OBJECTIVE: To construct a preoperative evaluation system for partial nephrectomy using CT three-dimensional visualization technology and to explore its practical value. METHODS: The clinical data of the patients who underwent partial nephrectomy for renal tumors in Department of Urology, Peking University First Hospital were collected retrospectively. At the same time, the homogenized standard data of patients who underwent partial nephrectomy for renal tumors were collected in 16 clinical centers in China. The CT three-dimensional visualization system was applied (IPS system, Yorktal) to evaluate tumor anatomy, blood supply, perirenal fat and other information. The parameters were summarized to build a three-dimensional nephrometry system, on the basis of which virtual surgery design and intraoperative navigation were completed. RESULTS: A three-dimensional visualization image was established based on the enhanced CT urography. The nephrometry system included the longest diameter and volume of the tumor, proportion volume of tumor invading the parenchyma, maximum depth of the tumor invading the parenchyma, contact surface area, flatness of the tumor surface, renal segment where the tumor was located, vascular variation, and perirenal fat. The average two-dimensional diameter of the tumor was (2.78±1.43) cm, the average three-dimensional maximum diameter was (3.09±1.35) cm, and the average postoperative pathological size was (3.01±1.38) cm. The maximum tumor diameter in the three-dimensional image was significantly related to the prolonged renal artery clamping time and intra-operative blood loss (r=0.502, P=0.020; r=0.403, P=0.046). The three-dimensional and pathological tumor volume were (25.7±48.4) cm³ and (33.0±36.4) cm³, respectively (P=0.229). The tumor volume was significantly related to the intraoperative blood loss (r=0.660, P < 0.001). The proportion volume of the tumor invading into renal parenchyma was significantly related to the prolongation of renal artery clamping and the occurrence of postoperative complications (r=0.410, P=0.041; r=0.587, P=0.005). The tumor contact surface area and the presence of vascular variation did not show correlation with the perioperative data and postoperative complications. While the preoperative evaluation was completed, the reconstructed three-dimensional image could be zoomed, rotated, combined display, color adjustment, transparency, and simulated cutting on the Touch Viewer system. The process generally consisted of showing or hiding the tissue, adjusting the transparency of the interested area, rotating and zooming the image to match the position of the surgical patient. Together, these functions met the requirements of preoperative virtual surgery plan and intraoperative auxiliary navigation. CONCLUSION Three-dimensional images can provide a more intuitive anatomical structure. The CT three-dimensional visua-lization system clearly displays tumor anatomical parameters, blood supply and perirenal fat. The three-dimensional nephrometry system for renal tumors can help predict the difficulty of partial nephrectomy and perioperative complications. Importing the reconstructed three-dimensional visualization image into the specified program or robot operating system can complete virtual surgery and intraoperative navigation, helping the surgeon to better grasp the surgical process. The indexes included in the nephrometry system and the score weights of each index need to be confirmed and perfected by multi-center study with large samples.
China ; Humans ; Kidney/surgery* ; Kidney Neoplasms/surgery* ; Laparoscopy ; Nephrectomy ; Retrospective Studies

Objective: Several COVID-19 patients have overlapping comorbidities. The independent role of each component contributing to the risk of COVID-19 is unknown, and how some non-cardiometabolic comorbidities affect the risk of COVID-19 remains unclear. Methods: A retrospective follow-up design was adopted. A total of 1,160 laboratory-confirmed patients were enrolled from nine provinces in China. Data on comorbidities were obtained from the patients' medical records. Multivariable logistic regression models were used to estimate the odds ratio ( Results: Overall, 158 (13.6%) patients were diagnosed with severe illness and 32 (2.7%) had unfavorable outcomes. Hypertension (2.87, 1.30-6.32), type 2 diabetes (T2DM) (3.57, 2.32-5.49), cardiovascular disease (CVD) (3.78, 1.81-7.89), fatty liver disease (7.53, 1.96-28.96), hyperlipidemia (2.15, 1.26-3.67), other lung diseases (6.00, 3.01-11.96), and electrolyte imbalance (10.40, 3.00-26.10) were independently linked to increased odds of being severely ill. T2DM (6.07, 2.89-12.75), CVD (8.47, 6.03-11.89), and electrolyte imbalance (19.44, 11.47-32.96) were also strong predictors of unfavorable outcomes. Women with comorbidities were more likely to have severe disease on admission (5.46, 3.25-9.19), while men with comorbidities were more likely to have unfavorable treatment outcomes (6.58, 1.46-29.64) within two weeks. Conclusion Besides hypertension, diabetes, and CVD, fatty liver disease, hyperlipidemia, other lung diseases, and electrolyte imbalance were independent risk factors for COVID-19 severity and poor treatment outcome. Women with comorbidities were more likely to have severe disease, while men with comorbidities were more likely to have unfavorable treatment outcomes.
Adult ; Aged ; COVID-19/virology* ; China/epidemiology* ; Comorbidity ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Severity of Illness Index ; Treatment Outcome

OBJECTIVETo investigate the effect of different pressure oxygen pre-breathing in preventing decompression sickness of rats.

METHODSForty male SD rats were randomly divided into 4 groups: decompression sickness (DCS) group and three oxygen pre-breathing groups with 1 ATA, 2 ATA and 3 ATA pressure respectively. The rats of DCS group were placed in the hyperbaric chamber and the chamber was compressed evenly within 3 minutes to depths of 7 absolute atmosphere(ATA) and held at the designated depth for 60 min, then decompressed (3 min) at constant speed to the surface pressure. After that, the rats were taken out for further detection. While the rats of oxygen pretreatment groups pre-breathed different pressure oxygen for 20 min before entering into chamber. The mortality and behavioral of rats were observed with 30 min post decompression. The dry/wet ratio of the lung, protein levels in the bronchoalveolar lavage fluid (BALF), and the inflammatory cytokine tumor necrosis factor (TNF-alpha) expression were also tested.

RESULTSCompared with that of the DCS group, the mortality and morbidity of oxygen pre-breathe groups didn't change obviously. But the total BALF protein level and the inflammatory cytokine TNF-alpha expression of 1 ATA oxygen pre-breathe group were obviously decreased, while the dry/wet ratio of lung as obviously increased instead (P < 0.05).

CONCLUSIONAlthough preoxygenation can' t obviously change the mortality and mobidity of rats, normal pressure oxygen pre-breathing can mitigate the protein infiltration in BALF and the expression of inflammatory cytokine in lung tissue.

Animals ; Bronchoalveolar Lavage Fluid ; chemistry ; Decompression Sickness ; Diving ; Lung ; pathology ; Oxygen ; physiology ; Pressure ; Rats ; Rats, Sprague-Dawley ; Tumor Necrosis Factor-alpha ; metabolism

OBJECTIVETo study the effects of the Chinese medicine Jinmaitong Capsule (, JMT) on the pathomorphology of sciatic nerves, ciliary neurotrophic factor (CNTF), and the mRNA expressions of CNTF in rats with streptozotocin-induced diabetes mellitus (STZ-DM).

METHODSThe animal model was established by one time intraperitoneal injection of streptozotocin. The rats were simply divided by random into 5 groups including model group, low-dose JMT group (JL), medium-dose JMT group (JM), high-dose JMT group (JH) and neurotropin group. For each of the above 5 groups, a group of 10 normal Wistar rats matched in body weight, age and gender were set as normal group. Intragastric administrations were started after the animal model established. The JL group were administered with five times the JMT dose recommended for a human adult; the JM group were administered with ten times the JMT dose recommended for a human adult; the JH group were administered with twenty times the JMT dose recommended for a human adult. The neurotropin group was administered with ten times the neurotropin dose recommended for a human adult. All rats were given intragastric administration for 16 weeks and then killed. In the 4th, 8th, 12th, 16th week, body weight and blood glucose level were detected before and after the intervention. The morphologic changes of the sciatic nerves were observed by optical microscope and transmission electron microscope. The CNTFmRNA expressions were detected by real-time fluorescent quantitative polymerase chain protein, and the CNTF protein expressions were detected by immunohistochemical method.

RESULTSThe blood glucose levels of the STZ-DM rats were much higher than normal group (P<0.01), and there was no apparent difference between any treatment groups and the model group (P>0.05). Before and after the intervention in the 4th, 8th, 12th, 16th week, there were no significant differences in the body weight among all the groups (P>0.05). The sciatic nerves of STZ-DM rats might have pathomorphological changes in axons, myelin sheaths, and interstitium. The levels of CNTF and CNTF-mRNA expressions in the STZ-DM rats were both significantly decreased (P<0.01). The sciatic nerves of STZ-DM rats might have pathomorphological changes in axons, myelin sheaths, and interstitium.

CONCLUSIONJMT could improve the pathomorphology of sciatic nerves by increasing CNTF's and CNTF-mRNA expressions in sciatic nerve tissues, and promote the repair and regeneration of damaged nerve fibers.

Animals ; Blood Glucose ; drug effects ; Body Weight ; drug effects ; Ciliary Neurotrophic Factor ; genetics ; metabolism ; Diabetes Mellitus, Experimental ; drug therapy ; pathology ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Gene Expression Regulation ; drug effects ; Humans ; Male ; RNA, Messenger ; genetics ; metabolism ; Rats ; Rats, Wistar ; Sciatic Nerve ; drug effects ; pathology ; ultrastructure

Objective To explore the effect of methylprednisolone combined with HBO on acute lung injury (ALI) induced by rush decompression.Methods Twenty-six male healthy rabbits were randomly divided into the normal control group (n =6),the model group and the combined therapy group.Four animals in the model group and the combined therapy group died,following development of the ALI model by rush decompression by using vacuum pumps.Then,the remaining 24 animals were randomly divided into the model group and the combined therapy group,each consisting of 12 animals.The moment after the animals were surfaced from the chamber,4 animals in each group were sacrificed for the detection of wet/dry ratio of the lung tissue.The remaining animals in the model and control groups were given normal feeding for 3 days,without any treatment.Following injection of methylprednisolone (1 mg/kg),the animals in the combined therapy group were exposed to HBO (0.1 MPa gauge pressure,breathing oxygen for 2 hours),one session a day for a succession of 3 days.Three days later,observations were made on the wet/dry ratio of the lung tissue,pathologic morphology,concentrations of TNF-α and IL-1β,and the expressions of NF-κB p65 mRNA.Results The moment and 3 days after rush decompression,the wet/dry values of the animals in the model group were (5.29 ±0.26,3.20 ±0.21),which were higher than those of the animals in the control group (2.32 ±0.54,2.15 ±0.40) (P ＜0.01).Significant pulmonary exudation and inflammatory infiltration could obviously been seen.Three days after treatment with methylprednisolone combined with HBO therapy,the wet/dry value of the animals in the treatment group decreased significantly (2.34 ± 0.49),without statistical significance,when compared with that of the control group.However,statistical significance could be noted,when compared with that of the model group.Three days later,concentrations of TNF-α and IL-1β of the model group increased [(9.53 ± 1.28),(20.34 ± 1.87) ng/L)],which were significantly higher than those of the control group [(6.42 ±0.95),(15.63 ± 1.85) ng/L)] (P ＜ 0.05 or P ＜ 0.01).The expressions of NF-κB p65 mRNA (1.32 ± 0.48) also increased,when compared with those of the control group (0.35 ± 0.07) (P ＜ 0.05).After 3 days of combined treatment with methylprednisolone and HBO,acute lung injury score of the treatment group was(4.43 ± 0.93),which showed a significant improvement,when compared with that of the model group (8.56 ± 1.73) (P ＜ 0.01).Nevertheless,it was still rather high,when compared with that of the control group(0.97 ± 0.17)(P ＜ 0.01).The concentrations of TNF-α and IL-1β in the homogenates decreased [(7.17 ±0.65),(16.63 ± 0.57)ng/L],which were significantly lower than those of the model group [(9.53 ± 1.28),(20.34 ± 1.84) ng/L) (P ＜ 0.05).In the meantime,the expression of N F-κB p65 mRNA also declined markedly (0.43 ±0.15),when compared with that of the model group(1.32 ±0.48) (P ＜ 0.05).Conclusions The combined treatment of methylprednisolone and HBO could produce positive effects on acute lung injury induced by rush decompression,the inhibition in the expression of NF-κB p65 might be one of the mechanisms involved.

Objective To develop the underwater decompression table for the 32％ nitrogen-oxygen mixed gas (32％ oxygen and 68％ nitrogen) diving operations.Methods In accordance with the Haldane theory,the assumed time units,the classification of tissue compartments,the nitrogen super-saturation safety coefficient and the selection of methods used for the calculation of 32％ nitrogen-oxygen mixed gas diving table were properly selected,and the calculating method for the diving decompression table was thus firmly established.Through animal experiments with 376 goat times and 94 compression profiles,Doppler ultrasonic gas bubble detection and ethological changes of the animals were monitored or observed,following decompression to the surface.Results By using the developed decompression table,no abnormal ethological changes in the animal behavior could be detected after compression and decompression to the surface,and the Doppler bubble sound grade was almost zero.Pulmonary and cerebral pathological observations indicated that there were no congestion and edema in the tissues.Conclusions The decompression table developed with theoretical calculation seemed to be safe and reliable.

Objective To develop the underwater decompression table for the 32％ nitrogen-oxygen mixed gas (32％ oxygen and 68％ nitrogen) diving operations.Methods In accordance with the Haldane theory,the assumed time units,the classification of tissue compartments,the nitrogen super-saturation safety coefficient and the selection of methods used for the calculation of 32％ nitrogen-oxygen mixed gas diving table were properly selected,and the calculating method for the diving decompression table was thus firmly established.Through animal experiments with 376 goat times and 94 compression profiles,Doppler ultrasonic gas bubble detection and ethological changes of the animals were monitored or observed,following decompression to the surface.Results By using the developed decompression table,no abnormal ethological changes in the animal behavior could be detected after compression and decompression to the surface,and the Doppler bubble sound grade was almost zero.Pulmonary and cerebral pathological observations indicated that there were no congestion and edema in the tissues.Conclusions The decompression table developed with theoretical calculation seemed to be safe and reliable.

Objective To explore the effect of methylprednisolone combined with HBO on acute lung injury (ALI) induced by rush decompression.Methods Twenty-six male healthy rabbits were randomly divided into the normal control group (n =6),the model group and the combined therapy group.Four animals in the model group and the combined therapy group died,following development of the ALI model by rush decompression by using vacuum pumps.Then,the remaining 24 animals were randomly divided into the model group and the combined therapy group,each consisting of 12 animals.The moment after the animals were surfaced from the chamber,4 animals in each group were sacrificed for the detection of wet/dry ratio of the lung tissue.The remaining animals in the model and control groups were given normal feeding for 3 days,without any treatment.Following injection of methylprednisolone (1 mg/kg),the animals in the combined therapy group were exposed to HBO (0.1 MPa gauge pressure,breathing oxygen for 2 hours),one session a day for a succession of 3 days.Three days later,observations were made on the wet/dry ratio of the lung tissue,pathologic morphology,concentrations of TNF-α and IL-1β,and the expressions of NF-κB p65 mRNA.Results The moment and 3 days after rush decompression,the wet/dry values of the animals in the model group were (5.29 ±0.26,3.20 ±0.21),which were higher than those of the animals in the control group (2.32 ±0.54,2.15 ±0.40) (P ＜0.01).Significant pulmonary exudation and inflammatory infiltration could obviously been seen.Three days after treatment with methylprednisolone combined with HBO therapy,the wet/dry value of the animals in the treatment group decreased significantly (2.34 ± 0.49),without statistical significance,when compared with that of the control group.However,statistical significance could be noted,when compared with that of the model group.Three days later,concentrations of TNF-α and IL-1β of the model group increased [(9.53 ± 1.28),(20.34 ± 1.87) ng/L)],which were significantly higher than those of the control group [(6.42 ±0.95),(15.63 ± 1.85) ng/L)] (P ＜ 0.05 or P ＜ 0.01).The expressions of NF-κB p65 mRNA (1.32 ± 0.48) also increased,when compared with those of the control group (0.35 ± 0.07) (P ＜ 0.05).After 3 days of combined treatment with methylprednisolone and HBO,acute lung injury score of the treatment group was(4.43 ± 0.93),which showed a significant improvement,when compared with that of the model group (8.56 ± 1.73) (P ＜ 0.01).Nevertheless,it was still rather high,when compared with that of the control group(0.97 ± 0.17)(P ＜ 0.01).The concentrations of TNF-α and IL-1β in the homogenates decreased [(7.17 ±0.65),(16.63 ± 0.57)ng/L],which were significantly lower than those of the model group [(9.53 ± 1.28),(20.34 ± 1.84) ng/L) (P ＜ 0.05).In the meantime,the expression of N F-κB p65 mRNA also declined markedly (0.43 ±0.15),when compared with that of the model group(1.32 ±0.48) (P ＜ 0.05).Conclusions The combined treatment of methylprednisolone and HBO could produce positive effects on acute lung injury induced by rush decompression,the inhibition in the expression of NF-κB p65 might be one of the mechanisms involved.

OBJECTIVETo investigate the expression and role of miRNA-126/miRNA-126(*) in the fetal lung development of rats.

METHODSTwelve pregnant Sprague-Dawley rats were randomly divided into 3 groups and the fetal rats were removed at 16, 19 and 21 days of gestation respectively. Hematoxylin and eosin staining was performed to observe lung morphology of fetal rats. Then microRNA (miRNA) microarray was used to study the expression patterns of miRNA-126/miRNA-126(*) in fetal lungs at the three time points. And miRNA-126(*) was selected for further study by real-time PCR.

RESULTSThere was no evident difference in the expression of miRNA-126 among the three groups, however the expression level of miRNA-126(*) increased gradually as the fetal lung developed. The real-time PCR result further showed that expression of miRNA-126(*) increased gradually with lung development, displaying significant differences among the three groups (P<0.05).

CONCLUSIONSmiRNA-126(*) may play an important role in development of the fetal lung in rats.

Animals ; Female ; Lung ; embryology ; Male ; MicroRNAs ; analysis ; physiology ; Pregnancy ; Rats ; Rats, Sprague-Dawley ; Real-Time Polymerase Chain Reaction

OBJECTIVETo study the expression pattern of peroxisome proliferator-activated receptor (PPAR) pathway molecules in rat lung tissue under hyperbaric oxygen exposure.

METHODSTwenty seven male SD rats were randomly divided into hyperbaric normoxia group (0.23 MPa air), hyperbaric oxygen treatment time series group (0.23 MPa oxygen, were exposed for 2 h, 4 h, 6 h or 8 h), continuous small flow of ventilation to maintain cabin O2 concentration > 99%. HE staining of lung tissue morphological changes and application oligo microarray to each time point lung were observed. Part of the PPAR pathway genes were validated by RT-PCR.

RESULTSCompared with hyperbaric normoxia group, the lung injury caused by hyperbaric oxygen treatment gradually deteriorated during the time series. Expression microarray analysis of gene ontology (Go) enrichment analysis results in a class of PPAR pathway class included multiple PPAR pathway molecule. RT-PCR results suggested that PPAR-8 and PPAR-Y were up-regulated in the lung tissue after a long time exposure to hyperbaric oxygen.

CONCLUSIONPro-longed hyperbaric oxygen exposure causing pulmonary oxygen toxicity can induce the activation of the PPAR pathway.

Animals ; Hyperbaric Oxygenation ; adverse effects ; Lung ; metabolism ; pathology ; Male ; Peroxisome Proliferator-Activated Receptors ; metabolism ; Rats ; Rats, Sprague-Dawley ; Signal Transduction