Objective To verify the safety and effectiveness of a new percutaneous controllable curved plasma radiofrequency instrument for nucleus pulposus ablation. Methods A new percutaneous controllable curved plasma radiofrequency instrument were designed (controllable curved group), and its ablation effect was compared with the currently used straight head non-bendable plasma ablation instrument (non-bendable group) on gross specimens. The ablation instrument was placed through the right intervertebral foramen, and continuous ablation on the same intervertebral disc was conducted for three times. The ablation range and trajectory were recorded, and the temperature changes in the front, back, left, and right of the ablation center during and 15 seconds after ablation were monitored by the inserted temperature probe. Results There were no difference in temperature changes in the front, back, right regions of the ablation center during and 15 seconds after ablation between the two groups. The temperature changes in the left region of the ablation center both during and 15 seconds after 3rd ablation were larger than those in the non-bendable group (P＜0.01). Compared with the non-bendable group, the controllable curved group achieved angle control and larger single ablation area (2.282 5 mm² vs 1.135 8 mm², P＜0.000 1). Conclusions This new percutaneous controllable curved plasma ablation instrument can achieve angle control and ablation on the side opposite to the puncture site, increase ablation volume, and is safe.

Objective To investigate the efficacy of endoscopic ligation combined with traditional Chinese medicine (TCM) syndrome differentiation-based treatment in the secondary prevention of esophageal variceal bleeding (EVB) in patients with liver cirrhosis. Methods A total of 108 EVB patients who were admitted to Department of Liver Cirrhosis, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from April 2015 to February 2021 and underwent endoscopic ligation were enrolled, among whom 59 patients with TCM treatment were enrolled as Chinese and Western medicine group, and 49 patients without TCM treatment were enrolled as Western medicine group. The two groups were compared in terms of the incidence rate of rebleeding, mortality rate, and the improvement rate of portal hypertensive gastropathy. The t -test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U rank sum test was used for comparison of non-normally distributed continuous data between groups; the chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups; a Cox regression analysis was used to evaluate the risk factors for rebleeding. Results Compared with the Western medicine group, the Chinese and Western medicine group had a significantly lower rebleeding rate within 13-24 months after ligation (2% vs 12%, P =0.045), a significantly lower mortality rate of rebleeding (2% vs 12%, P =0.045), and a significantly higher overall response rate of portal hypertensive gastropathy (90% vs 77%, P =0.04). Underlying diseases (mainly including diabetes, hypertension, and heart disease) and Child-Pugh class for liver function were significant risk factors for rebleeding (all P < 0.05). Conclusion Ligation combined with TCM treatment can significantly reduce the incidence rate of delayed rebleeding and the mortality rate of EVB and improve the degree of portal hypertensive gastropathy, which provides a new strategy for ligation combined with TCM treatment to improve the overall response of EVB secondary prevention.

OBJECTIVES: To study the gene expression of adipose tissue CD14 METHODS: The data of GSE54350 were obtained from the public database of gene expression profiling. The data were pre-processed by Network Analyst, String 11.0, Cytoscape 3.7.1, and other analytical software. The differentially expressed genes were analyzed by gene ontology biological function and kyoto encycopedia of genes and genomes (KEGG) signaling pathway to establish differential gene protein interaction network, transcription factor-gene regulatory network, microRNA-gene regulatory network, environmental factors-gene regulatory network, and other interaction systems. RESULTS: The gene expression pattern of CD14 CONCLUSIONS The gene expression of adipose tissue CD14
Adipose Tissue ; Computational Biology ; DNA-Binding Proteins ; Diabetes Mellitus, Type 2/genetics* ; Gene Expression ; Gene Expression Profiling ; Gene Regulatory Networks ; Humans ; MicroRNAs/genetics* ; Muscle Proteins

Objective:To investigate the changes of the expression levels of serum proliferating cell nuclear antigen (PCNA), tumor-specific growth factor (TSGF), soluble E-cadherin (SE-CAD) and the relationship with clinical prognosis of advanced non-small cell lung cancer (NSCLC) patients treated with intensity-modulated radiotherapy combined with chemotherapy.Methods:Eighty-four patients (29 cases of Ⅲ A, 30 Ⅲ B and 25 Ⅳ) with advanced NSCLC treated in our hospital from January 2016 to January 2018 were selected, and all patients were given with intensity-modulated radiotherapy combined with chemotherapy. The expression levels of serum PCNA, TSGF, and SE-CAD were compared among different TNM stages and before and after treatment. The serum PCNA, TSGF, SE-CAD levels were compared among patients with different clinical efficacy. The relationship between serum PCNA, TSGF and SE-CAD levels and clinical efficacy was assessed by Logistic regression analysis. The survival analysis was performed with Kaplan- Meier method. Results:The expression levels of serum PCNA, TSGF and SE-CAD before treatment in stage Ⅳ patients were significantly higher than those in stage Ⅲ B and Ⅲ A patients (584.11±60.25 pg/ml vs. 531.06±51.37 pg/ml and 477.54±46.49 pg/ml, 96.13±7.54 U/ml vs. 8.52±5.91 U/ml and 82.41±5.0 U/ml, 3.02±0.26 ng/ml vs. 2.87±0.22 ng/ml and 2.71±0.15 ng/ml, all P<0.05), and the serum levels of three cytokines in Ⅲ B stage patients were significantly higher than those in their Ⅲ A stage counterparts (all P<0.05). After treatment, the serum levels of PCNA, TSGF and SE-CAD were significantly lower than those before treatment (396.11±50.23 pg/ml vs. 528.37±75.09 pg/ml, 74.81±4.72 U/ml vs. 88.68±6.13 U/ml, 1.92±0.24 ng/ml vs.2.86±0.31 ng/ml, all P<0.05). At 18 months after treatment, the serum levels of PCNA, TSGF and SE-CAD in surviving patients were significantly lower than those of dead patients (332.51±54.32 pg/ml vs. 444.92±60.07 pg/ml, 70.59±6.20 U/ml vs. 78.05±8.44 U/ml, 1.71±0.24 ng/ml vs. 2.08±0.27 ng/ml, all P<0.05). The serum levels of PCNA, TSGF and SE-CAD were significantly associated with clinical prognosis (all P<0.05). Among 84 NSCLC patients, the objective response rate after treatment was 29%(24/84). The survival curves in patients with high expression levels of serum PCNA, TSGF and SE-CAD were significantly lower than those in the low-expression group (all P<0.05). Conclusion:Serum PCNA, TSGF and SE-CAD are highly expressed in patients with advanced NSCLC, which are closely correlated with clinical staging and prognosis and contribute to predicting survival status.

Objective:To evaluate the mid- and long-term outcomes of Dynesys hybrid surgery (in some segments act as a non-fusion device, in other segments act as an alternative of rigid fixation in combination with interbody fusion) in the treatment of multi-segmental lumbar degenerative disease (LDD).Methods:The data of 27 patients who received Dynesys hybrid surgery (hybrid group) for the treatment of LDD from May 2011 to September 2016 and completed the follow-up were retrospectively analyzed. Among them, there were 8 males and 19 females; their average age was 59.1±11.9 years (23-78 years). Main diagnosis: 13 cases of lumbar spinal stenosis, 14 cases of lumbar disc herniation; 4 cases of combined lumbar dynamic position instability, 7 cases of combined lumbar spondylolisthesis. There were 15 cases of two-segment disease, 11 cases of three-segment disease, and 1 case of four-segment disease. Segments distribution: 9 cases of L 3-L 5, 6 cases of L 4-S 1, 7 cases of L 3-S 1, 4 cases of L 2-L 5, and 1 case of L 2-S 1. Midline incision was used to exposure, followed by bilateral pedicle screws implantation, and interbody fusion cage with bone grafting were performed at the fusion level. Twenty-seven patients who underwent TLIF+rigid internal fixation during the same period were included as the control group. Clinical outcomes were measured by visual analog scale (VAS) for low back pain and leg pain, and Oswestry disability index (ODI). Radiological outcomes included fusion rate, intervertebral disc height (DH) of surgical segments and the proximal adjacent segment, range of motion (ROM) of non-fusion segments and the proximal adjacent segment. At the same time, the occurrence of complications was observed. Results:Patients of Hybrid group and control group were followed up for an average of 83.8±20.9 months (48-112 months) and 87.3±16.2 months (53-114 months), respectively. Baseline data of the two groups (average follow-up time, age, gender, surgical level, diagnosis) showed no significant difference. The operation time (183.0±27.8 min) and intraoperative blood loss (301.9±178.9 ml) in the hybrid group were significantly lower than those in the control group (operation time t=2.337, P=0.023; blood loss t=2.706, P=0.01). At the final follow-up, the VAS scores of low back pain and leg pain (low back pain t=12.164, P<0.001; leg pain t=20.603, P<0.001), as well as ODI were significantly improved ( t=22.827, P<0.001). A total of 32 segments received TLIF+Dynesys stabilization and 35 segments received Dynesys non-fusion stabilization in the hybrid group, with 28 segments (87.5%) achieved solid fusion at 1-year follow-up. There were 67 fusion segments in the control group, and the fusion rate at 1-year follow-up was 85.1%. DH of non-fusion segments were lower than that before surgery with statistical significance at final follow-up ( t=2.647, P=0.012), while DH of the fusion segments in the hybrid group and the surgical segments in the control group increased compared with that before surgery at the final follow-up. A certain degree of ROM (2.4°±1.5°) was retained of the non-fusion segments at the final follow-up; the ROM of proximal adjacent segments of non-fused segments was significantly smaller than that of proximal adjacent segments of fused segments ( t=2.126, P=0.044). In the hybrid group, screw loosening occurred in 4 patients (8 screws) and adjacent segment degeneration (ASD) occurred in 5 patients. In the control group, screw loosening occurred in 3 patients (6 screws), while ASD occurred in 8 patients. No screw fracture was observed during the follow-up period and no patients received reoperation. Conclusion:Hybrid surgery of Dynesys stabilization combined with interbody fusion is a safe and effective method for the treatment of multi-segmental LDD. Compared with multi-segmental fusion, this lumbar hybrid surgery has the advantages of less trauma and retaining partial segmental ROM.