Compared to traditional suturing, lung stapling using automatic staplers offers advantages such as smaller trauma, faster wound healing, ease of operation, and lower complication rates, making it widely used in clinical practice. However, there are significant differences in bronchial tissue thickness at different anatomical locations, and the market is flooded with various types of staplers. Currently, there is a lack of recommended stapling schemes for bronchial staplers at different anatomical locations. This article reviews the development and application of automatic staplers and summarizes some types of staplers that are currently used in clinical practice, with the aim of promoting the formation of individualized stapler selection protocols for minimally invasive thoracic surgery based on the Chinese population.

Objective To investigate the effect of piR-9994 on the biological behavior of gastric cancer cells and its possible mechanism. Methods The expression of piR-9994 in gastric cancer cell lines (MGC803 and AGS) and normal gastric epithelial cells (GES-1) were detected by qRT-PCR. MGC803 cell line with piR-9994 overexpression and knockdown were constructed. The effects of piR-9994 expression changes on cell proliferation were detected by MTT and clone formation assay. The scratch wound healing assay and Transwell invasion assay were used to detect cell migration and invasion abilities. qRT-PCR and Western blot were used to detect cell proliferation and EMT-related genes expression. Results The expression level of piR-9994 in MGC803 cells was significantly higher than that in normal gastric epithelial cell line GES-1 (P < 0.05). The overexpression of piR-9994 promoted the proliferation, invasion and metastasis of gastric cancer cells, while piR-9994 knockdown had the opposite effect. piR-9994 expression was closely related to cell cycle, especially in S phase. The overexpression of piR-9994 promoted the expression of proliferation-related genes PCNA, CCND1 and Bcl-2, inhibited the expression of apoptosis gene C-PARP, and promoted the expression of EMT-related genes N-cadherin, MMP7, Twist and Vimentin; while piR-9994 knockdown had the opposite effect. Conclusion Abnormal expression of piR-9994 affects the proliferation, invasion, metastasis and EMT process of gastric cancer cells. piR-9994 may be a new biomarker and therapeutic target for gastric cancer.

Objective:To establish a simple and fast differential scanning calorimetry (DSC) method for identifying different gelatin Chinese herbal slices and formula granules.Methods:Adopting DSC method with 100 mesh sample size, making aluminum crucible as the reference, nitrogen was atmosphere, and the flow rate was 100 ml/min. The optimal temperature increasing range and temperature increasing rate are investigated. Based on the optimized DSC test conditions, 42 batches of Asini corii colla, Cervi cornus colla, Testudinis carapacis and formula particles were identified.Results:The optimal heating range of DSC test was 30-500 ℃, and the heating rate was 30 ℃/min. There were 4, 3, 2 aracteristic peaks of Asini corii colla, Cervi cornus colla, and Testudinis carapacis et plastri colla, and their peaks' shapes and positions were different. The antler gum formula particles and tortoise shell formula particles had two exothermic peaks, but the peak positions were different. There was one exothermic peak in the Asini corii colla. There is an exothermic peak in the traditional Chinese medicine decoction pieces and formula particles of antler gum formula particles at about 325 ℃. This exothermic peak can be used as the characteristic peak of antler gum formula particles.Conclusions:DSC has the advantages of simple operation, small amount, no reagents, fast measurement, good reproducibility, and easy analysis of the spectrum. And it can identify the value and size to distinguish between various gel pieces and formula granules.

Cell-Free Nucleic Acids ; blood ; Female ; Humans ; Mosaicism ; Placenta ; Pregnancy

Objective:To study the expression of MMP-9 in nasal NK/T cell lymphoma, HIF-1a and its relationship with the clinical and pathologic characteristics. Methods:46 cases ( case group) of paraffin block specimens from patients with pathologically confirmed nasal NK/T cell lymphoma were collected from the Affiliated Hospital of Youjiang Medical College For Nationalities,the same period endoscopy turbinate mucosa were confirmed by pathology in 20 cases of chronic inflammation of mucosa specimens ( control group) , respectively HE staining and immunohistochemistry handle two specimens, observation of the expression differences of two groups of specimens of pathological morphology, MMP-9 and HIF-1a, and to analyze its relationship with the clinical and pathological features of the patients. Results: Case group HIF-1a expression rate 67. 39% (31/46), expression was 6. 52% (3/20) in control group. , the HIF-1a case group were significantly higher than control group (P<0. 05). Case group MMP-9 expression rate 71. 74%(33/46), in the control group expression was 6. 52% (3/20), MMP-9 expression in the case group was significantly higher than control group (P<0. 05). HIF-1a and MMP-9 in positive expression in Ann Arbor staging (Ⅲ-Ⅳ), lymph node metastasis, vascular invasion in patients with nasal NK/T cell lymphoma tissue appeared a high expression ( P< 0. 05 ) . Conclusion: Nasal NK/T cell lymphoma tissue of patients with HIF-1a, MMP-9 presented high expression, and there was a certain relationship between Arbor Ann stage (Ⅲ-Ⅳ) , lymph node metastasis and vascular invasion.

Objective To summarize the characterization of ovarian adrenal rest tumors (OART) in children and adolescent females with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency (21-OHD).Method We have diagnosed 4 cases of CAH 21-OHD with OART in the recent 5 years in pediatric endocrinology unit of the first affiliated hospital of Sun Yat-Sen University.Clinical characterizations were summarized,including symptoms,growth patterns and bone age advancements,serum steroid concentrations,imaging results and the follow-up data.Result The 4 cases of OART accounted for 2.5 ％ of the CAH 21-OHD girls,which was much lower than the detection rate,29.5％,of testicular ART in our patient group during the same period.The 4 cases included 3 salt wasters and 1 with simple virilizm.OART were diagnosed at the age of 8.9 years,15.8 years,21.4 years and 9.3 years,respectively.Before the diagnosis of OART,their daily hydrocortisone doses reached 16 mg/(m2 · d)to 24 mg/(m2 · d).The patients presented with deteriorated acne,deepened voice,amenorrhea (2 cases),accelerated growth and advanced bone age,△BA/△CA reached 1.2 (during GnRHa treatment) and 2.0.Their serum adrenal steroids increased significantly and hyperplasia of adrenal glands were found in all patients.The diagnosis could be confirmed before the operation in only 1 case.The diagnosis could not be made until the planned sub-total adrenalectomy in the other 3 cases.The follow-up periods of OART were 4.8,4.7,3.8and 2.7years,respectively.Removal of OART resulted in symptoms relief at least partialy and lowered daily hydrocortisone doses,14 to 19 mg/(m2 · d).Conclusion The detection rate of OART was much lower than testicular ART.Before the diagnosis of OART,the patients presented with deteriorated virilescence,accelerated growth and advanced bone age,elevated serum adrenal steroids and hyperplasia of adrenal glands.Removal of the OART resulted in symptoms relief at least partialy.

Objective To study the effect on body mass index ( BMI ) caused by treatment with Gonadotropin-releasing hormone analogs ( GnRHa) in girls with central precocious puberty ( CPP) or early and fast puberty ( EFP ) . Methods The BMI in 318 girls ( 227 CPP and 91 EFP ) treated with GnRHa alone was analyzed. Among them 89 were followed up to their final adult height. Results Before GnRHa treatment was started, thegirlswithCPPandEFPhadameanBMIstandarddeviationscore(SDS)forchronologicalage(BMISDSCA)of0.39 ±0.84andforboneage(BMISDSBA)of-0.11±0.69. Attheendoftreatment,themeanBMISDSCAwas0.59±1.01 and BMISDSBA was 0. 24 ± 0. 89, both were significantly higher than those at initiation. The increment in BMISDSBA (0.38±0.50)wasgreaterthanthatinBMISDSCA(0.21±0.56). Moreover,theratioofoverweight(BMI>85%)was significantly elevated. BMISDSCA of 89 girls who were visited at their final adult height was 0. 17 ± 1. 15, which was similar with BMISDS at initiation and in normal population. Conclusion The mean BMISDSCA of CPP and EFP was significantly higher than the general population, while BMISDSBA was significantly lower. During GnRHa treatment, BMISDS tended to be elevated. But it was reversible, for the mean BMISDS was back to normal at final adult height.

OBJECTIVETo investigate the effect of estrogen on cell proliferation and expression of proteins of C-type natriuretic peptide (CNP), natriuretic peptides B receptor (NPR-B) and natriuretic peptides C receptor (NPR-C) in ATDC5 cells during chondrogenesis.

METHODATDC5 cells were induced for differentiation with insulin 10 µg/ml (day 0), and were started to be investigated on day 6. They were incubated with: (1) Estradiol (E2) at different concentrations (10(-11)-10(-5) mol/L) for 24 hours (for studying cell proliferation), or for 48 hours (for studying CNP, NPR-B and NPR-C protein expression); (2) E2 (10(-8) mol/L) for 24, 48, 72, 96 and 120 h (for studying cell proliferation), or for 24, 48, 72 and 96 hours (for studying CNP, NPR-B and NPR-C protein expression); (3) E2 (10(-8) mol/L) , and/or ICI 182782 (estrogen receptor antagonist ) (10(-7) mol/L) for 24 hours (for studying cell proliferation). ATDC5 cells proliferation were determined by MTT (OD value). Western-blotting was performed to identify the protein levels of CNP, NPR-B and NPR-C.

RESULT(1) After incubation with E2 (10(-11)-10(-5) mol/L) for 24 h, ATD5 cell number increased with the increasing E2 concentration, peak in E2 concentrations of 10(-9) and 10(-8) mol/L (0.56 ± 0.06 and 0.52 ± 0.02, P < 0.05 and <0.01, respectively) , while significantly decreased in E2 (10(-5) mol/L) (0.30 ± 0.02) compared with DMSO-control (0.38 ± 0.02) (P < 0.05). After incubation with E2 (10(-11)-10(-5) mol/L) for 48 h, the protein level of CNP, NPR-B and NPR-C increased significantly, with the greatest effect seen at a concentration of 10(-10) mol/L E2 for CNP and NPR-B, 10(-9) mol/L E2 for NPR-C (P < 0.05). (2) After incubation with E2 (10(-8) mol/L) for 24 to 96 hours: (1) The cell number in each of the four time points was significantly increased compared with DMSO-control, with the greatest effect in 48 h (0.030 ± 0.003) (P < 0.05 or <0.01, respectively). While the cell number at 120 h was similar to that in DMSO-control. (2) The protein level of CNP increased significantly at 24 h (P < 0.05), seemed to be increased at 48 h and 72 h and decreased at 96 h. Both NPR-B and NPR-C level seemed to be increased at 24 h (P = 0.060 and 0.055, respectively) and seemed to decrease at 48 h, with decreasing significantly at both 72 h and 96 h (P < 0.05). (3) After incubation for 24 h, there was significant difference among the cell number of the four groups (P < 0.05). Cell number of group E2 (0.470 ± 0.032) was increased compared with group (E2+ICI) (0.410 ± 0.018), both being increased compared with group DMSO-control (0.370 ± 0.011, P < 0.05, respectively). There was no difference in cell number between group ICI 182782(0.360 ± 0.035) and group DMSO-control.

CONCLUSIONE2 promotes the proliferation of ATDC5 cells i.e. chondrogenesis via estrogen receptor mediated mechanism, in both concentration-dependent and time-dependent manner. E2 (10(-11)-10(-8) mol/L) up-regulates protein expression of CNP, NPR-B and NPR-C of ATDC5 cells during chondrogenesis, and regulate the expression of the three proteins mentioned above positively or negatively at different time point, which implied that estrogen is one of the regulators of CNP signaling pathway.

Animals ; Blotting, Western ; Cell Differentiation ; drug effects ; Cell Line ; Cell Proliferation ; drug effects ; Chondrogenesis ; Dose-Response Relationship, Drug ; Estradiol ; pharmacology ; Gene Expression Regulation ; drug effects ; Mice ; Natriuretic Peptide, C-Type ; metabolism ; Receptors, Atrial Natriuretic Factor ; metabolism ; Signal Transduction ; drug effects ; Time Factors

[ ABSTRACT] AIM:To investigate the effect of combined treatment with gonadotropin-releasing hormone analogue ( GnRHa) and growth hormone ( GH) on the linear growth in mid-and late pubertal girls at great bone ages with central precocious puberty ( CPP) or early and fast puberty ( EFP) , and to determine the relation between C-type natriuretic pep-tide ( CNP) signaling pathway and the accelerative effect of GH on long bone growth in these girls.METHODS:Twenty-two girls were diagnosed as CPP or EFP, whose bone ages were older than 11.5 years with impaired predicted adult height ( PAH) , and divided into GnRHa treatment group ( treated with GnRHa alone, slow-release of triptorelin 60~80 μg/kg every 4 weeks, im) and combined treatment group ( treated with GnRHa and GH, 1 U/kg GH every week for 6~7 times, sc) .The height, weight and pubertal stage were determined every 3 months.At the beginning and after 6 months of the treatment, the bone age was evaluated and the serum concentrations of amino-terminal pro-C-type natriuretic peptide ( NT-proCNP), insulin-like growth factor 1 (IGF-1) and procollagen type 1 amino-terminal propeptide (P1NP) were measured. Height velocity ( HV) , height SD score for bone age ( HtSDSBA ) , PAH and the serum indexes mentioned above were com-pared at the beginning and the end of the treatment.RESULTS: After 6 months of the treatment, HV, ΔHtSDSBA andΔPAH of the girls treated with GnRHa +GH were statistically higher than those of the girls given GnRHa alone ( P <0.01).Serum concentrations of NTproCNP, P1NP and IGF-1 were not significantly different between the beginning and the end of the 6-month combined treatment.The girls treated with GnRHa alone showed a significant decrease in both serum NTproCNP and P1NP levels (P<0.05) and no significant change of serum IGF-1 level after 6 months of the treatment. CONCLUSION:In the CPP or EFP girls who are in mid-and late puberty and at great bone ages, the combined treatment with GnRHa and GH may accelerate linear growth and improve predicted adult height.This effect of GH is not attributed to the change of serum IGF-1 level, and may be related in part to the acceleration of CNP-mediated long bone growth.

Objective To assess the efficacy and impact factors of treatment with Gonadotropin-releasing hormone analogs (GnRHa) in central precocious puberty (CPP) or early and fast puberty (EFP) girls in a retrospective unicenter study.Methods One hundred and two girls (75 CPP and 27 EFP) were treated with GnRHa alone and were followed up to their final adult hight (FAH).Results FAH was (158.0 ± 4.8) cm,being significantly higher than pretreatment predicted adult height [(151.1 ±5.1) cm,P＜0.01].There was no significant difference between CPP [(7.3 ± 4.4) cm] and EFP [(5.5 ± 4.5) cm] in net height gain.There was no significant improvement in FAH and pretreatment PAH for the patients who had menarche before treatment or whose growth velocity was less than 4 cm during the first year.Conclusion GnRHa treatment improves FAH efficiently for both CPP and EFP girls.Nevertheless,those who had menarche before treatment or whose growth velocity was less than 4 cm during the first year can hardly improve FAH by GnRHa treatment alone.