OBJECTIVES: To investigate the role of the calcium/calmodulin (CaM)-mediated activation of calcineurin (CN)-nuclear factor of activated T cells (NFAT) signaling pathway in mediating the regulatory effect of hyperforin (HY) on stress-induced depression-like disorder (DP) in mice. METHODS: C57BL/6J mice were randomly divided into control group, DP model group, and hyperforin treatment group (n=15). Behavioral changes of the mice were assessed using open field test (OFT), sucrose preference test (SPT), tail suspension test (TST), light/dark box test (LDB), and novel object suppression test (NSFT). Immunohistochemistry was used to detect tyrosine hydroxylase (TH) expression in the CA1 region of the hippocampus, and serum serotonin (5-HT) and norepinephrine (NA) levels were detected with ELISA. Western blotting was used to analyze the expressions of TNF-α, IL-1β, IL-2, and CN-NFAT pathway proteins. In cultured BV-2 microglial cells with lipopolysaccharide (LPS) stimulation, the effects of hyperforin and CN inhibitor (CNIS) on expressions of ionized calcium-binding adapter molecule 1 (IBA-1), 5-HT, NA, inflammatory cytokines and CN-NFAT pathway proteins were examined using immunofluorescence assay, ELISA or Western blotting. RESULTS: Compared with the control mice, the mice in DP group showed significantly reduced activity in OFT, decreased sucrose consumption in SPT, reduced shuttle crossing in LDB, and lowered food intake in NSFT with significantly increased immobility in TST. The mice with DP showed significantly decreased TH-positive neurons, lowered 5-HT and NA levels, and increased expressions of TNF-α, IL-1β, IL-2 and CaM-CN-NFAT pathway proteins. In cultured BV-2 cells, LPS stimulation strongly increased cellular IBA-1 expression, decreased the levels of neurotransmitters (5-HT and NA), and increased the levels of inflammatory cytokines and CN-NFAT signaling, and these changes were effectively reversed by treatment with hyperforin or CNIS. CONCLUSIONS Hyperforin improves stress-induced depression-like behaviors in mice and activated BV-2 cells by targeting the CN-NFAT signaling pathway.
Animals ; Mice, Inbred C57BL ; Mice ; Microglia/drug effects* ; Depression/etiology* ; Perylene/pharmacology* ; Calcineurin/metabolism* ; NFATC Transcription Factors/metabolism* ; Calcium Signaling/drug effects* ; Stress, Psychological ; Phloroglucinol/pharmacology* ; Signal Transduction ; Male ; Behavior, Animal/drug effects* ; Terpenes

Objective:To explore the application of 1 565 nm non-ablative fractional laser in the treatment of enlarged facial pores.Methods:It was a longitudinal cohort study. From September 2020 to September 2021, 68 patients with enlarged facial pores, including 5 male patients and 63 female patients, aged between 20 and 41 (29.3±4.6) years, were treated at the Department of Plastic and Reconstructive Surgery of Ningbo Sixth Hospital. They received 1 565 nm non-ablative fractional laser once every month for a total of 3 times. The number, score and percentile ranking of facial pores before and after treatment were recorded and compared by VISIA, and adverse reactions were observed.Results:The facial pores number before and after treatment were 890.75±312.61 and 834.37±289.94, the facial pores score were 25.76±1.08 and 24.81±8.59, respectively, indicating a statistically significant decrease in facial pores number and score compared to before treatment ( t=4.19, 2.65, P<0.05). The facial pores percentile ranking before and after treatment were 4.00% (2.00%, 7.00%) and 5.00% (2.25%, 8.00%), respectively, indicating a statistically significant increase in facial pores percentile ranking compared to before treatment ( Z=-3.35, P<0.05). Three patients had transient pigmentation, all of which were gradually faded within 1 month after the last treatment. One patient had a few inflammatory papules scattered on the cheek, which faded in 3 days by using erythromycin eye cream. Conclusions:The 1 565 nm non-ablative laser can effectively improve enlarged facial pores with light adverse reactions.

Objective:To investigate the application value of laparoscopic natural orifice specimen extraction surgery (NOSES) based on purse-string suture for sigmoid colon and upper rectal cancer.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 14 patients undergoing laparoscopic NOSES based on purse-string suture for sigmoid colon and upper rectal cancer in The First Affiliated Hospital of Sun Yat-sen University from October 2022 to June 2023 were collected. There were 8 males and 6 females, aged (56±10)years. Observation indicators: (1) surgical conditions; (2) postoperative conditions; (3) follow-up. Measurement data with normal distribution were represented as Mean± SD. Count data were described as absolute numbers. Results:(1) Surgical conditions. All patients underwent laparoscopic NOSES based on purse-string suture for sigmoid colon and upper rectal cancer successfully, without conversion to open surgery. The operation time of 14 patients was (162±32)minutes, and the volume of intraoperative blood loss was (22±12)mL. (2) Postoperative conditions. Time to postoperative first out-of-bed activity, time to postoperative first flatus, time to postoperative first drinking, time to postoperative initial liquid food intake, duration of postoperative hospital stay of 14 patients were (1.6±0.7)days, (2.1±0.6)days, (2.4±0.6)days, (3.8±1.0)days, (6.0±0.9)days, respectively. None of patient had perioperative complications such as postoperative anastomotic leakage and bleeding. (3) Follow-up. All 14 patients were followed up for (9.7±1.9)months. There was no postoperative recurrence, metastasis or death in 14 pati-ents.Conclusion:The laparoscopic NOSES based on purse-string suture can be used for sigmoid colon and upper rectal cancer, which is safe and feasible.

Objective: To prove the validity and accuracy of the digitizer instead of the conventional electronics plug-in for radionuclide measurement. Methods:  Based on a large-area flow-gas multi-wire proportional counter for 2πα and 2πβ surface particle emission rate measurement, the DT5730 digital waveform sampler developed by CAEN was used for waveform signal acquisition, amplitude analysis, and data processing of the α-plane source 241Am and the β-plane source nuclides 14C, 36Cl, and 90Sr-90Y of different energies. Results: The deviations between the α and β surface particle emission rate results obtained after dead time and background corrections and the measurements obtained based on the plug-in calibrator were all within 0.6%, within the uncertainty range, under consistent experimental conditions such as electronics threshold and high pressure. Conclusion The digitizer is an effective alternative to conventional electronics plug-ins for α and β signal acquisition and processing and the accurate measurement of α and β emission rates.

Objective:To analyze and evaluate the safety and efficacy of a Chinese domestically manufactured Heart Con-type implantable third-generation magnetic and hydrodynamic levitation left ventricular assist device(LVAD) for the treatment of end-stage heart failure(ESHF), by reporting the results of eleven-center clinical trial on 50 cases.Methods:This study was a multicenter clinical trial, designed by means of prospective, multicenter and single-group target value. 50 subjects with ESHF were competitively enrolled and treated with HeartCon as the LVAD in eleven centers. The primary efficacy measure was survival, defined as either the subjects experiencing the transition to heart transplantation(HT) or myocardial recovery assisted by the device within 90 days, or as successfully assisted by the LVAD for full 90 days after implantation. The target survival rate was 60%, other observations included implantation success rate, mortality, pump failure needing replacement or emergency heart transplantation.Results:All enrolled 50 patients received LVAD implantation successfully, 46 survived with the pump for 90 days, 1 patient transitioned to heart transplantation, and 3 patients experienced pump thrombosis, within which 2 patients underwent pump replacement and continued to live with the pump for 90 days, and the other one received emergency heart transplantation. There were no dropout subjects. The survival rate at full 90 days after HeartCon implantation was 100%. The survival rates with pump in the full set analysis and the protocol set analysis were 96.00% and 95.92% respectively, which were higher than the target value of 60%. The differences were both statistically significant( P<0.05). Conclusion:The results of the multicenter clinical trial with the largest sample size in China using domestically manufactured third-generation LVAD has demonstrated that, HeartCon is a safe and effective LVAD to treat ESHF patients.

Objective:To investigate the effect of tourniquet-reperfusion augmented infrared thermography(TRAIRT) on locating the dominant perforator to assist design of free medial sural artery perforator flap.Methods:The data of patients with skin soft tissue defect of upper limb repaired by free medial sural artery perforator flap in Department of Hand Surgery, Ningbo Sixth Hospital from May 2019 to January 2022 were retrospectively analyzed. Color Doppler ultrasonography (CDU) and TRAIRT were used to locate the dominant perforator auxiliary flap design before surgery and after anesthesia. In the TRAIRT video, the hot spot with "early emergence, high brightness and fast expansion" was selected as the advantageous perforator. During the operation, the flap was elevated and transferred to the affected area to cover the defect wound according to the designed mark points, and fixed by the absorbable sutures with an interrupted suturing method, then end-to-end vascular anastomosis was performed successively. The donor area was sutured directly or sutured with full thickness skin grafts depending on the area of the wound. The donor and recipient areas of the flap were observed and the patients’ satisfaction was recorded. The gold standard was the actual location of the perforating vessel found during the operation. Compared with the gold standard, the location of the perforating vessel explored by TRAIRT and CDU was considered to be accurate (positive) if the distance was less than 10 mm. The sensitivity (accurate number of perforators/actual number of perforators during operation ×100%) and positive predictive value (accurate number of perforators/total number of perforators×100%) of the two methods were calculated, expressed as %, and the sensitivity of the two methods was compared by paired χ2 test. Kappa coefficient was used to analyze the consistency of the two methods to detect perforating vessels. The perforator detection time of TRAIRT and CDU were recorded, expressed as Mean±SD, and statistically analyzed by paired sample t-test. Results:A total of 23 patients were included, consisting of 14 males and 9 females, agd 21-70 years old, average age of 43 years old. The wounds were on forearm in 5 cases, wrist in 2 cases, and hand in 16 cases. The wound area was 4.5 cm × 5.5 cm-6.5 cm × 12.0 cm. Intraoperative flap incision area was 5.0 cm × 6.0cm-7.0 cm × 13.0 cm. After operation, 22 cases of flaps survived, 1 case had superficial necrosis at the distal end, which healed after repeated dressing change. The donor area of flaps healed well, with primary suture in 20 cases and full thickness skin grafting in 3 cases. Postoperative follow-up was 5-16 months (mean 8.4 months). The flaps had no bulge, swelling and abrasion. The texture and color were similar to the medial calf skin, and the scars in the donor and recipient areas were not obvious. The patients were satisfied with the recovery. Among the 23 patients, 49 perforators were found by TRAIRT, 50 perforators were found by CDU, and 53 perforators were found intraoperatively. The sensitivity of TRAIRT and CDU was 88.7% (47/53) and 90.6% (48/53), with no significant differences ( P>0.05), and the positive prediction value was 95.9% (47/49) and 96.0% (48/50) respectively. The Kappa coefficient was 0.89, indicating a good consistency between the two methods. The time required for TRAIRT to detect perforators was significantly shorter than that of CDU, with statistical significance [(6.52±2.02) min vs. (17.87±2.49) min, P<0.01]. Conclusion:TRAIRT has a good consistency with CDU in detection of medial sural artery perforator. The application of TRAIRT in designing medial sural artery perforator flap for wound repair is good, and it has advantages of short time taking, simple operation, economy and non-invasiveness.

Objective:To investigate the effect of tourniquet-reperfusion augmented infrared thermography(TRAIRT) on locating the dominant perforator to assist design of free medial sural artery perforator flap.Methods:The data of patients with skin soft tissue defect of upper limb repaired by free medial sural artery perforator flap in Department of Hand Surgery, Ningbo Sixth Hospital from May 2019 to January 2022 were retrospectively analyzed. Color Doppler ultrasonography (CDU) and TRAIRT were used to locate the dominant perforator auxiliary flap design before surgery and after anesthesia. In the TRAIRT video, the hot spot with "early emergence, high brightness and fast expansion" was selected as the advantageous perforator. During the operation, the flap was elevated and transferred to the affected area to cover the defect wound according to the designed mark points, and fixed by the absorbable sutures with an interrupted suturing method, then end-to-end vascular anastomosis was performed successively. The donor area was sutured directly or sutured with full thickness skin grafts depending on the area of the wound. The donor and recipient areas of the flap were observed and the patients’ satisfaction was recorded. The gold standard was the actual location of the perforating vessel found during the operation. Compared with the gold standard, the location of the perforating vessel explored by TRAIRT and CDU was considered to be accurate (positive) if the distance was less than 10 mm. The sensitivity (accurate number of perforators/actual number of perforators during operation ×100%) and positive predictive value (accurate number of perforators/total number of perforators×100%) of the two methods were calculated, expressed as %, and the sensitivity of the two methods was compared by paired χ2 test. Kappa coefficient was used to analyze the consistency of the two methods to detect perforating vessels. The perforator detection time of TRAIRT and CDU were recorded, expressed as Mean±SD, and statistically analyzed by paired sample t-test. Results:A total of 23 patients were included, consisting of 14 males and 9 females, agd 21-70 years old, average age of 43 years old. The wounds were on forearm in 5 cases, wrist in 2 cases, and hand in 16 cases. The wound area was 4.5 cm × 5.5 cm-6.5 cm × 12.0 cm. Intraoperative flap incision area was 5.0 cm × 6.0cm-7.0 cm × 13.0 cm. After operation, 22 cases of flaps survived, 1 case had superficial necrosis at the distal end, which healed after repeated dressing change. The donor area of flaps healed well, with primary suture in 20 cases and full thickness skin grafting in 3 cases. Postoperative follow-up was 5-16 months (mean 8.4 months). The flaps had no bulge, swelling and abrasion. The texture and color were similar to the medial calf skin, and the scars in the donor and recipient areas were not obvious. The patients were satisfied with the recovery. Among the 23 patients, 49 perforators were found by TRAIRT, 50 perforators were found by CDU, and 53 perforators were found intraoperatively. The sensitivity of TRAIRT and CDU was 88.7% (47/53) and 90.6% (48/53), with no significant differences ( P>0.05), and the positive prediction value was 95.9% (47/49) and 96.0% (48/50) respectively. The Kappa coefficient was 0.89, indicating a good consistency between the two methods. The time required for TRAIRT to detect perforators was significantly shorter than that of CDU, with statistical significance [(6.52±2.02) min vs. (17.87±2.49) min, P<0.01]. Conclusion:TRAIRT has a good consistency with CDU in detection of medial sural artery perforator. The application of TRAIRT in designing medial sural artery perforator flap for wound repair is good, and it has advantages of short time taking, simple operation, economy and non-invasiveness.

Radiotherapy is the most common treatment for nasopharyngeal carcinoma, and the radiotherapy technique is essential for the prognosis of nasopharyngeal carcinoma. Due to the complexity of the structure of the intensity-modulated device and the accuracy of the clinical requirements of radiotherapy, it is inevitable that higher requirements will be imposed on the process of intensity-modulated radiotherapy. Currently, gaps exist in the radiotherapy equipment and personnel qualification among radiotherapy units, and thus the homogenization in the radiotherapy remains to be strengthened in China. With the application of radiotherapy information management system, digital medicine and artificial intelligence technologies in the field of radiotherapy, the original process fails to meet the application needs of the new precise radiotherapy technology. Therefore, this process is designed based on the existing radiotherapy procedures for nasopharyngeal carcinoma in combination with the latest developments in the field of radiotherapy, aiming to establish a novel standard process recommendation, ensuring the standardization and homogenization of radiotherapy and achieve the individualized intensity-modulated radiotherapy for nasopharyngeal carcinoma patients.