Objective To explore the clinical effect of cold treatment of replacement fluid in continuous blood purification(CBP)of patients with heat stroke.Methods Clinical data of 46 patients with heat stroke who were treated with CBP in Hainan Hospital of PLA General Hospital from July 2018 to September 2022 were retrospectively analyzed.The patients were assigned to control group(23 cases,conventional treatment for heat stroke and CBP with room temperature replacement fluid)and observation group(23 cases,conventional treatment for heat stroke and CBP with cooling replacement fluid).The body temperatures were compared between the two groups before treatment and 30 min,2 h,6 h,12 h and 24 h after treatment.The prothrombin activity(PTA),activated partial thromboplastin time(APTT),D-dimer(D-D),fibrinogen(FIB)and platelet count(PLT)before treatment and at 24 h(T1),3 d(T2)and 7 d(T3)after treatment,as well as the Acute Physiology and Chronic Health Evaluation Ⅱ(APACHEⅡ)score at 7 d after treatment were also compared between the two groups.Results There was no significant difference in temperature or coagulation function between the two groups before treatment(P>0.05).The temperature of the observation group was significantly different from that of the control group at 2 h,6h and 12h after treatment(P<0.05).After treatment,the levels of PTA,FIB and PLT in the observation group at T1,T2 and T3 were higher than those in the control group,while the level of D-D in the observation group was lower than that in the control group,and the APPT at T1 and T2 was significantly shorter than that in the control group(P<0.05).PTA,APPT,D-D,FIB and PLT of the two groups were improved after treatment(P<0.05).Conclusion The cold treatment of replacement fluid can quickly shorten the cooling time of patients with heat stroke during CBP,and significantly improve coagulation function.It is worthy of clinical promotion so as to improve the progrosis of patients with heat strok.

Background and objective Metabolic change is one of the important characteristics of radiation pneu-monitis.Radiotherapy,as a conventional method for the treatment of thoracic tumors,can not only effectively kill tumor cells,but also cause adverse reactions such as local inflammation and fibrosis,which leads to limited therapeutic effect and profound impact on the quality of life of patients.Therefore,it is of great significance to explore the metabolic changes caused by radio-therapy.The aim of this study was to investigate the effects of X-ray irradiation on the metabolism of a mouse lung epithelial cell line(murine lung epithelial-12,MLE12).Methods MLE12 cells were cultured in vitro and randomly divided into radiation group(IR)and control group(NC).Cells in the IR group were irradiated at a dose of 10 Gy using a Hitachi X-ray irradiator.Cell supernatant samples were collected at 48 h after irradiation.Metabolomic analysis of the samples was performed by liq-uid chromatograph mass spectrometer(LC/MS).Results LC/MS metabolomics analysis revealed the metabolic changes of MLE12 cells at 48 h after irradiation.A total of 38 secretory metabolites were altered in the IR group compared with the NC group.According to the annotation of Kyoto Encyclopedia of Genes and Genomes(KEGG)database,the differential metabo-lites are mainly involved in nucleotide metabolism,amino acid metabolism and lipid metabolism,among which the difference in nucleotide metabolism is the most significant.Conclusion The metabolism ofMLE12 cells was significantly affected by X-ray irradiation,mainly affecting the nucleotide metabolic pathways,including purine and pyrimidine metabolites and related meta-bolic pathways.

Objective ::To investigate the role of trehalose in hepatic ischemia-reperfusion injury and its underlying mechanisms.Methods:C57BL/6J mice were randomly divided into no-ischemia group, ischemia-reperfusion group, trehalose-treated group and normal saline control group. After ischemia for 90 minutes, reperfusion immediately or 6h, blood and liver tissues were collected, and serum was separated. The liver function parameters of ALT, AST, the inflammatory factors of TNF-α, IL-1β and IL-2, and the pathological changes of liver were detected to study the role of trehalose during hepatic ischemia-reperfusion injury. Hypoxia-reoxygenation cell model was established by AML12 mouse hepatocyte line, and divided into experimental group and control group. The experimental group was divided into low dose group and high dose group according to the concentration of trehalose administrated. And the control group had no use of trehalose. The level of apoptosis was measured to study the effect of trehalose on apoptosis induced by hepatic ischemia-reperfusion injury with flow cytometry. Western blot was utilized for detecting the levels of Caspase-3, Cleaved Caspase-3 and Bcl-2 protein to understand the molecular mechanisms of trehalose in apoptosis during hepatic ischemia-reperfusion injury.Results:In vivo animal experiments showed that liver function and such inflammatory factors as ALT, AST, TNF-α, IL-1β and IL-2 increased in ischemia-reperfusion group after hepatic ischemia-reperfusion ( P<0.05), and liver tissue became necrotic. After a treatment of trehalose, the levels of ALT, AST, TNF-α, IL-1β and IL-2 were lower than those of normalsaline control group and the area of liver tissue necrosis also decreased ( P<0.05). In vitro cell experiments showed that the apoptosis level of hepatocytes in the experimental group decreased compared with the control group.And the level of activated pro-apoptotic protein Cleaved Caspase-3 decreased, the level of anti-apoptotic protein Bcl-2 increased. Conclusions:Trehalose has protective effects on hepatic ischemia-reperfusion injury in vivo and in vitro. The mechanism may be involved in inhibiting inflammation induced by hepatic ischemia-reperfusion injury, suppressing the activation of Caspase-3 and promoting the expression of Bcl-2, thus played a protective role by extenuation of hepatocyteapoptosis.

Endothelial regeneration is a research hotspot in the field of dental pulp. The regeneration of endodontic blood flow is the bottleneck of dental pulp regeneration, and the applied scaffold material is the key to revascularization. Stent materials were reviewed. The literature review Results show that, depending on the source of the stent material used for endodontic revascularization, there are mainly natural, synthetic and composite materials. The natural scaffold materials used for vascular regeneration include chitosan, hyaluronic acid, bacterial cellulose, and proanthocyanidin; artificial scaffold materials include hydrogel, cryogel, and electrospinning. The bionic composite scaffold system with a double-layer tubular structure is low immunogenicity and good biocompatibility. Studies on the scaffold materials of bionic extracellular matrix, such as injectable hydrogels/microspheres, have promoted the development of dental pulp regeneration, that is, uniformly distributed scaffold materials in the root canal promote the generation of pulp-like tissue; Whether dental pulp tissue can establish effective blood circulation through the apical foramen remains a great challenge.

ObjectiveTo investigate the clinical effect of surgery in the treatment of calcified hepatic cystic echinococcosis. MethodsA retrospective analysis was performed for the clinical data of 16 patients with 20 calcified hepatic hydatid cysts who underwent surgical treatment (total pericystectomy, subtotal pericystectomy, and endocystectomy) in The First Affiliated Hospital of Shihezi University School of Medicine from November 2015 to February 2019. ResultsOf all 16 patients, 1 underwent total pericystectomy, 5 underwent endocystectomy, and 10 underwent subtotal pericystectomy. One patient experienced bile leakage after surgery since the cyst ruptured and entered the bile duct and there was a biliary fistula in the outer wall of the cyst before surgery, and the other patients had no residual cavity complications including residual cavity effusion and infection, bile leakage, or jaundice. There was no death and recurrence after operation. ConclusionSurgical treatment is necessary for non-stationary calcified hepatic cystic echinococcosis. Total pericystectomy is not suitable, while subtotal pericystectomy may be the preferred surgical method, especially when the calcified hepatic hydatid cyst is located near the porta hepatis or the intrahepatic and extrahepatic vessels and there is no obvious lacunae between the adventitia and the outer cyst. Endocystectomy can be selected when hepatic hydatid cyst ruptures.

Epithelial-mesenchymal transition (EMT) is involved in both physiological and pathological processes. EMT plays an essential role in the invasion, migration and metastasis of tumours. Autophagy has been shown to regulate EMT in a variety of cancers but not in head and neck squamous cell carcinoma (HNSCC). Herein, we investigated whether autophagy also regulates EMT in HNSCC. Analyses of clinical data from three public databases revealed that higher expression of fibronectin-1 (FN1) correlated with poorer prognosis and higher tumour pathological grade in HNSCC. Data from SCC-25 cells demonstrated that rapamycin and Earle's balanced salt solution (EBSS) promoted autophagy, leading to increased FN1 degradation, while 3-methyladenine (3-MA), bafilomycin A1 (Baf A1) and chloroquine (CQ) inhibited autophagy, leading to decreased FN1 degradation. On the other hand, autophagic flux was blocked in BECN1 mutant HNSCC Cal-27 cells, and rapamycin did not promote autophagy in Cal-27 cells; also in addition, FN1 degradation was inhibited. Further, we identified FN1 degradation through the lysosome-dependent degradation pathway using the proteasome inhibitor MG132. Data from immunoprecipitation assays also showed that p62/SQSTM1 participated as an autophagy adapter in the autophagy-lysosome pathway of FN1 degradation. Finally, data from immunoprecipitation assays demonstrated that the interaction between p62 and FN1 was abolished in p62 mutant MCF-7 and A2780 cell lines. These results indicate that autophagy significantly promotes the degradation of FN1. Collectively, our findings clearly suggest that FN1, as a marker of EMT, has adverse effects on HNSCC and elucidate the autophagy-lysosome degradation mechanism of FN1.
Autophagy ; Cell Line, Tumor ; Female ; Fibronectins ; Humans ; Lysosomes/metabolism* ; Ovarian Neoplasms ; Sequestosome-1 Protein/metabolism* ; Squamous Cell Carcinoma of Head and Neck

Objective: To establish and evaluate diagnostic efficacy and applicability of serum Golgi protein (GP) 73 based non-invasive diagnostic model with other conventional serological indicators for compensated stage hepatitis B cirrhosis. Methods: 666 cases with chronic hepatitis B (CHB) who had visited to the Fifth Medical Center of People’s Liberation Army General Hospital from January 2010 to December 2017 were selected as the study subjects, and were classified according to compensated stage cirrhosis into clinical and pathological diagnosis group based on whether or not the liver histological examination was performed. A diagnostic model of compensated stage hepatitis B cirrhosis in the clinical diagnosis group was established. The current clinically used diagnostic model of liver cirrhosis, aspartate aminotransferase/platelet ratio index (APRI), fibrosis index (FIB)-4 and liver stiffness measurement (LSM) were compared. Eventually, the diagnostic model was verified step by step by pathological diagnosis group. Results: The area under the receiver operating characteristic curve (AUC) of GP73 and APRI, FIB-4, and LSM for cirrhosis patients in the clinical diagnosis group were 0.842, 0.857, 0.864, and 0.832, respectively. The diagnostic efficiency of the four indicators were of similar (P value > 0.05). A diagnostic model of compensated stage hepatitis B cirrhosis (GAPA) using logistic regression analysis was established: LogitP = 1/ [1 + exp (1.614-0.054 × GP73-0.045 × Age + 0.030 × PLT-0.015 × ALP)]. The AUC of the model was as high as 0.940 and the optimal cut-off value were 0.41. The corresponding diagnostic sensitivity and specificity were 0.92 and 0.82, respectively. The diagnostic efficiency was better than that of APRI, FIB-4, LSM and GP73 alone (P < 0.05). The AUC of GAPA was 0.877 in the pathological diagnosis group, which was similar to the diagnostic efficacy of LSM (0.891) and FIB-4 (0.847) (P > 0.1), but still superior to that of APRI (0.811) and GP73 alone (0.780) (P < 0.001). Conclusion GAPA, a diagnostic model for compensated stage hepatitis B cirrhosis established in this study, has a good diagnostic efficacy in both the clinical and pathological diagnosis group, and has certain auxiliary diagnostic value in the areas where resources are relatively scarce or where LSM has not been developed.

Objective: To explore the clinical effects of split-thickness scalp and allogenic acellular dermal matrix (ADM) in repairing deep wounds of hands in patients with extremely extensive burns. Methods: Six patients with extremely extensive burns complicated by deep burn in hands were admitted to our department from December 2014 to December 2017, including 4 males and 2 females, aged 21 to 58 years. Their total burn areas were from 85% to 95% total body surface area (TBSA), and the sum of deep-partial thickness and full-thickness wounds was larger than 50% TBSA. Under general anesthesia, deep wounds of 10 dorsal hands were repaired by combined transplantation of split-thickness scalp and allogenic ADM in 4 to 6 weeks after injury. The skin grafting range was beyond the metacarpophalangeal joint, including partial dorsal digital deep wounds. Survival of skin grafts on dorsal hands, follow-up of hand shape and functional recovery were observed and recorded. Results: Six patients were successfully treated. There was no infection on the dorsal deep wounds of 10 hands after surgery, and the grafts survived well. During follow-up of 1 to 2 years after operation, there were no recurrent tension blisters or dorsal extension deformity of the metacarpophalangeal joints in 10 hands, the shape and function of hands recovered well, and hand Carroll scores were from 90 to 99 points, with functional levels of Ⅴ and Ⅵ. Conclusions The combined transplantation of split-thickness scalp and allogenic ADM is a good method for repairing deep hand wounds in patients with extremely extensive burns, which can alleviate the cicatrix hyperplasia and contracture of healed hand wounds, and improve the shape and function of hands.

Objective To investigate the risk factors of lymphedema in patients with breast cancer after operation.Methods From January 2012 to May 2016,the clinical data of 350 patients with breast cancer who underwent surgical treatment in First People's Hospital of Foshan were collected.According to the occurrence of postoperative lymphedema,the patients were divided into lymphedema group (87 cases) and non lymphedema group (263 cases).The possible risk factors were evaluated from general demographic indicators,pathological data of breast cancer,perioperative related data and preventive action implementation.Results General demographic data:there was no correlation between the incidence of lymphedema and age,preoperative body mass index (BMI),postoperative BMI,educational level,marital status,residence,family income,menopause,hypertension history (P ＞ 0.05).Pathological data of breast cancer:the occurrence of lymphedema was related with tumor quadrant (x2 =20.039,P ＜ 0.001) and axillary lymph node metastasis (Z =4.713,P ＜ 0.001),but not related with clinical stage and pathological type of tumor (both P≥0.05).Perioperative data:the occurrence of lymphedema was related with the type of incision (x2 =16.921,P ＜ 0.001),axillary lymph node dissection level (x2 =4.433,P ＜ 0.001),the number of axillary lymph node dissection (Z =3.620,P ＜0.001),radiotherapy (x2 =33.290,P ＜ 0.001),endocrine therapy (x2 =10.428,P =0.001),but not related with surgical methods,postoperative complications (subcutaneous fluid,upper limbedema,infection,serum swelling),chemotherapy and neoadjuvant chemotherapy (all P ＞0.05).Comparison of preventive behaviors:avoiding injuries such as cuts and bites (x2 =15.754,P ＜0.001),trimming nails (x2 =9.018,P =0.003),avoiding grasping heavy objects (x2 =11.828,P =0.001) were related with postoperative lymphedema,but other preventive behaviors did not show significant correlation (all P ＞ 0.05).Lymphedema as the dependent variable,multivariate logistic regression analysis results showed that tumor located in the upper outer quadrant (OR =3.943,P ＜ 0.001),surgical incision for longitudinal incision (OR =3.767,P ＜0.001) or oblique incision (OR =2.492,P ＜ 0.001),Ⅱ (OR =1.707,P =0.003) or Ⅲ (OR =4.211,P ＜ 0.001) axillary lymph node dissection,breast/chest wall radiotherapy (OR =2.869,P ＜0.001) or lymph node radiotherapy (OR =4.829,P ＜ 0.001),grabing heavy objects or not (OR =3.264,P ＜ 0.001),avoiding injuries such as cuts and bites (OR =2.602,P ＜ 0.001) were independent risk influence factors of postoperative lymphedema.Conclusion A variety of factors affect the occurrence of postoperative lymphedema in breast cancer patients.Tumors located in the upper outer quadrant,longitudinal or oblique incision,high level of axillary lymph node dissection,radiotherapy,having injuries such as cuts and bites,grabing heavy objects are independent risk influence factors of postoperative lymphedema in breast cancer patients.More attention should be paid to the high risk of lymphedema,and the preventive measures should be taken actively.