Objective To compare the myocardial protective effects of Del nido cardioplegia(DC)and microplegia(MP)in the isolated coronary artery bypass grafting(CABG)underwent the cardiopulmonary by-pass(CPB),and evaluate the safety and efficacy of DC in isolated CABG.Methods A retrospective analysis was performed on 128 patients with isolated CABG by the same surgical team form January 2018 to April 2021 at the Second Affiliated Hospital of Army Medical University.The patients were divided into MP group(n=57)and DC group(n=71)according to the use of intraoperative cardioplegia during the surgery.Preoper-ative baseline data,blood gas at 4 time points of CPB 20 min(T1),CPB 60 min(T2),end of CPB(T3),and re-turning of ICU(T4),as well as perioperative data,major postoperative complications,mortality,medium and long-terms survival rate were collected.Results Compared with preoperative baseline data,the lactate(Lac)level in the DC group was lower;During the operation,the DC group had fewer times of cardiac arrest fluid perfusion and a larger amount volume of cardioplegia(P＜0.001);In CPB,there was a higher fluid balance and a higher rate of spontaneous rebeating(88.7％vs.52.6％),differences were statistically significant(P＜0.05).Blood gas at all 4 time points showed that the DC group had lower blood glucose level(P＜0.05).The cardiac troponin Ⅰ(cTnⅠ)concentration 24 h postoperative was higher(P＜0.05),and the ICU duration was shorter(P＜0.05).Correlation analysis indicated that there was no correlation between cTnⅠ concentration 24 h postoperative and aortic cross clamping time(ACCT)in both groups(P＞0.05).There was a positive correlation between the concentration of cTnⅠ 24 h postoperative and the numbers of cardioplegia deliveries(r=0.331,P=0.005)in DC group,but there was no correlation in MP group(r=0.023,P=0.866).There was no significant difference in perioperative period,postoperative complications and mortality between the two group(P＞0.05).Kaplan-Meier analysis showed that there was no statistically significant difference in the 5 years survival rate between two groups(P=0.966).Conclusion Compared with MP,DC provides a comparable myocardial protection effect in the isolated CABG,with higher security,without affecting the short and medium-term clinical outcomes in patients.

OBJECTIVE: To evaluate effectiveness of proximal femur bionic nail (PFBN) in treatment of intertrochanteric fractures in the elderly compared to the proximal femoral nail antirotation (PFNA). METHODS: A retrospective analysis was made on 48 geriatric patients with intertrochanteric fractures, who met the selection criteria and were admitted between January 2020 and December 2022. Among them, 24 cases were treated with PFBN fixation after fracture reduction (PFBN group), and 24 cases were treated with PFNA fixation (PFNA group). There was no significant difference in baseline data such as age, gender, cause of injury, side and type of fracture, time from injury to operation, and preoperative mobility score, American Society of Anesthesiologists (ASA) score, Alzheimer's disease degree scoring, self-care ability score, osteoporosis degree (T value), and combined medical diseases between the two groups ( P>0.05). The operation time, intraoperative blood loss, number of blood transfusions, transfusion volume, length of hospital stay, occurrence of complications, weight-bearing time after operation, and postoperative visual analogue scale (VAS) score, walking ability score, mobility score, self-care ability score were recorded and compared between the two groups. And the radiographic assessment of fracture reduction quality and postoperative stability, and fracture healing time were recorded. RESULTS: The operations in both groups were successfully completed. All patients were followed up 6-15 months with an average time of 9.8 months in PFBN group and 9.6 months in PFNA group. The operation time was significantly longer in PFBN group than in PFNA group ( P<0.05), but there was no significant difference in intraoperative blood loss, number of blood transfusions, transfusion volume, length of hospital stay, change in activity ability score, and change in self-care ability score between the two groups ( P>0.05). The weight-bearing time after operation was significantly shorter in PFBN group than in PFNA group ( P<0.05), and the postoperative VAS score and walking ability score were significantly better in PFBN group than in PFNA group ( P<0.05). Radiographic assessment showed no significant difference in fracture reduction scores and postoperative stability scores between the two groups ( P>0.05). All fractures healed and there was no significant difference in fracture healing time between the two groups ( P>0.05). The incidence of complications was significantly lower in PFBN group (16.7%, 4/24) than in PFNA group (45.8%, 11/24) ( P<0.05). CONCLUSION Compared with PFNA, PFBN in the treatment of elderly intertrochanteric fractures can effectively relieve postoperative pain, shorten bed time, reduce the risk of complications, and facilitate the recovery of patients' hip joint function and walking ability.
Humans ; Aged ; Retrospective Studies ; Fracture Fixation, Intramedullary ; Bionics ; Blood Loss, Surgical ; Treatment Outcome ; Bone Nails ; Hip Fractures/surgery* ; Femur

Objective: To evaluate the residual radioactivity after ¹³¹I treatment in postoperative inpatients with differentiated thyroid carcinoma (DTC) using service robot in nuclear medicine ward, and assess the time for patients to be released from isolation. Methods: From September 2017 to June 2018, 297 patients (94 males, 203 females, age: 19-80 years) with DTC who underwent ¹³¹I treatment after surgery were included. According to the purpose of treatment and the prescription dosage of ¹³¹I, patients were divided into 8 groups: 4 groups accepted ¹³¹I remnant ablation therapy (RAT) with different dosages, which were 3 700 MBq (RAT1, n=34), 4 440 MBq (RAT2, n=122), 5 550 MBq (RAT3, n=81) and 7 400 MBq (RAT4, n=27), respectively; 4 groups had ¹³¹I treatment for recurrent/metastatic lesions (RMLT), and the dosages were 3 700 MBq (n=1), 4 440 MBq (n=2), 5 550 MBq (n=14) and 7 400 MBq (n=16). At 4, 24, 48 and 72 h after ¹³¹I administration, the dose equivalent rates at 2 cm away from the patient′s neck and at 1 m away from the body were measured by the robot designed for nuclear medicine ward. Kruskal-Wallis rank sum test and Mann-Whitney U test were used to analyze the data. Results: Neck dose equivalent rates for patients with RAT at different time points (4, 24, 48 and 72 h) after ¹³¹I administration were significantly different among 4 groups (H values: 20.889-46.410, all P<0.05), as well as the body dose equivalent rates (H values: 27.181-35.497, all P<0.05). The neck dose equivalent rates at 24, 48 and 72 h after ¹³¹I administration were statistically different between group 3 and 4 for patients with RMLT (z values: 2.328-3.076, all P<0.05; data in group 1 and 2 were too limited to be compared), while there was no statistical difference for the body dose equivalent rates (z values: 0.333-1.621, all P>0.05). The radioactivity retention in patients decreased rapidly within 24 h, then slowed down gradually and became extremely low at 72 h. At 72 h after ¹³¹I administration, 96.6%(255/264) patients with RAT and 100%(33/33) patients with RMLT were lower than 23.3 μSv/h, which meant the patients could be discharged from hospitalization. Conclusions Nuclear medicine ward service robots may dynamically measure residual radioactivity in DTC patients who take ¹³¹I treatment, providing individualized isolation solutions.

Objective To explore the effect of tumor-associated macrophage (TAM) on invasion and migration of breast cancer cells T47D.Methods Briefly,phorbol 12-myristate 13-acetate (PMA) was employed to treat mononuclear cells THP-1.And then interleukin 4 (IL-4) was applied to stimulate mentioned cells to establish activated TAM.Furthermore,the supernatant of M0 and M2 was used to culture T47D cells,respectively.Then,the wound healing experiment and transwell assay were carried out to investigate cells invasion and migration.Finally,epithelial-mesenchymal transition (EMT) biomarkers in T47D cells treated with M0 or M2 were determined by quantitative real time polymerase chain reaction (qRT-PCR) and western blot assays.Results Activated TAM model was successfully established by PMA following with IL-4.Comparing with M0,M2 evidently accelerated invasion and migration in T47D cells.Meanwhile,M2 upregulated N-cadherin,vimentin and β-catenin,downregulated E-cadherin at mRNA and protein expression levels.Conclusions M2 promotes invasion and migration of T47D cells via EMT.

Objective To investigate the safety and efficacy of ureteral access sheath (UAS) with vacuum suction during flexible ureteroscopic lithotripsy in the treatment of renal stones.Methods The clinical data on 56 patients with infectious renal stones who received flexible ureteroscopic lithotripsy were retrospectively analyzed.The patients were randomly divided into group A (26 patients) and group B (30 patients).Intrapelvic pressure,stoneclearance rate,surgical duration,formation of steinstrasse,postoperative fever (temperature ＞ 38.5 ℃C),PCT,leukocyte count,length of hospital stay,and hospitalization cost were evaluated.Results Intrapelvic pressure was much lower in group A than in group B;stone clearance rate was 96.2％ for group A and 83.3％ for group B;and surgical duration was (80.1 ± 2.2) min and (105.2 ± 3.5) min,respectively.One patient developed steinstrasse and one had postoperative fever in group A,while six patients developed steinstrasse and 4 had postoperative fever in group B;PCT and leukocyte count was much lower in group A than in group B.There were statistical differences between the two groups (P ＜ 0.05).The length of hospital stay and hospitalization cost were (7.4 ± 0.8)d and (20857.1 ± 389.4) RMB for group A and (8.2±1.3)d and (22008.5±394.3) RMB;but there were no statistical differences between the two groups (P ＞ 0.05).Conclusions Application of ureteral access sheath with vacuum suction during flexible ureteroscopic lithotripsy in the treatment of renal stones was safe and effective.It can shorten surgical duration,improve stoneclearance rate and reduce incidence of adverse reactions.This procedure has better value of clinical application.

OBJECTIVE: To examine the expression of liver X receptor-β (LXR-β) in human gastric cancer tissue, and to explore the effect of GW3965, an agonist of LXRs, on proliferation of gastric cancer cell line SGC-7901.
 METHODS: The immunohistochemical assay was used to detect the expression of LXR-β, activating transcription factor 4 (ATF4) in gastric cancer tissues and the corresponding pericarcinoma tissues in 114 patients. Real-time quantitative PCR and Western blot were used to determine mRNA and protein levels of ATF4 and ATP-binding cassette 1 (ABCA1), one of the downstream target genes of LXRs, in SGC-7901 cells with or without GW3965 treatment. Cell counting kit-8 (CCK-8) assay was performed to detect cell proliferation. The expression of ATF4 was silenced by short hairpin RNA (shRNA).
 RESULTS: The expressions of LXR-β and ATF-4 were obviously down-regulated in the gastric cancer tissues than that in the corresponding pericarcinoma tissues (both P<0.05). Compared with the control cells, GW3965 treatment inhibited proliferation of SGC-7901 cells and up-regulated ATF4 and ABCA1 expressions (both P<0.05). Knockdown of ATF4 can reverse the antiproliferative effect of GW3965 on SGC-7901 cells.
 CONCLUSION The expression of LXR-β is decreased in human gastric cancer tissues, and activation of LXRs by GW3965 could inhibit the proliferation of SGC-7901 cells via ATF4.
Activating Transcription Factor 4 ; genetics ; metabolism ; Benzoates ; pharmacology ; Benzylamines ; pharmacology ; Cell Line, Tumor ; drug effects ; Cell Proliferation ; Gene Expression Regulation, Neoplastic ; Gene Silencing ; Humans ; Liver X Receptors ; Orphan Nuclear Receptors ; genetics ; metabolism ; RNA, Messenger ; genetics ; metabolism ; RNA, Small Interfering ; genetics ; Stomach Neoplasms ; pathology ; Up-Regulation

Objective To explore the mid-term efficacy of biological type,long-stem artificial caput femo-ris replacement operation in the treatment of unstable senile intertrochanteric fracture.Methods 73 patients accepted the treatment of biological type long-stem artificial caput femoris replacement operation,and 64 cases were followed. After 3 months of operation,these 64 patients were divided into four groups which marked as A,B,C and D according to the Berg balance scale(BBS).Accordingly,54 patients that in grade A,B and C would be brought into in long-term follow-up study.54 cases include 25 male patients and 29 female patients with an average age of 81.6 years old who aged from 73 to 94 years old.According to Evans-Jensen classification,28 cases were Evans-JensenⅡand the left 26 cases were Evans -JensenⅢ.Results The follow-up period was in the range of 24 to78 months (mean 42months).During this period,except the 9 death cases,there was no case of femoral trochanteric ununited fracture, femoral prostheses loosening or dislocation of hip joint.In total,3 cases occurred with loss of fixing wire,4 cases occurred with acetabular wear,one case was experienced prosthesis adjacent fracture and three cases of heterotopic ossification.According to the Engh standard,all femoral prostheses got osseous fixation.The rate of excellent and good result were 88.9%with in which excellent in 23 cases and good in 17 cases.Conclusion The application of biological type long-stem artificial caput femoris replacement in the treatment of unstable senile intertrochanteric fracture can achieve satisfactory mid-term efficiency.

Objective To discuss the short-term outcomes of uncemented APL stem hip hemiarthroplasty for unstable intertrochanteric fracture in elderly patients.Methods From July 2008 to December 2011,26 cases of intertrochanteric fractures were treated by hemiarthroplasty using uncemented APL stem.There were 10 men and 16 women with a mean age of 82.5 years (range,75-94 years).According to EvansJensen classification system,16 cases were type Ⅱ fractures,the other 10 were type Ⅲ.Results The mean operation time was 56 min (range,48 to 72 min).The average blood loss during the operation was 360 ml (range,240-600 ml).One of the patients died in the perioperative period,2 died during the follow-up.The other 23 patients were followed up with an average of 21.5 months (range,12-42 months).The patients were encouraged to walk with aid about 2-3 weeks postoperatively.Three months after the operation,the walking ability were almost recovered to pre-injury level in 21 cases.The acetabular wear,the prosthetic loosening and subsidence were not found.The complications included 1 case of cerebral infarction,1 case of deep venous thrombosis,2 urinary infection,1 skin ulcer due to the long-term use of cortical steroid and 2 heterotopic ossifications.According to Harris hip score,12 cases were classified as excellent,10 cases as good and 1 case as fair.Conclusion Hemiarthroplasty using uncemented APL stem is an effective way to treat the unstable intertrochanteric fracture in elderly patients.The quality of life of the elderly patients can be improved due to early mobilization after the surgery.

OBJECTIVETo define the clinicopathological risk factors of intravesical recurrence of primary transitional cell carcinoma of the ureter after surgical intervention.

METHODSPatients with primary carcinoma of the ureter treated between January 2000 and December 2010 were retrospectively analyzed. The intravesical recurrence-free survival rate was calculated using Kaplan-Meier method. Multivariate analysis was conducted with Cox's regression.

RESULTSA total of 104 patients were enrolled, who were followed up for a median of 46 months (13-89 months). Thirty-nine of the patients showed postoperative intravesical recurrence. Urine exfoliative cytology (P=0.000), number of tumors (P=0.006), tumor grade (P=0.039) and co-existence of bladder tumor (P=0.014) were found to independently influence the postoperative intravesical recurrence. Patients with more risk factors had poorer intravesical recurrence-free survival.

CONCLUSIONUrine exfoliative cytology, number of tumors, tumor grade and co-existence of bladder tumor are independent risk factors for postoperative intravesical recurrence of primary transitional cell carcinoma of the ureter. Close follow-up and rigorous treatment are essential for patients with high risk factors.

Adult ; Aged ; Carcinoma, Transitional Cell ; pathology ; surgery ; Causality ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Regression Analysis ; Retrospective Studies ; Risk Factors ; Ureteral Neoplasms ; pathology ; surgery ; Urinary Bladder Neoplasms ; pathology