Objective To investigate the long-term incidence of in-stent stenosis(ISS)in patients with intracranial aneurysms receiving pipeline embolization device(PED)who showed no ISS at short-to-medium term follow-up examination.Methods The clinical data of patients,who received PED treatment at the Department of Neurointervention,First Affiliated Hospital of Zhengzhou University of China between April 2015 and June 2022,were retrospectively collected.The patients with intracranial aneurysms,who showed no ISS at the initial follow-up with DS A and completed＞12 months long-term follow-up check after treatment at the same hospital,were screened out,and their relevant clinical data and imaging materials were collected.The incidence of ISS occurring in postoperative＞12 months long-term follow-up was calculated.The ISS was defined as a＞25％lumen loss of the parent artery when compared with its lumen size measured immediately after PED implantation.Results A total of 57 patients with 61 aneurysms were enrolled in this study,and a total of 68 PEDs were implanted.Forty-one(67.21％)aneurysms were treated by PED implantation only,and 20(32.79％)aneurysms by PED plus spring coils.The median initial follow-up time was 184.0 days(119.0,212.5).At postoperative＞12 months long-term follow-up visit,DSA was employed for 35(57.38％)aneurysms,CTA was adopted for 22(36.07％)aneurysms,and 3D-SPACE sequence MR scan was performed in 4(6.56％)aneurysms.The median follow-up time was 538.0 days(407.5,678.0),and the incidence of ISS was 0％.No ISS-related neurological symptoms occurred in all patients.Conclusion In treating intracranial aneurysms with PED,the postoperative incidence of ISS is low.No ISS is found during the short-term follow-up period,and long-term follow-up results tend to indicate that no ISS events have occurred.

AIM: To evaluate the safety and efficacy of ultrasonic cycloplasty(UCP)combined with anti-vascular endothelial growth factor(VEGF)+ panretinal photocoagulation(PRP)in the treatment of advanced neovascular glaucoma(NVG).METHODS: Retrospective study. A total of 45 patients(45 eyes)with advanced NVG who received surgery in our hospital from August 2020 to September 2022 were collected and divided into UCP+ anti-VEGF +PRP group(16 patients, 16 eyes), transscleral cyclophotocoagulation(TCP)+anti-VEGF+PRP group(20 patients, 20 eyes), UCP alone group(9 patients, 9 eyes). The intraocular pressure, pain scores, postoperative medication, effective rate, total success rate and the incidence of complications of the patients in the three groups were compared before surgery and at 1 d, 1 wk, 1 and 3 mo after surgery.RESULTS: There was no significant difference in preoperative intraocular pressure, pain scores and preoperative medication of patients in the three groups(all P>0.05). While there were statistical significance in the intraocular pressure and pain scores at 1 d, 1 wk, 1 and 3 mo after surgery(all P<0.01). The intraocular pressure of the UCP alone group(31.78±10.23 mmHg)was found to be higher than that of both the UCP+ anti-VEGF +PRP group(19.44±8.23 mmHg)and the TCP+ anti-VEGF +PRP group(20.80±10.27 mmHg)at 1 mo postoperatively(all P<0.017). The pain score of the TCP+ anti-VEGF +PRP group at 1 d and 1 wk postoperatively was higher than both the UCP+ anti-VEGF +PRP group and the UCP alone group(all P<0.017). The effective rates of UCP+ anti-VEGF +PRP group, TCP+ anti-VEGF +PRP group and UCP alone group were 81%(13/16), 75%(15/20)and 67%(6/9), respectively,(P=0.675), and the success rates were 69%(11/16), 50%(10/20), and 0(0/9), respectively(P=0.003). There was no significant difference in complications of patients in the three groups(P>0.05).CONCLUSION: UCP combined with anti-VEGF +PRP and TCP combined with anti-VEGF +PRP showed comparable efficacy in reducing intraocular pressure in advanced NVG. UCP combined with anti-VEGF+PRP was more effective in relieving pain and with no serious complications in advanced NVG. UCP alone can effectively control intraocular pressure and alleviate the pain of patients in the early postoperative period, but long-term control still requires anti-VEGF+PRP.

As an important part of tumor microenvironment, neutrophils are poorly understood due to their spatiotemporal heterogeneity in tumorigenesis. Here we defined, at single-cell resolution, CD44-CXCR2- neutrophils as tumor-specific neutrophils (tsNeus) in both mouse and human gastric cancer (GC). We uncovered a Hippo regulon in neutrophils with unique YAP signature genes (e.g., ICAM1, CD14, EGR1) distinct from those identified in epithelial and/or cancer cells. Importantly, knockout of YAP/TAZ in neutrophils impaired their differentiation into CD54+ tsNeus and reduced their antitumor activity, leading to accelerated GC progression. Moreover, the relative amounts of CD54+ tsNeus were found to be negatively associated with GC progression and positively associated with patient survival. Interestingly, GC patients receiving neoadjuvant chemotherapy had increased numbers of CD54+ tsNeus. Furthermore, pharmacologically enhancing YAP activity selectively activated neutrophils to suppress refractory GC, with no significant inflammation-related side effects. Thus, our work characterized tumor-specific neutrophils in GC and revealed an essential role of YAP/TAZ-CD54 axis in tsNeus, opening a new possibility to develop neutrophil-based antitumor therapeutics.
Humans ; Animals ; Mice ; Adaptor Proteins, Signal Transducing/metabolism* ; Transcription Factors/metabolism* ; Stomach Neoplasms/pathology* ; Neutrophils/pathology* ; Signal Transduction/genetics* ; YAP-Signaling Proteins ; Tumor Microenvironment ; Hyaluronan Receptors/genetics*

Objective:To investigate the clinical effects of robot-assisted minimally invasive percutaneous pedicle screwing in the treatment of multi-segmental thoracolumbar burst fractures without neurological dysfunction.Methods:A retrospective analysis was conducted of the 24 patients who had been treated at Department of Orthopaedics, Hospital Affiliated to Inner Mongolia Medical University for multi-segmental thoracolumbar fractures from January 2019 to December 2020. They were randomly divided into a robot group ( n=12) in which the minimally invasive percutaneous pedicle screwing was assisted by a surgical robot and a manual group ( n=12) in which the minimally invasive percutaneous pedicle screwing was performed manually. There were 8 males and 4 females in the robot group, aged from 35 to 74 years; there were 7 males and 5 females in the manual group, aged from 36 to 69 years. The clinical effects were evaluated by comparing the 2 groups in terms of operation time, fluoroscopy frequency, fluoroscopy time, intra-operative needle adjustments, intra-operative blood loss, screwing accuracy, and visual analogue scale (VAS) scores, anterior vertebral height ratios and sagittal cobb angles at preoperation, postoperative 3 days and the last follow-up. Results:There was no statistically significant difference in the preoperative general data between the 2 groups, showing comparability ( P>0.05). A total of 128 screws were implanted in the robot group and 126 ones in the manual group. In the robotic group, operation time [(129.2±10.5) min], fluoroscopy frequency [(8.5±2.1) times], fluoroscopy time [(9.8±1.9) s], guide needle adjustments [(2.3±1.4) times], and intraoperative blood loss [(65.3±9.8) mL] were significantly less than those in the manual group [(153.8±18.1) min, (39.8±5.1) times, (43.9±4.8) s, (18.6±2.6) times and (96.8±10.9) mL] (all P<0.05). Regarding the screwing accuracy evaluated using CT scanning, the robot group was significantly higher (93.75%, 120/128) than the manual group (84.92%, 107/126) ( P<0.05). There was no significant difference between the 2 groups in VAS score, anterior vertebral height ratio or sagittal cobb angle at postoperative 3 days or the last follow-up ( P>0.05). The VAS scores, anterior vertebral height ratios and sagittal cobb angles at postoperative 3 days and the last follow-up were significantly improved than the preoperative values in all patients ( P<0.05). There was no supplementary surgery or screw loosening in either of the 2 groups. Conclusion:In the treatment of multi-segmental thoracolumbar fractures, robot-assisted percutaneous pedicle screwing can achieve satisfactory clinical effects, because, compared with traditional open surgery, it has exhibited advantages of less operation time, lower radiation exposure, less intraoperative blood loss, and higher screwing accuracy.

Objective:To develop the Chronic Disease Management Ability Self-assessment Questionnaire for Community Nurses, and test its reliability and validity, so as to provide an evaluation tool for assessing community nurses ' chronic disease management ability. Methods:Guided by the competency theory, the first draft of the Chronic Disease Management Ability Self-assessment Questionnaire for Community Nurses was formed through literature review, semi-structured interviews, Delphi expert consultation and pre-experiment. From July to August 2019, 30 community nurses from a community health service center in Zhengzhou were selected by convenience sampling method for pre-survey and the project analysis. From September to November 2019, the convenience sampling method was used to select 415 community nurses from 60 community health service centers in Zhengzhou were selected for a formal survey, and the reliability and validity of the questionnaire were evaluated.Results:Exploratory factor analysis extracted 4 common factors, and the cumulative variance contribution rate was 61.040%. The content validity of each item of the questionnaire was from 0.800 to 1.000, and the overall level content validity of the questionnaire was 0.980. The Cronbach 's α coefficient was 0.964, and the Cronbach 's α coefficient of each dimension was from 0.800 to 0.958. The test-retest reliability of the questionnaire was 0.864, and the test-retest reliability of each dimension was from 0.908 to 0.986. The final version of the questionnaire contained 4 dimensions of professional knowledge, professional skills, professional abilities, and personal characteristics, with a total of 44 items. Conclusions:The Chronic Disease Management Ability Self-assessment Questionnaire for Community Nurses has good reliability and validity, and can be used as an assessment tool for community nurses ' chronic disease management ability.

Objective To evaluate the cardiac hemodynamics and function before and after balloon pulmonary angioplasty ( BPA ) treatment in patients with chronic thromboembolic pulmonary hypertension ( CTEPH) using echocardiography ,and to discuss the clinical value of the treatment . Methods A total of 36 CT EPH patients with medium‐high risk stratification underwent BPA during the period of September 2016 to January 2019 in Beijing Chao‐Yang Hospital ,Capital M edical University were recruited . T he following conventional echocardiographic parameters including right ventricular basal diameter ( RVD ) ,left ventricular basal diameter ( LVD) ,right atrial diameter ( RAD) ,left atrial diameter ( LAD) ,main pulmonary artery diameter ( DM PA ) , left ventricular eccentricity index ( LVEI ) , left ventricular ejection fraction ( LVEF) and pulmonary artery systolic pressure ( PASP ) were recorded .Echocardiographic parameters of right ventricular ( RV ) function including tricuspid annular plane systolic excursion ( T APSE ) , right ventricular fractional area change ( RVFAC ) ,tissue Doppler – derived tricuspid lateral annular systolic velocity ( S′) ,RV index of myocardial performance ( RIM P ) and right ventricular free wall longitudinal strain ( GLS) were measured . T he patients were divided into 2 groups according to the threshold value of postoperative SPAP of 50 mmHg (group Ⅰ :SPAP ≤ 50 mmHg ,group Ⅱ :SPAP＞50 mmHg) . Changes between each parameter before and after BPA were analyzed . Results ① T he frequency of BPA treatment for CT EPH patients ranged from 1 to 6 times . After BPA treatment ,SPAP decreased significantly ,and the measurements of RV function including T APSE ,RVFAC ,RIM P and GLS improved significantly ( all P ＜0 .05) . ②Patients in group Ⅰ showed significantly better RV function including T APSE ,RVFAC and GLS compared with group Ⅱ before BPA ( P ＜0 .05) . ③Univariate logistic regression showed that parameters of preoperative RV function T APSE , RVFAC and GLS had certain effects on the curative effect of interventional surgery . Conclusions Echocardiography can evaluate the hemodynamics and RV function in CT EPH patients with BPA .After BPA ,pulmonary artery pressure decreases and RV function improves to some extent ,suggesting that the treatment of BPA has certain clinical application and popularization value .

Objective: To evaluate the cardiac hemodynamics and function before and after balloon pulmonary angioplasty (BPA) treatment in patients with chronic thromboembolic pulmonary hypertension (CTEPH) using echocardiography, and to discuss the clinical value of the treatment. Methods: A total of 36 CTEPH patients with medium-high risk stratification underwent BPA during the period of September 2016 to January 2019 in Beijing Chao-Yang Hospital, Capital Medical University were recruited. The following conventional echocardiographic parameters including right ventricular basal diameter (RVD), left ventricular basal diameter (LVD), right atrial diameter (RAD), left atrial diameter (LAD), main pulmonary artery diameter (DMPA), left ventricular eccentricity index (LVEI), left ventricular ejection fraction (LVEF) and pulmonary artery systolic pressure (PASP) were recorded.Echocardiographic parameters of right ventricular (RV) function including tricuspid annular plane systolic excursion (TAPSE), right ventricular fractional area change (RVFAC), tissue Doppler–derived tricuspid lateral annular systolic velocity (S′), RV index of myocardial performance (RIMP) and right ventricular free wall longitudinal strain (GLS) were measured. The patients were divided into 2 groups according to the threshold value of postoperative SPAP of 50 mmHg (group Ⅰ: SPAP ≤ 50 mmHg, group Ⅱ: SPAP>50 mmHg). Changes between each parameter before and after BPA were analyzed. Results: ①The frequency of BPA treatment for CTEPH patients ranged from 1 to 6 times. After BPA treatment, SPAP decreased significantly, and the measurements of RV function including TAPSE, RVFAC, RIMP and GLS improved significantly (all P<0.05). ②Patients in group Ⅰ showed significantly better RV function including TAPSE, RVFAC and GLS compared with group Ⅱ before BPA (P<0.05). ③Univariate logistic regression showed that parameters of preoperative RV function TAPSE, RVFAC and GLS had certain effects on the curative effect of interventional surgery. Conclusions Echocardiography can evaluate the hemodynamics and RV function in CTEPH patients with BPA.After BPA, pulmonary artery pressure decreases and RV function improves to some extent, suggesting that the treatment of BPA has certain clinical application and popularization value.

Tremendous efforts have been devoted to the enhancement of drug solubility using nanotechnologies, but few of them are capable to produce drug particles with sizes less than a few nanometers. This challenge has been addressed here by using biocompatible versatile -cyclodextrin (-CD) metal-organic framework (CD-MOF) large molecular cages in which azilsartan (AZL) was successfully confined producing clusters in the nanometer range. This strategy allowed to improve the bioavailability of AZL in Sprague-Dawley rats by 9.7-fold after loading into CD-MOF. The apparent solubility of AZL/CD-MOF was enhanced by 340-fold when compared to the pure drug. Based on molecular modeling, a dual molecular mechanism of nanoclusterization and complexation of AZL inside the CD-MOF cages was proposed, which was confirmed by small angle X-ray scattering (SAXS) and synchrotron radiation-Fourier transform infrared spectroscopy (SR-FTIR) techniques. In a typical cage-like unit of CD-MOF, three molecules of AZL were included by the -CD pairs, whilst other three AZL molecules formed a nanocluster inside the 1.7 nm sized cavity surrounded by six -CDs. This research demonstrates a dual molecular mechanism of complexation and nanoclusterization in CD-MOF leading to significant improvement in the bioavailability of insoluble drugs.

Objective To compare the clinical effects between laparoscopic radical resection combined with radiofrequency ablation (RFA) and open radical resection for colorectal liver metastases.Methods The retrospective cohort study was conducted.The clinicopathological data of 120 colorectal liver metastases patients who were admitted to the Mengchao Hepatobiliary Hospital of Fujian Medical University (80 patients) and the Third Mfiliated Hospital of Chongqing Medical University (40 patients) between September 2012 and April 2017 were collected.Sixty patients undergoing laparoscopic radical resection of colorectal cancer combined with RFA of liver metastases were allocated into the laparoscopy with RFA group,and 60 undergoing open radical resection of colorectal liver metastases were allocated into the open group.Observation indicators:(1) surgical and postoperative situations;(2) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed to detect postoperative survival up to May 2017.Measurement data with normal distribution were represented as x±s,and comparisons between groups were analyzed using independent-sample t test.Measurement data with skewed distribution were described as M (range).Comparisons of count data were analyzed using chi-square test or Fisher exact probability.The repeated measures data were analyzed using the repeated measures ANOVA.The survival curve and rate were respectively drawn and calculated by the Kaplan-Meier method,and the Log-rank test was used for survival analysis.Results (1) Surgical and postoperative situations:① All the patients underwent successful surgery,without conversion to open surgery in the laparoscopy with RFA group.Operation time,volume of intraoperative blood loss,cases with overall complications,death,abdominal pain,nausea and vomiting,liver dysfunction,pleural effusion,non-calculus cholecystitis and peptic ulcer and duration of postoperative hospital stay were respectively (135±34)minutes,(451±197)mL,31,0,18,6,6,4,3,2,(13±4)days in the laparoscopy with RFA group and (165±49)minutes,(794±204)mL,42,1,15,9,10,11,5,5,(19±4)days in the open group,with statistically significant differences in operation time,volume of intraoperative blood loss,cases with overall complications and duration of postoperative hospital stay between groups (t =3.983,9.394,x2 =4.232,t =9.148,P＜0.05),and no statistically significant differences in cases with death,abdominal pain,nausea and vomiting,liver dysfunction,pleural effusion,non-calculus cholecystitis and peptic ulcer between groups x2 =0.376,0.686,1.154,3.733,0.134,0.607,P＞0.05).() Levels of alanine aminotransferase (ALT),total bilirubin (TBil) and prothronbin time (PT) before operation,at day 1 and 3 postoperatively were respectively (70±9)U/L,(399±36)U/L,(231±19) U/L,(21±3) μmol/L,(26±3) μmol/L,(23±5) μmol/L,(17.3±2.4) seconds,(20.2-±4.4) seconds,(18.9±2.8) seconds in the laparoscopy with RFA group and (68± 8) U/L,(412±39)U/L,(253±22)U/L,(21±4)μmol/L,(28±4)μmol/L,(27±8)μmol/L,(16.6±3.0)seconds,(22.1±5.2) seconds,(20.1± 4.4)seconds in the open group,with statistically significant differences in the levels of ALT,TBil and PT before operation,at day 1 and 3 postoperatively between groups (F=16.727,13.115,4.194,P＜0.05).(2) Follow-up and survival situations:120 patients were followed up for 7-24 months,with a median time of 20 months.The postoperative 1-and 2-year tumor-free survival rates,1-and 2-year overall survival rates were respectively 23.3％,11.9％,85.0％,40.0％ in the laparoscopy with RFA group and 20.0％,12.8％,83.3％,38.3％ in the open group,with no statistically significant difference in above indicators between groups (x2 =0.145,0.069,0.012,0.196,P＞0.05).Further analysis showed that postoperative 2-year overall survival rate of patients with 1,2,3 and ＞3 liver metastasis lesions were respectively 53.3％,38.2％,40.0％,16.7％ in the laparoscopy with RFA group and 50.0％,35.7％,40.0％,15.4％ in the open group,with a statistically significant difference in 2-year survival rate of patients with different liver metastasis lesions in the laparoscopy with RFA group (x2 =20.949,P＜0.05) and in the open group (x2 ＝ 21.349,P＜0.05).Conclusion There are some advantages of fewer traumas,less complications,faster postoperative recovery and minimally invasive in laparoscopic radical resection combined with RFA for colorectal liver metastases,meanwhile,less liver metastasis lesions and better prognosis are found.

Objective To investigate the effects of α-linolenic acid (ALA) on acute inflammation and neurological functional recovery of mice with traumatic brain injury (TBI). Methods The C57BL6/N mice were divided into high ALA dietary group (20 pregnant and 88 new-born mice) and low ALA dietary group (20 pregnant and 84 new-born mice) in this study. The contents of polyunsaturated fatty acids in the brain of the two groups were detected by gas chromatography. Mouse TBI model was established by control cortical impact method. The expression levels of inflammatory cytokines and cellular markers of the two groups were detected by reverse transcription-quantitative polymerase chain reaction and enzyme linked immunosorbent assay or Western Blotting at 0, 4, 24 and 96 h after TBI, respectively. The neurological functions were analyzed by the rotarod, beam walk test and fear conditioning experiment. Results The content of brain docosahexoenoic acid (DHA) was significantly higher in the high ALA dietary group than in the low ALA dietary group (15.48±1.20% vs 9.98±1.10%, P<0.05). The expression levels of TNF-α, IL-1β , IL-6 and CCL12 were lower in high ALA groups than in low ALA group after TBI (P<0.05). The motor function recovery 24 h after TBI was faster in the high ALA dietary group than in the lower ALA diet group. The cognitive function 24 h after TBI was better in the high ALA dietary group than in the low ALA group. Conclusion Increasing DHA levels in the brain can reduce acute inflammation and improve neurological function recovery after TBI.