,while the expression level of serum ApoJ(68.83±12.24 ng/L vs 81.07±13.15 ng/L)was lower than that in the control group,with significant differences(t=32.054,7.174,all P＜0.001).The expression level of serum AIM2 mRNA in the severe group was higher than that in the mild and moderate groups(q=12.807,15.780),the expression level of serum Apo J and MMSE score in the severe group were lower than those in the mild and moderate groups(q=26.201,4.301;12.193,20.802),the expression level of serum AIM2 mRNA in the moderate group was higher than that in the mild group(q=14.688),and the expression level of serum Apo J and MMSE score in the moderate group were lower than those in the mild group(q=20.338,37.537),with significant differences(all P＜0.001).The expression level of serum AIM2 mRNA(5.27±0.60)in the grade Ⅲgroup of vascular dementia was higher than that in the grade Ⅱ(3.36±0.58)and grade Ⅰ groups(2.23±0.55),while the expression level of serum Apo J(51.22±12.21 ng/L)was lower than that in the grade Ⅱ(64.15±12.23 ng/L)and grade Ⅰgroups(77.53±12.25 ng/L).The expression level of serum AIM2 mRNA in the grade Ⅱ group was higher than that in the gradeⅠ group,while the expression level of serum Apo J in the grade Ⅱ group was lower than that in the grade Ⅰ group,with significant differences(q=5.630～30.740,all P＜0.001).The level of serum AIM2 in patients with vascular dementia was negatively correlated with MMSE score but positively correlated with prognosis(ADL grade)(r=-0.535,0.432,all P＜0.001),while the level of serum Apo J in patients with vascular dementia was positively correlated with MMSE score but negatively correlated with prognosis(ADL grade)(r=0.467,-0.496,all P＜0.001).Serum AIM2 mRNA[OR(95％CI):2.746(1.481～5.091)],Apo J[OR(95％CI):0.496(0.311～0.791)],and MMSE score[OR(95％CI):0.568(0.347～0.931)]were influencing factors for the prognosis of vascular dementia patients(all P＜0.05).Conclusion The increase of serum AIM2 mRNA expression level and the decrease of serum Apo J expression level in patients with vascular dementia were closely related to the clinical severity and prognosis of patients,which may effectively evaluate the prognosis of patients.

Objective:To investigate the application value of combined open and laparos-copic incisional hernia repair (hereinafter referred to as hybrid technique) in the treatment of recurrent incisional hernia.Methods:The retrospective and descriptive study was conducted. The clinical data of 36 patients with recurrent incisional hernia who were admitted to the Affiliated Beijing Chaoyang Hospital of Capital Medical University from January 2015 to December 2021 were collected. There were 10 males and 26 females, aged 62(range, 25-83)years. All patients underwent incisional hernia repair using the hybrid technique. Observation indicators: (1) intraoperative situa-tions; (2) postoperative situations; (3) follow-up. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers. Results:(1) Intraoperative situations. All 36 patients did not undergo component separation and successfully closed the hernia defect before completing the surgery. The operation time, defect area and area of mesh of the 36 patients were (102±41)minutes, (73±39)cm 2 and 300(range, 150-600)cm 2. Of the 36 patients, 9 cases required complete removal of the previous mesh, 2 cases had partial removal of the previous mesh and 25 cases did not require mesh removal. Two of the 36 patients had intestinal serosal tears, which needed suture repair during the operation. (2) Postoperative situations. Eight of the 36 patients had post-operative complications, including 6 cases of seroma, 1 case of subcutaneous hematoma and 1 case of undetected iatrogenic intestinal injury during the operation. The duration of the postoperative hospital stay of the 36 patients was 14(range, 7-57)days. (3) Follow-up. All 36 patients were followed up for 64 (range, 13-96)months. During the follow-up period, 2 cases had hernia recurrence and 1 case had intestinal obstruction. Conclusion:The hybrid technique in the treatment of recurrent incisional hernia is safe and feasible.

Neural circuits provide an anatomical basis for functional networks. Therefore, dissecting the structure of neural circuits is essential to understanding how the brain works. Recombinant neurotropic viruses are important tools for neural circuit tracing with many advantages over non-viral tracers: they allow for anterograde, retrograde, and trans-synaptic delivery of tracers in a cell type-specific, circuit-selective manner. In this review, we summarize the recent developments in the viral tools for neural circuit tracing, discuss the key principles of using viral tools in neuroscience research, and highlight innovations for developing and optimizing viral tools for neural circuit tracing across diverse animal species, including nonhuman primates.
Animals ; Brain

Myoclonus dystonia syndrome (MDS) is an inherited movement disorder, and most MDS-related mutations have so far been found in the ε-sarcoglycan (SGCE) coding gene. By generating SGCE-knockout (KO) and human 237 C > T mutation knock-in (KI) mice, we showed here that both KO and KI mice exerted typical movement defects similar to those of MDS patients. SGCE promoted filopodia development in vitro and inhibited excitatory synapse formation both in vivo and in vitro. Loss of function of SGCE leading to excessive excitatory synapses that may ultimately contribute to MDS pathology. Indeed, using a zebrafish MDS model, we found that among 1700 screened chemical compounds, Vigabatrin was the most potent in readily reversing MDS symptoms of mouse disease models. Our study strengthens the notion that mutations of SGCE lead to MDS and most likely, SGCE functions to brake synaptogenesis in the CNS.

Objective:To investigate the application value of transversus abdominis muscle release technique in giant ventral hernia repair.Methods:The retrospective and descriptive study was conducted. The clinical data of 72 patients with giant ventral hernia who were admitted to Beijing Chaoyang Hospital of Capital Medical University from January 2017 to January 2020 were collected. There were 47 males and 25 females, aged from 29 to 79 years, with a median age of 56 years. All patients underwent ventral hernia repair with transversus abdominis muscle release technique and preperitoneal/retro-muscular polypropylene mesh reinforcement. Observation indicators: (1) surgical situations; (2) postoperative complications; (3) hernia-related quality of life. Follow-up was conducted using outpatient examination and telephone interview to detect postoperative complications at postoperative 1, 6 and 12 months. Follow-up was up to January 2021. Measurement data with normal distribution were represented as Mean± SD, and comparison within groups was analyzed using the paired t test. Measurement data with skewed distribution were represented as M (range). Count data were described as absolute numbers. Results:(1) Surgical situations: all 72 patients underwent ventral hernia repair with transversus abdominis muscle release technique and preperitoneal/retro-muscular polypropylene mesh reinforcement successfully. The operation time, volume of intraoperative blood loss and mesh size of the 72 patients were (105±46)minutes, (55±15)mL and (680±225)cm 2, respectively. (2) Postoperative complications: 72 patients were followed up for 12 to 48 months, with a median follow-up time of 16 months. During the follow-up, 7 of the 72 patients were diagnosed with seroma by abdominal computed tomography (CT) scan at postoperative 1 week, the size of which was (460±130)mm 2. The 7 patients with seroma were followed up and results of abdominal CT scan at postoperative 6 months showed that the seroma was completely absorbed. Two of the 72 patients had postoperative intestinal obstruction, which was considered as postoperative paralytic ileus. After conservative treatment, the 2 patients were improved 2 weeks after operation. None of the 72 patients had surgical site infection, intestinal fistula or hernia recurrence. (3) Hernia-related quality of life: the score of hernia-related quality of life of 72 patients before operation and at postoperative 12 months were 40±12 and 73±17, respectively, showing a significant difference ( t=12.527, P<0.05). Conclusion:Transversus abdominis muscle release technique in the giant ventral hernia repair is safe and effective, which can improve hernia-related quality of life of patients.

Sensory processing is strongly modulated by different brain and behavioral states, and this is based on the top-down modulation. In the olfactory system, local neural circuits in the olfactory bulb (OB) are innervated by centrifugal afferents in order to regulate the processing of olfactory information in the OB under different behavioral states. The purpose of the present study was to explore the organization of neural networks in olfactory-related cortices and modulatory nuclei that give rise to direct and indirect innervations to the glomerular layer (GL) of the OB at the whole-brain scale. Injection of different recombinant attenuated neurotropic viruses into the GL showed that it received direct inputs from each layer in the OB, centrifugal inputs from the ipsilateralanterior olfactory nucleus (AON), anterior piriform cortex (Pir), and horizontal limb of diagonal band of Broca (HDB), and various indirect inputs from bilateral cortical neurons in the AON, Pir, amygdala, entorhinal cortex, hippocampus, HDB, dorsal raphe, median raphe and locus coeruleus. These results provide a circuitry basis that will help further understand the mechanism by which olfactory information-processing in the OB is regulated.

Sparse labeling of neurons contributes to uncovering their morphology, and rapid expression of a fluorescent protein reduces the experiment range. To achieve the goal of rapid and sparse labeling of neurons in vivo, we established a rapid method for depicting the fine structure of neurons at 24 h post-infection based on a mutant virus-like particle of Semliki Forest virus. Approximately 0.014 fluorescent focus-forming units of the mutant virus-like particle transferred enhanced green fluorescent protein into neurons in vivo, and its affinity for neurons in vivo was stronger than for neurons in vitro and BHK21 (baby hamster kidney) cells. Collectively, the mutant virus-like particle provides a robust and convenient way to reveal the fine structure of neurons and is expected to be a helper virus for combining with other tools to determine their connectivity. Our work adds a new tool to the approaches for rapid and sparse labeling of neurons in vivo.
Animals ; Cells, Cultured ; Gene Expression ; Genetic Vectors ; genetics ; metabolism ; Green Fluorescent Proteins ; genetics ; metabolism ; Immunohistochemistry ; methods ; Male ; Mice, Inbred C57BL ; Microscopy, Fluorescence ; methods ; Neurons ; cytology ; metabolism ; Purkinje Cells ; cytology ; metabolism ; Semliki forest virus ; genetics