Objective:To explore the efficacy and safety of endovascular intervention combined with preoperative laparoscopic exploration in the treatment of patients with acute mesenteric artery ischemia.Methods:This was a prospective cohort study (NCT04686981). The study enrolled 31 patients with acute mesenteric artery ischemia from Oct 1, 2020 to Oct 1, 2022. Among them, 26 patients (84%) were male, with a mean age of (67±13) years and a mean time to onset of (21±8) hours. All patients underwent laparoscopic exploration in the hybrid operating room. If the presence of intestinal necrosis or suspected necrosis was clearly determined, the patient would undergo open surgery (mesenteric artery embolization, intestinal resection and intestinal double stoma) as the treatment by gastrointestinal surgeon. If intestinal necrosis or suspected necrosis was not found by laparoscopy, the patient would undergo endovascular intervention by vascular surgeon. The primary observational endpoints of this study were the proportion of patients who were not dependent on total parenteral nutrition and all-cause mortality within 30 days after operation. The secondary observational endpoints were the rate of mesenteric vascular patency within 30 days and the proportion of interventions that were converted to open surgery.Results:Six patients underwent open surgery and 25 patients underwent endovascular intervention, including 13 cases of thrombus reduction alone, 3 cases of stent implantation during the same period after reduction, and 9 cases of stent implantation alone. Twenty-four patients (77%) were completely weaned from the TPN within 30 days after the procedure, and all-cause mortality was observed in 3 cases (9.7%). The patency rate of the mesenteric artery within 30 days after the procedure was 82.1%. The rate of conversion to open surgery after intervention was 16%.Conclusions:Endovascular intervention combined with preoperative laparoscopic exploration can clarify intestinal ischemia in acute mesenteric patients as early as possible, and individualized treatment strategies for each patient by multidisciplinary care team can potentially improve the prognosis of such patients.

Objective This study aims to investigate the influence of glucose regulated protein(GRP)78 on osteo-blast differentiation in periodontal ligament fibroblasts(PDLFs)under cyclic mechanical stretch and determine the under-lying mechanism.Methods FlexCell 5000 cell mechani-cal device was applied to simulate the stress environment of orthodontic teeth.GRP78High and GRP78Low sub-population were obtained by flow sorting.Gene transfec-tion was performed to knockdown GRP78 and c-Src ex-pression and overexpress c-Src.Western blot analysis was used to detect the protein expression of Runt-related gene 2(RUNX2),Osterix,osteocalcin(OCN),and osteopontin(OPN).Immunoprecipitation assay was used to determine the interaction of GRP78 with c-Src.The formation of cellular mineralized nodules was determined by alizarin red staining.Results GRP78 was heterogeneously expressed in PDLFs,and GRP78High and GRP78Low subpopulations were obtained by flow sorting.The osteogenic differentiation ability and phosphorylation level of c-Src kinase in the GRP78High subpopulation were significantly increased com-pared with those in GRP78Low subpopulation after cyclic mechanical stretch(P<0.05).GRP78 interacted with c-Src in PDLFs.The overexpression c-Src group showed significantly increased osteogenic differentiation ability than the vector group(P<0.05),and the sic-Src group showed significantly decreased osteogenic differentiation ability(P<0.05)after cy-clic mechanical stretch.Conclusion GRP78 upregulates c-Src expression by interacting with c-Src kinase and pro-motes osteogenic differentiation under cyclic mechanical stretch in PDLFs.

Cystic fibrosis (CF) is a rare autosomal recessive disease with only one pathogenic gene cystic fibrosis transmembrane conductance regulator (CFTR). To identify the potential pathogenic mutations in a Chinese patient with CF, we conducted Sanger sequencing on the genomic DNA of the patient and his parents and detected all 27 coding exons of CFTR and their flanking intronic regions. The patient is a compound heterozygote of c.2909G > A, p.Gly970Asp in exon 18 and c.1210-3C > G in cis with a poly-T of 5T (T5) sequence, 3 bp upstream in intron 9. The splicing effect of c.1210-3C > G was verified via minigene assay in vitro, indicating that wild-type plasmid containing c.1210-3C together with T7 sequence produced a normal transcript and partial exon 10-skipping-transcript, whereas mutant plasmid containing c.1210-3G in cis with T5 sequence caused almost all mRNA to skip exon 10. Overall, c.1210-3C > G, the newly identified pathogenic mutation in our patient, in combination with T5 sequence in cis, affects the CFTR gene splicing and produces nearly no normal transcript in vitro. Moreover, this patient carries a p.Gly970Asp mutation, thus confirming the high-frequency of this mutation in Chinese patients with CF.
China ; Cystic Fibrosis/genetics* ; Cystic Fibrosis Transmembrane Conductance Regulator/genetics* ; Humans ; Mutation ; Poly T ; RNA, Messenger/genetics*

Objective:To analyze the effect of endovascular therapy (including balloon dilation, debulking and anti-restenosis technique) for below-the-ankle atherosclerotic lesions in chronic limb threatening ischemic patients.Methods:A retrospective analysis was performed on the clinical data of 465 patients (570 limbs) with below-the-ankle atherosclerosis who were consecutively admitted to Beijing Tsinghua Changgung Hospital Affiliated to Tsinghua University from April 2018 to December 2021. All patients received balloon dilatation below the ankle artery as basic treatment, including 67 patients in debulking subgroup, 82 patients in anti-restenosis subgroup and 11 patients in the triple therapy subgroup. The reocclusion rate, target lesion reintervention rate at 1, 3, 6 and 12 months after surgery were compared; The wound healing rate at 3 months, limb salvage rate at 6 and 12 months and mortality at 12 months in the Global Limb Anatomic Staging System (GLASS) grading groups P0, P1 and P2 were compared.Results:The technical success rate of this group was 76.0%(433 limbs/570 limbs). The follow-up rates of 6 and 12 months after operation were 85.4%(370 limbs/433 limbs) and 75.3%(326 limbs/433 limbs), respectively. The length of treated lesions was (3.6±1.3)cm; The reocclusion rates were 5.5%(23 limbs/420 limbs), 8.2%(33 limbs/403 limbs), 14.9%(55 limbs/370 limbs) and 23.6%(77 limbs/326 limbs) at 1, 3, 6 and 12 months after operation; The reintervention rate of target lesions in 6, 12 months was 7.6%(28 limbs/370 limbs) and 12.0%(39 limbs/326 limbs) respectively; The wound healing rate in groups P0, P1 and P2 within 3 months was 87.3%(192 limbs), 70.5%(62 limbs) and 10.5%(2 limbs) respectively ( P<0.001), the limb salvage rate in 6 months was 96.2%(200 limbs), 84.7%(127 limbs) and 33.3%(4 limbs) respectively ( P<0.001), and the limb salvage rate in 12 months was 78.7%(170 limbs), 54.5%(55 limbs) and 22.2%(2 limbs) respectively ( P<0.001). The mortality was 6.9%(32/465) 12 months after operation. Conclusions:Endovascular therapy below-the-ankle is feasible and has high technical success rate. The constitute integrity of pedal-plantar loop in limb- threatening phase is related to 3-month wound healing rate and limb salvage rate.

Objective:To understand the expression levels of γδT cells and CD4 + CD25 + regulatory T cells in the peripheral blood of HIV-infected/AIDS patients, and explore the correlation and possible relationship between γδT cells and CD4 + CD25 + regulatory T cells in the progression of HIV infection/AIDS Mechanism. Methods:Immunofluorescent monoclonal antibody labeling technology and flow cytometry were used to detect 12 cases of AIDS, 19 cases of intermediate HIV infection, 15 cases of early HIV infection, and 30 cases of healthy physical examination in peripheral blood CD3 + T cells and CD4 + The expression levels of T cells, CD8 + T cells, γδT cells, CD4 + CD25 + regulatory T cells; Pearson was used to analyze the correlation between γδT cells and CD4 + CD25 + regulatory T cells. Results:The expression (Mean± SD, %) of γδT cells in the peripheral blood of the AIDS group, the mid-stage HIV infection group, the early HIV infection group and the healthy control group were: 4.46±1.37, 3.59±0.67, 3.12±0.33, 1.73±0.36, group The time ratio, F=6.091, P=0.018. The expression (Mean± SD, %) of CD4 + CD25 + regulatory T cells in the peripheral blood of the AIDS group, the mid-stage HIV infection group, the early HIV infection group, and the healthy control group were: 10.28±1.94, 7.37±1.03, 6.68±0.58, 4.03±0.82, ratio between groups, F=13.568, P=0.002. The comparison of γδT and CD4 + CD25 + regulatory T cells among the four groups is statistically significant, AIDS group>HIV mid-infection group>HIV early infection group>control group. In terms of correlation, γδT, CD4 + CD25 + regulatory T cells are negatively correlated with CD4 + T cells ( r value are -0.982, -0.712, P value are 0.001, 0.002, respectively), and positively correlated with CD8 + T cell counts ( r value are 0.873 , 0.809, P value are 0.000 and 0.000 respectively); γδT cells are positively correlated with CD4 + CD25 + regulatory T cells ( r=0.911, P=0.000). Conclusions:HIV infection induces the proliferation of γδT cells and CD4 + CD25 + regulatory T cells, both of which participate in the immune response caused by HIV infection. γδT cells are positively correlated with CD4 + CD25 + regulatory T cells, and the two may have a synergistic effect.

Objective To evaluate the experience and early results of radiofrequency ablation (RFA) therapy for varicose veins.Methods In this study 380 extremities of 356 patients undergoing RFA therapy with RFA catheter for varicose veins from Nov 2015 to Sep 2017 in Beijing Tsinghua Changgung Hospital were retrospectively reviewed.Each patient was scheduled to follow up at 1,6 and 12 months respectively.Results Technical success were achieved in all cases.Obliteration rate was 99.0％ in 1 month,97.9％ in 6 months and 97.1％ in 12 months after the RFA therapy.Conclusions RFA therapy for varicose veins is safe and effective and achieves good early result.Intraoperative ultrasound examination and endovascular technique is important for a successful RFA procedure.

OBJECTIVETo study the relationship between sub-health status and the health-promoting lifestyle of employees.

METHODSA total of 5316 employees in a company in Guangdong were surveyed using sub-health measurement scale version 1.0 (SHMS V1.0) and the health-promoting lifestyle profile (HPLP-II). The former scale included 3 subscales of somatic sub-health, psychological sub-health and social sub-health, and the latter included 6 subscales of self-actualization, healthy responsibility, physical exercise, nutrition, interpersonal sensitivity and stress treatment.

RESULTSThe total healthy rate was 12.86% among the employees, with 76.76% and 10.5% in sub-health and disease states. The mean scores of HPLP-II was 115.95∓21.468 in the total population surveyed, 134.23∓24.72 in healthy employees and 114.69∓19.25 in the patients. There was a significant difference in the grades of health-promoting lifestyle between sub-healthy and healthy employees (P<0.05) as well as in the scores of HPLP-II and the scores of the 6 subscales (P<0.05). An appreciable correlation was found between sub-health status and the 6 subscales, and self-realization, physical exercise and stress management showed significant inverse correlation with sub-health status.

CONCLUSIONSub-health status is related to health-promoting lifestyle, and self-realization, physical exercise and management are the protective factors that influence sub-health status.

Adult ; Cross-Sectional Studies ; Female ; Health Behavior ; Health Promotion ; Health Status ; Humans ; Life Style ; Male ; Surveys and Questionnaires ; Young Adult

Objective To summarize the experiences in clinical diagnosis and surgical treatment of chest cancers invading the superior vena cava (SVC). Method Retrospective study of 12 cases with chest cancers invading the SVC, SVC and innominate vein were reconstructed with prosthesis in 3 cases, the side wall of the SVC was excised and repaired in 9 cases. Results Complete resection was performed in 10cases,2 cases had incomplete resection. There was no death associated with operation in these patients. All patients were followed up for 1 - 7 years after operation,and 3 cases were lost to follow up,5 of remaining 9cases were dead because of relapse and metastasis, their median survival time was 8 months,other 4 cases lived, their median survival time was 42 months. Conclusions Patients with chest cancers invading the SVC should have surgical treatment of not only tumor resection but also the vessel reconstruction,the prognosis would be better than without surgical treatment. These patients have a high quality of life and live with long-term survival.

Objective To investigate the mechanism that BC047440 gene regulates nuclear fac-tor κB sigal passway and analyze the differential expression gene between HepG2 cells and HepG2 cells BC047440 gene silenced by RNAi using 35K Human Genome Array. Methods The differential expres-sion gene between HepG2 cells and HepG2 cells with BC047440 gene silenced was analyzed by 35K Human Genome Array, and the data were submitted to the database and MAS system of Capitalbio Corporation.Then TRAF6 was confirmed by RT-PCR test. Results Among the total 35000 probe sets, the expression of 59 genes was down-regulated for more than 50% and 130 genes were up-regulated more than 2 fold in the silencing group when compared with normal controls. TRAF6 mRNA was decreased for 29.5% in silicening HepG2 compared with that of wild HepG2 by RT-PCR, which is similar to human genome array(23.06%).Conclusion The high throughput and effective oligomicroarray can analyze the differential expression gene and BC047440 gene might regulate NF-κB signal pathway inderectly by TRAF6.

Objective To evaluate the influence of respiration on the radiation dose distribution within target volume in radiotherapy with film dosimetry. Methods Radiation of 50 MU was delivered by a square, round, ellipse, dumb bell, or female shaped filed to the films within a moving or motionless Respiration Motion Phantom respectively, the dose distributions for the two motion status were measured and compared. In order to further verify the impact of respiration, a plank phantom was used on different shifting value: 0, 0.5, 1.0, 1.5 and 2.0 cm, respectively. A square, round, or eUipse-shaped filed was used for irradiation and the distributions in different status were measured and compared with film dosimetry. Iso-dose line comparison, NAT(Normalized Agreement Tests) and γ comparison were used for the comparison of dose distributions. Fs can be an index to reflect the variability of the areas that surrounded by iso-dose lines. (FS90, FS50, FS25 delegates the ratio of the areas that surrounded by 90 %,50 %,25 % iso-dose hne in different situation respectively). Results (1) Compared with motionless situation, the FS90 in horizontal movement situation became small and the FS25 became large. As the displacement became larger, the FS90 became larger and the FS25 became smaller. FS in vertical movement situation, square and dumb bell fields changed while the others didn't have a change. (2)γ and NAT comparison: In the horizontal movement situation, compared with the static phantom, Pγ < 60 % and PNAT < 75 %. Under vertical movement situation, Pγ were less than 85 % for the square, round, dumb bell and female shaped fileds. In the plank phantom verification, Pγ and PNAT became smaller as the movement became larger. Conclusions The respiration can impact on the dose distribution within the target volume in radiotherapy, leading to a smaller area of higher dose level and an expanded area of lower dose level. The influence will become more significant with larger movement of the target.