Objective:To evaluate the effect of neoadjuvant chemotherapy combined with immunotherapy on the perioperative renal function in patients undergoing radical resection for esophageal cancer.Methods:This was a retrospective cohort study. Clinical data from patients undergoing neoadjuvant chemotherapy combined with immunotherapy for esophageal cancer in Tianjin Medical University Cancer Institute & Hospital and Tianjin University Chest Hospital from January 2020 to April 2022 were retrospectively collected. According to the preoperative treatment regimen, the patients were divided into neoadjuvant chemotherapy group (group nCT) and neoadjuvant chemotherapy combined with immunotherapy group (group nCT+ IT). nCT group underwent neoadjuvant chemotherapy, which included a platinum-based regimen combined with fluorouracil or taxanes. In nCIT+ IT group, programmed cell death protein 1 inhibitors were used for immunotherapy based on neoadjuvant chemotherapy. All the patients underwent 2-3 cycles of therapy, with each cycle lasting 21 days. Surgery was performed 4-6 weeks after the completion of the last therapy. The concentrations of serum creatinine, uric acid and blood urea nitrogen were detected before therapy, at 72 h before surgery and at 72 h after surgery. The acute kidney injury (AKI) diagnosed by the Kidney Disease: Improving Global Outcomes criteria at 72 h before surgery and 72 h after surgery were recorded. The pathological complete response rates, recurrence rate and disease-free survival time after surgery were collected.Results:Compared with group nCT, the serum urea concentration was significantly increased after treatment, the serum uric acid concentrations were increased at 72 h before surgery and 72 h after surgery, the pathological complete response rate was increased, the recurrence rate was decreased, the disease-free survival time was prolonged ( P<0.05), and no statistically significant changes were found in the incidence of AKI at 72 h before surgery and 72 h after surgery in group nCT+ IT ( P>0.05). Conclusions:Although neoadjuvant chemotherapy combined with immunotherapy can raise the pathological complete response rate and disease-free survival rate, it has a certain effect on renal function. Perioperative renal function testing should be strengthened to prevent the occurrence of AKI in the patients undergoing radical resection for esophageal cancer.

Objective:To observe the clinical effect of adjustable silicone strap suspension in the treatment of myasthenia gravis ptosis.Methods:From January 2019 to January 2020, 60 patients with myasthenia gravis ptosis (35 males, 25 females, age distribution from 25 to 58 years, with average of 35.63 years) were collected from the Department of Ophthalmoplasty of Aier Eye Hospital affiliated to Wuhan University. They were divided into control group and observation group, with 30 cases in each group. The observation group was treated with adjustable silicone band suspension, and the correction effect, satisfaction, recovery status, ocular surface function index, recurrence rate and complications of the two groups were compared.Results:The excellent rate of operation in the observation group was 93.33% (28/30), which was significantly higher than 63.33% (19/30) in the control group (χ 2=6.29, P<0.05), and the satisfaction of patients in the observation group was 100% (30/30), which was significantly higher than 76.67% (23/30) in the control group (χ 2=5.82, P<0.05). The preoperative corneal curvature and fluorescein staining in the observation group and the control group were significantly lower than those in the postoperative state ( t=6.17, 21.48, P<0.05). The corneal curvature and fluorescein staining score of the observation group were significantly higher than those of the control group at 3 months after surgery ( t=3.00, 9.06, P<0.05). There was no significant difference between the two groups in the incidence of complications such as eyelid imclosure, upper eyelid inversion and unnatural upper eyelid curvature (χ 2=0.19, P>0.05). Follow up at 3 months after surgery, the recurrence rate in the observation group was lower than that in the control group (χ 2=4.63, P<0.05). Conclusions:Surgery is an option for patients with myasthenia gravis ptosis who are not responding well to medical treatment and whose condition is stable. Adjustable silicone strap suspension for the treatment of myasthenia gravis ptosis can significantly improve the surgical success rate and patient satisfaction, with low postoperative complication rate and recurrence rate, which is suitable for clinical application.

Epilepsy is a disorder of the brain charac-terized by abnormal neuron excitability.However,the underlying molecular mechanism of neuron excitability modulation remains elusive.With the help of bioinformatic methods,we have identified receptor-type tyrosine-pro-tein phosphatase-like N(PTPRN)as a critical gene dur-ing epileptogenesis.PTPRN recruits NEDD4L ubiquitin E3 ligase to NaV1.2 sodium channels,facilitating NEDD4L-mediated ubiquitination and endocytosis.Knockout of PTPRN endows hippocampal granule cells with augmented depolarization currents and higher intrinsic excitability,which is reflected by increased seizure susceptibility of transgenic mice.On the contrary,reduced neuron excit-ability and decreased seizure susceptibility are observed after PTPRN overexpression.Meanwhile,we find that a 133 aa fragment recaptures modulation effect of PTPRN full-length,and this fragment shows therapeutic potential towards epilepsy caused by NaV1.2 gain of function vari-ants.In brief,our results demonstrate PTPRN playsa criti-calroleinregulatingneuronexcitability,providing a poten-tial therapeutic approach for epilepsy.

Objective:To observe the changes of corneal curvature and ocular surface after congenital ptosis.Methods:A total of 188 patients with congenital blepharoptosis were treated with frontal muscle flap suspension, levator eyelid muscle shortening and fixation, and levator aponeurosis according to different conditions. The postoperative correction effect, corneal curvature, and ocular surface changes were observed.Results:There was no significant difference in the good correction rate among the three methods ( P>0.05). The corneal curvature at 3 months after operation was lower than that before operation and 7 days after operation ( P<0.05). The fluorescein staining score at 7 days after operation was higher than that before operation and 3 months after operation ( F=2 910.05, P<0.05). The tear film rupture time at 7 days after operation was significantly shorter than that before operation and 3 months after operation ( F=758.12, P<0.05). There was no significant difference in tear secretion test before operation, 7 days after operation and 3 months after operation ( P>0.05). The conjunctival congestion score at 3 months after operation was lower than that at 7 days after operation, and the incidence of meibomian gland dysfunction and abnormal eyelash angle at 3 months after operation was lower than that at 7 days after operation ( t=113.56, χ 2=11.02, 11.46, P<0.05). 3 months after operation, the average diopters of 3 mm and 5 mm were higher than those before operation ( t=12.35, 15.19, P<0.05). Conclusions:Frontal muscle suspension, levator eyelid muscle shortening and fixation, and levator aponeurosis are effective in treating congenital blepharoptosis, and can effectively improve the ocular surface and corneal curvature. Clinically, the appropriate one can be selected according to the condition of the child correction method.

Objective: To observe the effect of modified myocutaneous flaps in the treatment of lower eyelid relaxation. Methods: From June 2017 to November 2018, 85 patients with lower eyelid relaxation were treated in our hospital. Modified musculocutaneous flaps were used in all cases. The techniques of preservation of eye fur, treatment of lacrimal grooves and muscle resection and suture were emphasized during the operation. All patients were followed up for 6 months to observe the occurrence of complications. At 6 months after operation, the satisfaction of operation was evaluated. Results: After 6 months of follow-up, 79 cases (92.94%) were satisfied. The symptoms included the disappearance of lower eyelid skin relaxation, the disappearance of lower eyelid margin baggy groove, no eyelid retraction, the formation of " orbicularis oculi muscle threshold" on the eyelid margin, and no obvious scar. There were 6 cases of basic satisfaction and 0 cases of unsatisfactory. Two patients had mild eyelid ectropion, 2 patients had slight scar hyperplasia at the lateral canthus incision, and no complications such as retrobulbar hematoma, infection and facial nerve injury occurred. No second repair operation was performed. Conclusions Modified musculocutaneous flaps have a satisfactory effect in the treatment of lower eyelid skin relaxation. It not only takes into account the advantages of the two traditional methods of skin flaps and musculocutaneous flaps, but also retains the natural physiological curvature of eye fur. It can also significantly improve the wrinkles and lacrimal grooves of lower eyelid. It is worthy popularizing.

Objective: To reveal the harm seriousness of bug bites induced rhabdomyolysis complicated with acute renal failure to human body and provide case evidence for clinical workers to improve the understanding and treatment level of insect bites related diseases.Methods: The clinical diagnosis and treatment of one case of insect bites induced rhabdomyolysis complicated with acute renal failure was tracked, and the individualized diagnosis and treatment were performed and summarized according to the clinical symptoms and the conditions of the patient.Results: All the indicators of the patient returned to normal with satisfactory curative effect and promising prognosis.Conclusion: The treatment of rhabdomyolysis complicated with acute renal failure needs quick identification and reversible factors correction, which are beneficial to the improvement of organ function and prognosis.

The main constituents of a typical medicinal herb,Polygonum muMflorum (Heshouwu in Chinese),that induces idiosyncratic liver injury remain unclear.Our previous work has shown that cotreatment with a nontoxic dose of lipopolysaccharide (LPS) and therapeutic dose of Heshouwu can induce liver injury in rats,whereas the solo treatment cannot induce observable injury.In the present work,using the constituent "knock-out" and "knock-in" strategy,we found that the ethyl acetate (EA) extract of Heshouwu displayed comparable idiosyncratic hepatotoxicity to the whole extract in LPS-treated rats.Results indicated a significant elevation of plasma alanine aminotransferase,aspartate aminotransferase,and liver histologic changes,whereas other separated fractions failed to induce liver injury.The mixture of EA extract with other separated fractions induced comparable idiosyncratic hepatotoxicity to the whole extract in LPS-treated rats.Chemical analysis further revealed that 2,3,5,4'-tetrahydroxy trans-stilbene-2-O-β-glucoside (trans-SG) and its cis-isomer were the two major compounds in EA extract.Furthermore,the isolated cis-,and not its trans-isomer,displayed comparable idiosyncratic hepatotoxicity to EA extract in LPS-treated rats.Higher contents of cis-SG were detected in Heshouwu liquor or preparations from actual liver intoxication patients associated with Heshouwu compared with general collected samples.In addition,plasma metabolomics analysis showed that cis-SG-disturbing enriched pathways remarkably differed from trans-SG ones in LPS-treated rats.All these results suggested that cis-SG was closely associated with the idiosyncratic hepatotoxicity of Heshouwu.Considering that the cis-trans isomerization of transSG was mediated by ultraviolet light or sunlight,our findings serve as reference for controlling photoisomerization in drug discovery and for the clinical use of Heshouwu and stilbene-related medications.

Objective To observe the effect of electroacupuncture(EA) on Calbindin D28K(CB) expression and apoptosis in hippocampus in hyperlipemia rats with concomitant cerebral ischemia(CI).Methods Forty male SD rats were rando-mized into control,hyperlipemia+CI(model),acupuncture Ⅰ,and acupuncture Ⅱ groups,with 10 cases in each.Hyperlipemia model was established by feeding the animals with high fat forage for 6 weeks and CI model established by occlusion of the unila-teral middle cerebral artery.For rats of acupuncture Ⅰ group,EA(1-3 mA,15 Hz) was applied to bilateral "Sanyinjiao"(SP 6) and "Fenglong"(ST 40) for 20 min every time,once daily for 10 days before CI.For rats of both acupuncture Ⅰ and Ⅱ groups,after CI,EA was applied to SP 6,ST 40,"Baihui"(GV 20) and "Shuigou"(GV 26) were punctured with filiform needles and stimulated by twirled the needle with hand continuously for 1 min,once daily for 7 days.The apoptotic cells of hippocampal CA 3 area were displayed by TUNEL(terminal deoxynucleotidyl transferase biotin-dUTP nick end labeling) method.CB antibody staining with immunohistochemistry was used to show CB-positive cells which were observed by optic microscope.Results In comparison with control group,the percentage of apoptotic cells of the hippocampal CA 3 area in model group increased considerably(P

Objective To observe the effect of electroacupuncture (EA) and acupuncture (A) on the proliferation of stem cells in the subependymal zone (SPZ) of the lateral ventricle and the frontal lobe cortex in hyperlipemia(HL) combined with cerebral ischemia (CI) rats. Methods A total of 72 male SD rats were randomized into control,HL,HL+ EA,CI,CI+A,HL+CI,HL+CI+EAⅠ and HL+CI+EAⅡgroups (n= 9 /group).HL model was established by feeding the animals with high fat forage for 6 weeks and CI model was established by FeCl3-induced occlusion of the unilateral middle cerebral artery. EA was applied to "Sanyinjiao" (SP 6) and "Fenglong" (ST 40) once daily for 17 days for HL+ EA group; and acupuncture to "Baihui" (GV 20) and "Shuigou" (GV 26) once daily for 7 days for CI+A group. For HL+CI+EA Ⅰ group,EA was applied to SP 6+ST 40 first before CI,once daily for 10 days,followed by EA of SP 6+ST 40 and acupuncture of GV 20+GV 26 for 7 days after CI. For HL+CI+EA Ⅱ group,no treatment was given before CI,then,acupuncture of GV 20+GV 26 and EA of SP 6+ST 40 were given once daily for 7 days after CI.The immunoactivity of Nestin and proliferation cell nuclear antigen (PCNA) of SPZ was detected by immunohistochemistry.Results In comparison with normal control group,the numbers of both Nestin and PCNA immunoreaction (IR) positive cells in the dorsolateral extension and the wall of the lateral ventricle of the brain increased significantly in CI and HL+CI groups (P0.05). Conclusion EA can upregulate Nestin and PCNA expression of the dorsolateral extension and the wall of the lateral ventricle of the brain on the ischemic side in rats with CI,and with HL+CI,which may contribute to its effects in promoting the proliferation and migration of neural stem cells in the brain.