Objective To investigate the progression of breast cancer in mice induced by chronic binding stress and the regulatory mechanism of Xiaoyao SAN based on TGF-β1/CD147 signal pathway.Methods 40 BABL/c mice were randomly divided into tumor group,model group,Xiaoyaosan group and Mifepristone group,and then 4T1 cell line was inoculated into the armpits of each group of mice.After Tumor formation,mice in all groups except tumor group were subjected to chronic restraint stress for 21 days.Meanwhile,mice in Xiaoyaosan and Mifepristone groups were gavaged with the corresponding drugs,and mice in the other two groups were gavaged with normal saline.After the modeling,the mice were sacrificed after anaesthesia.The weight and volume of the tumors and visceral index of the mice were measured.The contents of serum tumor markers(CA199,CEA,VEGF),serum neurotransmitters(DA and CORT),and inflammatory mediators(TGF-β1 and IL-10)in tumor tissues were detected by Elisa.The expressions of iNOS and Arg-1,the polarization markers of macrophages,and the expressions of CD147 and its downstream signaling molecules MMP2,MMP9 and VEGF in tumor tissues were all detected by immunohistochemistry and Western blot.Results Compared with tumor group,in model group,tumor weight and volume,serum CA199,CEA,VEGF,CORT content,tumor TGF-β1 and IL-10 content were significantly increased;visceral index and serum DA content were significantly reduced;the expression of M2-type polarization marker Arg-1 in tumor macrophages was significantly increased,while the expression of M1-type polarization marker iNOS was significantly decreased;the expressions of CD147 and its downstream signaling molecules MMP2,MMP9 and VEGF were significantly increased.Both Xiaoyaosan and mifepristone could effectively reverse the above changes.Conclusion The mechanism of chronic restraint stress promoting breast cancer progression in mice is related to the increased release of TGF-β1 from M2-type polarization of tumor-associated macrophages,which activates CD147 and its downstream related signals.Xiaoyaosan could relieve the M2-type polarization of macrophages caused by increased corticosterone under stress conditions,reduce the production of TGF-β1,inhibit CD147 and its downstream signal,and thus inhibit the progression of breast cancer caused by chronic restraint stress in mice.

Objective To study the core behavioral symptoms,biological indicators,and pathological changes of a mouse model of breast cancer complicated with depression induced using 4T1 breast cancer cell inoculation combined with chronic restraint stress(CRS).Methods BABL/c mice were randomly divided into Control,Stress,Tumor,and stress combined with tumor(S+T)groups.Mice in the tumor and S+T groups were inoculated under the front legs with breast cancer 4T1 cells.After tumor formation,mice in the stress and S+T groups were subjected to CRS for 21 days.The body weight and food intake of each group were monitored during modeling.After the experiment,the occurrence of depression-like behavior of mice in each group was evaluated by sucrose preference test,open field test,elevated plus-maze test,and forced swimming test.After the mice were decapitated,the weights and volumes of the tumors were measured.Concentrations of serum tumor markers,including carbohydrate antigen(CA199),carcinoembryonic antigen(CEA),and vascular endothelial growth factor(VEGF),and related neurotransmitters,including 5-hydroxytryptamine(5-HT),norepinephrine(NE),and corticosterone(CORT),were determined using ELISA.HE staining was used to observe histopathological changes to the hippocampus and tumor.Results In S+T group mice,body weight and food intake were significantly decreased,tumor weight and volume were significantly increased,serum tumor marker(CA199,CEA,VEGF)levels were significantly increased,enthusiasm and desire to explore a new environment were reduced,stress and despair behaviors were significantly increased,and levels of the serum neurotransmitters 5-HT and NE and levels of CORT were significantly increased.In addition,the cell arrangement in the tumor tissue was loose,the amount of intercellular substance decreased,the pathological nuclear classification phase was increased,the arrangement and morphology of neurons in the CA3 region of the hippocampus were disordered,and there were obvious nuclear vacuolation-like changes.Conclusions A mouse model of breast cancer complicated with depression induced by 4T1 breast cancer cell inoculation combined with CRS showed the typical dual symptoms and biological indicators of breast cancer and depression and can be used as a good reference model for experimental studies of breast cancer complicated with depression.

Both morbidity and mortality of gastric cancer are in the front rank among malignant tumors.At present,enhanced CT is served as an important imaging method for preoperative diagnosis and assessment of gastric cancer,but it is mostly based on morphological evaluation and unable to perform quantitative analysis.The functional imaging technology represented by energy spectral CT and CT perfusion imaging has a variety of quantitative parameters,which is expected to make up for the shortcomings of conventional CT.The review introduces the basic principles of energy spectral CT and CT perfusion imaging,and summarizes their applications in the diagnosis,pathological classification,grading,staging and efficacy prediction of gastric cancer,aiming to improve the understanding of functional CT imaging for the pretreatment assessment in gastric cancer.

OBJECTIVE: To summarize the biomechanical characteristics, diagnosis, and hip arthroscopic treatment of borderline developmental dysplasia of hip (BDDH) with Cam-type femoroacetabular impingement (Cam FAI). METHODS: The literature on BDDH with Cam FAI at home and abroad in recent years was extensively reviewed and analyzed. RESULTS: In patients with BDDH and Cam FAI, the femoral neck anteversion angle and femoral neck shaft angle increase, the pelvis tilts, and the acetabulum rotates, resulting in instability of the hip joint. In order to maintain the stability of the hip joint, the direction of biomechanical action of the hip joint has changed, which further affects the anatomical structures such as the proximal femur and acetabular morphology. BDDH with Cam FAI can be diagnosed clinically by combining lateral center edge angle, anterior center edge angle, and acetabular index. BDDH with Cam FAI can be effectively treated through arthroscopic polishing of the edges of the acetabular proliferative bone, excision of Cam malformations, and minimally invasive repair of the glenoid lip and cartilage of the hip joint. CONCLUSION Currently, there is no unified standard for the diagnosis and treatment of BDDH with Cam FAI. Minimally invasive treatment of the hip under arthroscopy can achieve good early- and medium-term effectiveness, and has certain advantages in repairing and maintaining the integrity of the glenoid lip and suturing/compression joint capsule. However, the long-term effectiveness needs to be further followed up to determine. The timing of surgery, intraoperative bone edge depth polishing, and joint capsule suturing/compression techniques also need to be further explored.
Humans ; Femoracetabular Impingement/surgery* ; Arthroscopy/methods* ; Hip Joint/surgery* ; Acetabulum/surgery* ; Hip Dislocation, Congenital/surgery* ; Treatment Outcome ; Retrospective Studies

Objective:To investigate the optimal monochromatic level for evaluation of in-stent lumen after transjugular intrahepatic portosystemic shunt (TIPS) by dual-layer detector CT.Methods:Twenty-nine patients after TIPS were retrospectively enrolled who underwent abdomen enhanced examinations with portal venous phases by a dual-layer detector CT between December 2019 and July 2021. The mixed iterative image (conventional group) and monochromatic images (40 keV group, 50 keV group, 60 keV group and 70 keV group) were obtained by reconstruction. Circular regions of interest were placed in the in-stent of the cross-sectional reconstructed image and in the vertical spinal muscle on the same plane to obtain the corresponding average CT value and noise. The contrast to noise ratio (CNR) and signal to noise ratio (SNR) were calculated. Then 4-point scale was performed to evaluate image quality subjectively by 2 physicians blindly and separately. One-way ANOVA or Kruskal Wallis H rank-sum test was used for the overall analysis between groups, and LSD test or Dunn′s Bonforoni test was used for pairwise comparison within groups. Results:There was no significant difference in noise values among the 5 groups ( P>0.05). The difference of CNR and SNR between the 5 groups was statistically significant ( F=72.28, 56.45, P<0.001). The CNR and SNR in the 40 keV group were the highest, which were 50.4±15.7 and 59.3±18.4 respectively, and the difference was statistically significant ( P<0.001). Subjective scores showed statistically significant differences among the 5 groups (χ2=101.61, P<0.001). The score of the 40 keV group was higher than that of the 60 keV group, 70 keV group, and conventional group ( P<0.001), and there was no significant difference when compared with the subjective score of the 50 keV group ( P>0.05). Conclusions:The 40 keV monochromatic image of dual detector spectral CT is the best image to observe the lumen of the stent after TIPS.

BACKGROUND: The aging and lesions of the intervertebral disc are closely related to the lack of nutritional blood supply to the disc. Aquaporin plays an important role in the nutritional supply to the intervertebral discs, but the specific mechanism has not been fully defined. OBJECTIVE: To study the mechanism of Yaobishu on degenerated intervertebral disc in rabbits based on the changes of aquaporin (AQP) 1 and AQP3 protein expression. METHODS: Thirty-six New Zealand white rabbits were randomly divided into model group, low-dose Yaobishu group and high-dose Yaobishu group. Animal models of lumbar intervertebral disc prolapse were prepared through an injection of normal saline into L4/5 and L5/6 segments. The model group was intragastrically given normal saline 5 mL/kg per day, the low-dose group was intragastrically given Yaobishu 5 mL/kg per day, and the high-dose group was intragastrically given Yaobishu 10 mL/kg per day, twice a day, for 21 days. After 6 weeks of treatment, the intervertebral discs were taken for anatomical and histological observation using hematoxylin-eosin staining. Expression of AQP1 and AQP3 in the nucleus pulposus at protein and mRNA levels was quantified by RT-PCR and western blot assay. RESULTS AND CONCLUSION: In all the three groups, the annulus fibrosus was destroyed, abnormal cartilage tissue appeared, and the nucleus pulposus was reduced in number. Severest degeneration of the intervertebral disc was found in the model group, followed by the low-dose Yaobishu and high-dose Yaobishu groups in turn. The expression of AQP1 and AQP3 mRNA and protein in the high-dose Yaobishu group and low-dose Yaobishu group increased significantly after 6 weeks of treatment (P < 0.05), while the expression in the model group showed no significant difference before and after treatment (P > 0.05). There were significant differences in the expression of AQP1 and AQP3 mRNA and protein among the three groups (P < 0.05). Therefore, Yaobishu may alleviate the degeneration of the rabbit intervertebral disc by increasing the expression of AQP1 and AQP3.

Objective To observe the therapeutic effect of combined acupuncture combined with omeprazole on patients with craniocerebral trauma complicated with stress gastric mucosal injury. Methods Patients with stress gastric mucosal injury after cerebral trauma admitted to neurology of Brain Hospital, Affiliated Hospital of Logistics University from June 2016 to July 2017 were enrolled, with the inclusion criteria within 24 hours after injury at admission, and Glasgow coma scale (GCS) less than 12. Patients were divided into omeprazole group, acupuncture group and acupuncture plus omeprazole combined treatment group according to random number table method. All patients in the three groups were given symptomatic treatment in time after admission. After diagnosis, omeprazole group was injected intravenously omeprazole, 40 mg each time, one dose in 12 hours for 7 days; acupuncture group was acupunctured at bilateral Zusanli point and Zhongwan point, 20 minutes for needle retention, once a day for 7 days;combined treatment group was given acupuncture and omeprazole at the same time. The GCS score and the occult stool test were performed at admission and treatment of 7 days; the pH of gastric juice, the levels of serum neurotensin (NT) and endothelin-1 (ET-1) were measured at admission and treatment 1, 3, 5, 7 days. At the same time, 10 healthy persons were selected as the control. Results Finally, 90 patients were selected, 30 in each group. GCS score at 7 days after treatment in omeprazole group, acupuncture group and combined treatment group were significantly higher than those at admission, but there was no statistical difference among the groups (9.46±2.81, 10.26±2.24, 10.52±2.50, F = 2.010, P = 0.141). For treatment of 7 days, the incidence of occult stool in the combined treatment group was significantly lower than that in the omeprazole group and acupuncture group (13.3% vs. 36.7%, 40.0%, both P < 0.05). The pH value of gastric excretion was increased gradually after treatment in the three groups. The pH value of gastric excretion in the combined treatment group was significantly higher than that in the omeprazole group and acupuncture group at 5 days of treatment (4.58±0.53 vs. 4.20±0.52, 4.28±0.43, both P < 0.05). The levels of serum NT in the three groups were both bi-directional: the level of NT at admission was significantly higher than that in the healthy control group, then decreased significantly, and the treatment of 3 days was significantly lower than that in the healthy control group and then rise gradually. The level of NT at treatment 5 days in the combined treatment group was significantly higher than that of the omeprazole group and the acupuncture group (ng/L: 45.88±8.03 vs. 36.15±11.54, 37.32±7.79, both P < 0.05), and had returned to normal level on the 7th day after treatment (ng/L: 56.88 ±12.54). The level of serum ET-1 in the three groups showed a bimodal change: the level of ET-1 at admission was significantly higher than that of the healthy control group. The treatment of 1 day to the normal range was gradually increased, and the peak of 5 days appeared again and then decreased slowly. The level of ET-1 at treatment of 7 days in the combined treatment group was significantly lower than that of the omeprazole group and acupuncture group (ng/L: 53.25±7.60 vs. 63.74±9.05, 65.50±12.73, both P <0.05), and had been restored to normal. Conclusion Combined acupuncture at points of Zusanli and Zhongwan for the treatment of stress gastric mucosal injury after traumatic brain injury, can reduce gastric acid secretion, promote the level of NT in serum, reduce the secretion of ET-1 level, help to repair the gastric mucosa, and the effect of combined with omeprazole is more significant.

Objective To explore the curative effect of oral cancer radical surgery plus free anterolateral thigh flap repair and analyze the influence factors of skin flap necrosis.Methods The data of 98 patients who underwent oral cancer radical surgery with concurrent free anterolateral thigh flap repair in our hospital from January 2010 to June 2015 were retrospectively analyzed.The complete survival rate of skin flaps and incidence of complications in all patients were statistically analyzed.The age,diabetes,infection in implanted skin flap area,smoking and mental status,etc.of patients with survived or necrotic skin flaps were compared between patients with survival flaps and patients with flap necrosis,and multivariate Logistic regression analysis was performed.Results Among the 98 cases,86 cases of flaps survived completely and the survival rate was 87.8%.Fifteen cases with the skin flap necrosis,the incidence of complications was 15.3%,including 7 cases of surgi-cal site infection and 5 cases of skin flap necrosis with massive hemorrhage.The donor site incisions of all patients were primary healing and the patients were satisfied with the postoperative appearance.Among the patients with flap necrosis,the incidence rates of ≥60 years old,with diabetes,infection in flap implanted area,smoking and poor mental state (41.7%,41.7%,58.3%,75.0%,83.3%)were higher than those corresponding proportions in the patients with with survival flaps(P <0.05).Multivariate Logistic regression analysis showed that age,diabe-tes,infection in implanted skin flap area,smoking and poor mental status were the influencing factors for flap necrosis.Conclusion Oral cancer radical surgery with concurrent free anterolateral thigh flap repair has good curative effects.The age,combined with diabetes,smoking,infec-tion in flap implanted area and poor mental state are the risk factors for flap necrosis in patients with oral cancer after flap repair,which should be given intervention to improve the survival rate of skin flap in clinic.

Objective To investigate the bettertherapeutic method and clinical efficacy of discoid meniscus injury under arthroscope.Methods Forty-one patients with discoid meniscus injury were selected as our subjects from Nov.2011 to Feb.2013,who were treated by arthroscopic surgery and performed with meniscus plasty.Thirt-eight patients were received ultra Fast-fix meniscal repair system.Joint function exercises were performed on bed within 1 month after operation.Incomplete weight bearing were performed after 1 month postoperation.After 3 month postoperation,they were permitted for full weight bearing.Results All patients were treated successfully with surgery and no postoperative complications occurred.The patients were followed up from 3.0 to 18.0 months and average was 10.5 months.The preoperative Lysholm scores were(68.28 ±8.04)) lower than that at the postoperation (88.17 ± 7.49)) and the difference were significant (t =11.59,P ＜ 0.05).Furthermore,according to Ikeuchi criterion,the outcomes were 28 cases with excellent,10 cases with good and 3 cases with general rank.Conclusion Discoid meniscus plasty and suture under arthroscope is proved to be a better approach with less trauma,recovery quickly and fewer complications.It should be a preferred method for discoid meniscus injury.

Objective To determine the effect of moderate hypothermia on coagulation in patients with severe traumatic brain injury (sTBI) and investigate the clinical significance of thrombelastogram (TEG) monitoring.Methods Seventy-five patients with sTBI were randomly assigned to hypothermia group (conventional treatment + moderate hypothermia within 24 hours posttrauma,n =38) and control group (conventional treatment alone,n =38).TEG aided in monitoring coagulation function by measuring clot reaction time (R),clot formation time (K),clotting rate (α),maximal amplitude (MA),and percent fibrinolysis at 30 minutes after MA (LY30).Meantime,the intracranial pressure,vital signs,blood gas values,and blood electrolytes were also measured.Outcome was evaluated by using Glasgow outcome scale (GOS).Results The two groups were similar on admission with respect to R,K,α,MA,and LY30 (P ＞ 0.05),but the coagulation index in hypothermia group was significantly different from that in control group at days 1,2,3 and 7 posttreatment (P ＜ 0.05).Moreover,moderate hypothermia therapy demonstrated decrease of intraeranial pressure (P ＜ 0.01),with no severe complications,low mortality and improved outcome in comparison with control group.Conclusion Moderate hypothermia improves the hypercoagulability in patients with sTBI without increasing the risk of hyperfibrinolysis and protects brain tissue by decreasing intracranial pressure.