Objective To compare the accuracy of consolidation/tumor ratio(CTR)measured at different CT thresholds for the prediction of invasiveness in small lung cancer with diameter≤2 cm using artificial intelligence-assisted measurements,and to explore the CTR thresholds and the corresponding CT thresholds for predicting lung cancer invasiveness.Methods Clinical data from 59 lung cancer patients(78 lung nodules in total)treated at Wuwei Hospital of Traditional Chinese Medicine from January 2021 to May 2023 were collected to analyze the prediction efficacy of CTR on invasiveness in small lung cancer with diameter≤2 cm measured at CT thresholds of-400,-350,-300,-250,-200,-150 HU.ROC curves were plotted to determine the optimal critical value for invasiveness prediction,followed by the corresponding CT threshold.Results The highest diagnostic efficacy for the invasiveness of lung nodules was achieved at a CT threshold of-250 HU,with an area under the curve of 0.931,sensitivity of 77.5％,specificity of 100％,and an optimal CTR threshold of 0.322.Conclusion For small lung cancers with a maximum diameter≤2 cm,CTR measured at a CT threshold of-250 HU can accurately predict lung cancer invasiveness.At CTR>0.322,the nodule is more likely to be microinvasive or invasive adenocarcinoma.

Objective:To analyze the clinical efficacy of internal fixation and prosthesis revision in the treatment of periprosthesis fracture after total knee arthroplasty.Methods:A total of 35 patients (35 knees) with periprosthetic fractures after total knee arthroplasty were retrospectively analyzed from January 2008 to January 2022 in the Department of Orthopaedics, West China Hospital, Sichuan University, including 13 males and 22 females, aged 71.4±4.1 years (range, 62-81 years). Left knee 19 cases, right knee 16 cases. There were 20 cases of Rorabeck type II and 15 cases of Rorabeck type III. The initial replacement was performed using a fixed platform post-stabilized knee prosthesis, which was fixed with bone cement. Patients with Rorabeck type II were treated with internal fixation alone (internal fixation group) and patients with Rorabeck type III underwent revision with replacement prosthesis (revision group). The Hospital for Special Surgery (HSS) score, range of motion (ROM) of knee joint, alignment of lower extremity and incidence of postoperative complications were compared between the two groups.Results:All patients successfully completed the operation and were followed up for 5.2±3.6 years (range, 1-12 years). Intraoperative blood loss was 680±102 ml (range, 420-1100 ml). The operative time in the internal fixation group was 105±17 min, which was less than 140±21 min in the revision group, and the difference was statistically significant ( t=-5.450, P<0.001). There was no complication of nerve or blood vessel injury during the operation. Five cases in the internal fixation group had unsatisfactory lower extremity force lines (>3° deviation from normal) after surgery, and all lower extremity force lines in the revision group were satisfied, and the difference in the satisfaction rate of lower extremity force lines between the two groups was not statistically significant ( P=0.057). The fracture healing time, knee ROM and HSS scores at the last follow-up were 5.1±1.3 months, 86°±5° and 84±5 in the internal fixation group and 4.8±1.5 months, 83°±6° and 82±4 in the revision group. One case in the revision group was diagnosed postoperatively with periprosthetic infection with pathogen culture suggestive of Candida albicans, recurrent anterior knee sinus tracts and patellar ectasia, which progressed to osteomyelitis, and mid-thigh amputation was performed 1 year after revision. Conclusion:The stability of prosthesis is an important reference for the treatment of periprosthetic fractures after total knee arthroplasty. Strong internal fixation in patients with unloosened prosthesis and revision with replacement of prosthesis in patients with loose prosthesis can achieve good knee joint function.

Objective:To investigate effect of curcumin on sepsis-induced acute lung injury rats based on Nrf2/Keap1 signaling pathway.Methods:Thirty rats were randomly divided into sham operation group,model group,curcumin low,medium and high doses groups,with 6 rats in each group.Rats in sham operation group were exposed by removing cecum and then returned to abdominal cavity,while rest of rats were constructed a model of acute lung injury in sepsis,and drugs were administered immediately after surgery for 3 consecutive days.After anaesthesia with 40 mg/kg pentobarbital,blood and alveolar lavage fluid were collected from common carotid arteries,and lung tissues were taken after death.Severity of sepsis in rats was evaluated;total cell count and neutrophil count of alveo-lar lavage fluid were detected;HE staining was performed to observe pathological damage of lung tissues;colorimetric method was used to detect SOD and MDA activities of lung tissues;ELISA was used to detect TNF-α,IL-1β and IL-6 levels;qRT-PCR was used to detect Nrf2,Keap1 and HO-1 mRNA expressions in lung tissues;Western blot was used to detect Nrf2,Keap1 and HO-1 protein expressions in lung tissues.Results:Compared with sham operation group,severity scores of sepsis in model group,curcumin low,medium and high doses groups were increased,total number of cells and neutrophil number were increased,SOD level was decreased,MDA level was increased,TNF-α,IL-1β and IL-6 levels were increased,Nrf2,HO-1 mRNA and protein expressions were decreased,Keap1 mRNA and protein expressions were increased(P<0.05);compared with model group,sepsis severity scores of curcumin low,medium and high doses groups were decreased,total number of cells and neutrophil number were decreased,SOD level was increased,MDA level was decreased,TNF-α,IL-1β and IL-6 levels were decreased,Nrf2 and HO-1 mRNA and protein expressions were increased,Keap1 mRNA and protein expressions were decreased in a dose-dependent manner(P<0.05).Conclu-sion:Curcumin can improve acute lung injury in rats with sepsis,improve lung pathological injury and protect lung tissue,which may be achieved by regulating Nrf2/Keap1 pathway and expressions of related factors.

Objective To explore the Aucubin by regulating programmed death-1(PD-1)/programmed death ligand-1(PD-L1)signaling pathway mediated immune escape the influence of radiation sensitivity on the lung cancer cells and its mechanism of action.Methods Human lung cancer cell line NCI-H1299 was trea-ted with 0-300 μmol/mL Aucubin,and cell viability was detected by MTT assay.Cells were divided into nor-mal control group(Control group),radiotherapy group(6 Gy group),Aucubin group,Aucubin+radiotherapy group(Aucubin+6 Gy group).Cell proliferation were detected by colony formation assay and Edu assay.Cell apoptosis was detected by flow cytometry.The levels of tumor necrosis factor-α(TNF-α),interferon-y(IFN-y)and interleukin(IL)-2 in the supernatant of cell culture medium were detected by enzyme-linked immu-nosorbent assay(ELISA).The protein expressions of PD-1 and PD-L1 were detected by Western blot.A mouse model of lung cancer xenograft was established and divided into Control group,radiotherapy group(5 Gy group),Aucubin group,and Aucubin+5 Gy group.The volume and mass of transplanted tumor were measured.ELISA was used to detect the levels of TNF-α,IFN-y,and IL-2,and Western blot was used to de-tect the protein expressions of PD-1 and PD-L1.Results Compared with 0 μmol/mL Aucubin,25-125μmol/mL Aucubin could reduce cell viability,and 100 μmol/mL aucubin was selected for subsequent experi-ments.Compared with the Control group,cell clone formation number,Edu positive rate,TNF-α level,PD-1 and PD-L1 protein expression levels were significantly decreased(P＜0.05),and the apoptosis rate,IFN-γ and IL-2 levels were significantly increased(P＜0.05)in the 6 Gy group and the Aucubin group.Compared with the 6 Gy group and Aucubin group,the Aucubin+6 Gy group had significantly lower cell colony formation number,Edu positive rate,TNF-α level,PD-1 and PD-L1 protein expression levels(P＜0.05),and significant-ly higher apoptosis rate,IFN-γ and IL-2 levels(P＜0.05).Compared with the Control group,the trasplanted tumor volume and weight,TNF-α level and PD-1 and PD-L1 protein expression levels in the 5 Gy group and Aucubin group were decreased(P＜0.05),while IFN-γ and IL-2 levels were increased(P＜0.05).Compared with the 5 Gy group and Aucubin group,the Aucubin+5 Gy group had significantly lower transplanted tumor volume and mass,TNF-α level and PD-1 and PD-L1 expression levels(P＜0.05),and significantly higher IFN-γ and IL-2 levels(P＜0.05).Conclusion Aucubin may enhance the radiosensitivity of lung cancer cells by blocking the immune escape mediated by PD-1/PD-L1 signaling pathway.

Objective:To explore the effect of signal transducer and activator of transcription 6 (STAT6) on ferroptosis in skeletal muscle cells in sepsis model and its potential mechanism.Methods:Twenty-four 8-week-old male specific pathogen free Kunming mice were divided into normal control group, sham group, sepsis model group and STAT6 inhibitor pretreatment group according to random number table method with 6 mice in each group. A mouse sepsis model was reproduced by cecal ligation and perforation (CLP). In the sham group, the skin of mice was sutured after exposing the cecum tissue. In the STAT6 inhibitor pretreatment group, 10 mg/kg AS1517499 was injected intraperitoneally 1 hour before model reproduction. The sham group and the model group were intraperitoneally injected with the same volume of normal saline. Mice in the normal control group did not receive any operation or drug intervention. The mice were sacrificed 24 hours after model reproduction, and the muscle tissue of hind limb was obtained under sterile condition. Hematoxylin-eosin (HE) staining was used to observe the histopathology with optical microscope, and mitochondrial morphological changes were observed by transmission electron microscopy after double staining with uranium acetate lead citrate. The ferroptosis marker proteins expressions of chitinase-3-like protein 1 (CHI3L1), cyclooxygenase-2 (COX-2), acyl-CoA synthetase long-chain family member 4 (ACSL4), ferritin heavy chain 1 (FTH1), and glutathione peroxidase 4 (GPx4) were detected by Western blotting.Results:Under the optical microscope, the morphology and structure of skeletal muscle tissues in the normal control and sham groups were normal. In the model group, the structure of skeletal muscle tissues was loose, the muscle fiber became smaller and atrophic, inflammatory cell infiltration and even muscle fiber loss were found. Compared with the model group, the structure of skeletal muscle tissues was tight and skeletal muscle atrophy was improved in the STAT6 inhibitor pretreatment group. The ultrastructure of skeletal muscle cell in the normal control and sham groups was normal under transmission electron microscope. The ultrastructure characteristics of skeletal muscle in the model group showed that cell membrane was broken and blister, mitochondria became smaller and membrane density increased, the mitochondrial crista decreased or disappeared, the mitochondrial outer membrane was broken, and the nucleus was normal in size but lacked chromatin condensation. Compared with the model group, the STAT6 inhibitor pretreatment group had a significant improvement in the ultrastructure of muscle cells. Compared with the normal control and sham groups, the protein expressions of CHI3L1, COX-2, ACSL4 and FTH1 in the muscle of the model group were significantly increased, while the protein expression of GPx4 was decreased significantly, indicating that the skeletal muscle cells in the mouse sepsis model showed characteristic mitochondrial injury and abnormal expression of ferroptosis markers. Compared with the model group, the protein expressions of CHI3LI, COX-2, ACSL4 and FTH1 in the STAT6 inhibitor pretreatment group were significantly decreased [CHI3L1 protein (CHI3L1/GAPDH): 0.70±0.08 vs. 0.97±0.09, COX-2 protein (COX-2/GAPDH): 0.61±0.03 vs. 0.83±0.03, ACSL4 protein (ACSL4/GAPDH): 0.75±0.04 vs. 1.02±0.16, FTH1 protein (FTH1/GAPDH): 0.49±0.06 vs. 0.76±0.13, all P < 0.05], while the protein expression of GPx4 was significantly increased (GPx4/GAPDH: 1.14±0.29 vs. 0.53±0.03, P < 0.05). Conclusions:Sepsis can induce ferroptosis in skeletal muscle cells of mice. STAT6 may mediate ferroptosis in mouse skeletal muscle cells by regulating the expressions of COX-2, ACSL4, FTH1 and GPx4, thereby inducing skeletal muscle cell injury in sepsis.

Humans ; Tranexamic Acid ; Atrial Fibrillation ; Antifibrinolytic Agents ; Arthroplasty ; Blood Loss, Surgical ; Arthroplasty, Replacement, Hip

Objective: To analyze the prevalence of dry and wet age-related macular degeneration (AMD) in patients with diabetes, hypertension and hyperlipidemia, and to analyze the risk factors for AMD. Methods: A population-based cross-sectional epidemiologic study was conducted involving 14,440 individuals. We assessed the prevalence of dry and wet AMD in diabetic and non-diabetic subjects and analyzed the risk factors for AMD. Results: The prevalence of wet AMD in diabetic and non-diabetic patients was 0.3% and 0.5%, respectively, and the prevalence of dry AMD was 17% and 16.4%, respectively. The prevalence of wet AMD in healthy, hypertensive, hyperlipidemic, and hypertensive/hyperlipidemic populations was 0.5%, 0.3%, 0.2%, and 0.7%, respectively. The prevalence of dry AMD in healthy, hypertensive, hyperlipidemic, and hypertensive/hyperlipidemic populations was 16.6%, 16.2%, 15.2%, and 17.2%, respectively. Age, sex, body mass index, and use of hypoglycemic drugs or lowering blood pressure drugs were corrected in the risk factor analysis of AMD. Diabetes, diabetes/hypertension, diabetes/hyperlipidemia, and diabetes/hypertension/hyperlipidemia were analyzed. None of the factors analyzed in the current study increased the risk for the onset of AMD. Conclusion There was no significant difference in the prevalence of wet and dry AMD among diabetic and non-diabetic subjects. Similarly, there was no significant difference in the prevalence of wet and dry AMD among subjects with hypertension and hyperlipidemia. Diabetes co-existing with hypertension and hyperlipidemia were not shown to be risk factors for the onset of dry AMD.
Cross-Sectional Studies ; Diabetes Mellitus/epidemiology* ; Humans ; Hyperlipidemias/epidemiology* ; Hypertension/epidemiology* ; Macular Degeneration/etiology* ; Risk Factors

Objective: To evaluate the shoulder function in patients after repair of head and neck defects with supraclavicular flap. Methods: A retrospective analysis was performed on 56 patients (54 males, 2 females, aged 35-74 years old) who received the repair of head and neck defects with supraclavicular flaps at Department of Otorhinolaryngology Head and Neck Surgery of Beijing Tongren Hospital, Capital Medical University in January 2013-December 2020. The areas and types of flaps, disruption or infections of the incision at the donor sites and other postoperative complications were recorded. Quick disabilities of the arm, shoulder and hand (Quick-DASH) was used for evaluating the shoulder functions in 43 patients conforming to the standard for evaluation of the clinical functions of shoulders and upper limbs, to compare the postoperative upper limb functions between patients treated with clavicular flaps and patients with acromion flaps. Meanwhile, 30 patients who received bilateral neck lymph node dissection over the same period of time were selected for a comparative evaluation of the donor sides (observation group) and the opposite sides (control group). Data were processed with SPSS 22.0. Results: The areas of obtained supraclavicular flaps were (4-10) cm × (10-18) cm. Three patients (5%) showed the defect widths of 8-10 cm at the donor sites, which couldn't be sutured directly, received the repair of their shoulder defects with partial flaps. Defects in other patients were sutured directly. After surgery, 3 patients (5%) suffered from disruption of the acromion incision, which healed after 2 weeks of local dressing. The follow-up time was 6-43 (27±14) months. All patients expressed no dissatisfaction with the appearance. Among 43 patients, 28 (65%) were clavicular type and 15 (35%) were acromion type. The acromion type showed average motor ability and Quick-DASH scores higher than the clavicular type [(average motor ability: (14.4±4.7) vs. (11.8±3.1), t=2.105, P=0.048; Quick-DASH: (16.9±11.6) vs. (12.2±7.1), t=2.284, P=0.033]. Among 30 patients who received bilateral neck lymph node dissection over the same period of time, the observation group showed higher average motor ability, local symptoms and Quick-DASH scores than the control group [average motor ability: (13.4±5.8) vs. (9.8±4.2), t=3.024, P=0.004; average local symptoms: (4.1±1.0) vs. (3.4±1.0), t=2.537, P=0.014; Quick-DASH: (15.6±14.7) vs. (5.2±11.1), t=3.106, P=0.003]. Conclusion: Shoulder dysfunction exists after treatment with supraclavicular flap, which is related to the flap type.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; Retrospective Studies ; Shoulder/surgery* ; Skin Transplantation ; Soft Tissue Injuries/surgery* ; Treatment Outcome

Objective:To explore the potential mechanism of chitinase-3-like protein 1 (CHI3L1) involved in skeletal muscle stem cell injury induced by sepsis.Methods:Six different concentrations of lipopolysaccharide (LPS) were used to stimulate mouse skeletal muscle satellite cells cultured in vitro. Enzyme linked immunosorbent assay (ELISA) and cell counting kit-8 (CCK-8) were used to determine the optimal concentration. The overexpression and interference vectors of CHI3L1 were constructed to transfect skeletal muscle satellite cells, and the transfection efficiency was verified by polymerase chain reaction (PCR) and Western blotting. The cells were randomly divided into blank control group (cells without any intervention), model group (LPS-stimulated untransfected cells), overexpressing CHI3L1 group (LPS-stimulated cells transfected with CHI3L1 plasmid), overexpressing CHI3L1 control group [LPS-stimulated cells transfected with negative control (NC) plasmid], CHI3L1 interference group [LPS-stimulated cells transfected with CHI3L1 small interfering RNA (siRNA)], CHI3L1 interference control group (LPS-stimulated cells transfected with CHI3L1-siRNA NC). The levels of extracellular caspase-1 and interleukin-1β (IL-1β) were detected by ELISA. The protein expressions of intracellular IL-1β, signal transducer and activator of transcription 3 (STAT3), protein kinase B (Akt) and phosphorylated Akt (p-Akt) were detected by Western blotting. Results:According to the results of CCK-8 and ELISA, the best concentration of 5 mg/L LPS was selected for the subsequent experiment. The transfection was validated by PCR and Western blotting. Compared with the blank control group, the levels of extracellular IL-1β, caspase-1 and the protein expressions of intracellular Akt, p-Akt, and IL-1β were significantly increased in the model group [IL-1β (ng/L): 11.22±0.55 vs. 8.63±0.63, caspase-1 (pmol/L): 9.47±0.22 vs. 8.65±0.15, Akt/GAPDH: 1.36±0.12 vs. 1.06±0.15, p-Akt/GAPDH: 0.78±0.07 vs. 0.09±0.01, IL-1β/GAPDH: 1.38±0.12 vs. 0.18±0.03, all P < 0.05]. Compared with the model group and the overexpressing CHI3L1 control group, the levels of extracellular IL-1β, caspase-1 and the protein expressions of intracellular p-Akt and IL-1β were significantly increased in the overexpressing CHI3L1 group [IL-1β(ng/L): 14.93±0.97 vs. 11.22±0.55, 9.38±0.40, caspase-1 (pmol/L): 10.35±0.03 vs. 9.47±0.22, 8.46±0.24, p-Akt/GAPDH: 1.21±0.04 vs. 0.78±0.07, 0.63±0.04, IL-1β/GAPDH: 1.87±0.08 vs. 1.38±0.12, 1.51±0.17, all P < 0.05]. Compared with the model group and the CHI3L1 interference control group, the levels of extracellular IL-1β, caspase-1 and the protein expressions of intracellular p-Akt and IL-1β were significantly decreased in the CHI3L1 interference group [IL-1β(ng/L): 8.98±0.73 vs. 11.22±0.55, 10.44±0.65, caspase-1 (pmol/L): 7.61±0.63 vs. 9.47±0.22, 8.37±0.38, p-Akt/GAPDH: 0.50±0.04 vs. 0.78±0.07, 0.94±0.06, IL-1β/GAPDH: 0.77±0.02 vs. 1.38±0.12, 1.13±0.07, all P < 0.05]. Conclusions:CHI3L1 may mediate the damage of skeletal muscle stem cells in sepsis by increasing the expression of caspase-1 and IL-1β. CHI3L1 may be involved in the regulation of Akt signaling pathway in skeletal muscle stem cells, but has no significant effect on STAT3 signaling pathway.

Female ; Humans ; Hysteroscopy ; Infertility, Female ; Laparoscopy ; Pregnancy ; Uterus/surgery*