ObjectiveTo explore the effect of virtual reality on upper limb function in stroke patients through diffusion tensor imaging (DTI). MethodsFrom September, 2021 to March, 2023, 80 stroke patients in the Fuzhou Second General Hospital were randomly divided into control group (n = 40) and experimental group (n = 40). Both groups received routine rehabilitation, while the experimental group received virtual reality training additionally, for four weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and Action Research Arm Test (ARAT) before treatment, after treatment and after four-week follow-up; and they were scaned with DTI to measure the fractional anisotropy (FA) and relative anisotropy (RA) of cerebral peduncle and posterior limb of inner capsule of the affected side before and after treatment. ResultsTwo cases dropped in each group. The FMA-UE and ARAT scores increased in both groups after treatment and follow-up (F > 2.790, P < 0.001), and increased more in the experimental group than in the control group (t > 2.297, P < 0.05). FA and RA in the posterior limb of inner capsule increased in both groups after treatment (t > 21.013, P < 0.001), and increased more in the experimental group (t > 2.006, P < 0.05). The d-value of FA of the posterior limb of internal capsule before and after treatment (ΔFA) was positively correlated with the d-value of FMA-UE score (r > 0.362, P < 0.05) in both groups, the ΔFA of the posterior limb of internal capsule was positively correlated with the d-value of ARAT score (r = 0.459, P < 0.01). ConclusionVirtual reality training can promote the recovery of upper limb function in stroke patients, which may associate with the conductivity of posterior limb of inner capsule.

Objective To analyze the influencing factors and management of benign anastomotic stenosis in patients with colorectal cancer after concurrent prophylactic ileostomy.Methods The clinical data of 74 colorectal cancer patients undergoing preventive ileostomy admitted to Quanzhou First Hospital Affiliated to Fujian Medical University from April 2018 to June 2022 were selected,according to the presence or absence of anastomotic stenosis after surgery,patients were divided into anastomotic stenosis group and anastomotic normal group.The influencing factors of stenosis were analyzed using statistical methods,and the management methods for anastomotic stenosis were summarized.Results 15 cases of anastomotic stenosis occurred after surgery,with an incidence rate of 20.3%.Compared with anastomotic normal group,patients in anastomotic stenosis group had a higher proportion of preoperative radiation therapy,preoperative neoadjuvant chemotherapy,and a higher incidence of postoperative anastomotic leakage/pelvic infection,with statistical significance(P<0.05);Multivariate analysis suggests that preoperative radiotherapy,anastomotic leakage/pelvic infection are independent risk factors for anastomotic stenosis.Conclusion Patients with colorectal cancer who undergo preoperative radiotherapy,neoadjuvant chemotherapy,and postoperative anastomotic leakage/pelvic infection should pay attention to the occurrence of anastomotic stenosis after undergoing ileostomy;Postoperative anastomotic stenosis should be treated according to the characteristics of the stenosis.

Objective:To investigate the effects of myeloid differentiation protein-2 (MD-2) on paclitaxel resistance cells in triple negative breast cancer (TNBC) through EGFR signaling pathway.Methods:Immunohistochemical method was used to detect the expression of MD-2 in cancer tissue and adjacent tissue of TNBC patients, and the relationship between MD-2 expression and clinicopathological parameters of patients was analyzed. The TNBC paclitaxel-resistant cell line was constructed and MD-2 expression in cells was interfered. Cell invasion was detected by Transwell, and cell apoptosis was detected by flow cytometry. The signaling pathways regulated by MD-2 were screened by transcriptome sequencing and verified by Western blot.Results:The expression of MD-2 was significantly enhanced in cancer tissues relative to adjacent tissues. High expression of MD-2 was closely related to clinical stage, tumor size, tumor recurrence and metastasis ( χ2=4.50, P=0.032; χ2=2.55, P=0.011; χ2=4.40, P=0.036). In cell experiments, compared with normal breast cells, the expression of MD-2 in TNBC cell lines was significantly enhanced. Compared with sh-NC group (100±11.52) (6.81±0.57), knockdown of MD-2 could inhibit the invasion (61.44±6.78) ( t=4.99, P=0.008) but promote apoptosis (15.19±1.06) ( t=12.06, P<0.001) of paclitaxel resistant TNBC cells. Transcriptome sequencing and Western blot results showed that MD-2 mainly affects the biological behavior of TNBC cells by regulating the EGFR signaling pathway. Conclusions:MD-2 promoted TNBC cell invasion and paclitaxel resistance, which may be achieved by affecting the EGFR signaling pathway. MD-2 is expected to become an effective target in TNBC treatment.

Tumor microenvironments (TMEs) are closely related to tumor resistance. TMEs are divided into cellular components and acellular components. The cellular components include tumor-associated macrophages, tumor-associated fibroblasts, mesenchymal stem cells, etc., which can enhance tumor resistance through recruitment and secretion of a variety of protective cytokines; acellular components such as extracellular matrix, hypoxia and acidification, etc., can mediate drug resistance by constructing physical barriers, affecting tumor cell growth and metabolism. Studying the mechanisms of TME-mediated drug resistance and reshaping TMEs can provide new strategies for anti-tumor therapy.

Objective:To observe the curative effects of berberine in rats with high-fat diet induced non-alcoholic fatty liver and to further explore its possible mechanism.Methods:Twenty-six Sprague-Dawley rats (120-160 g) were randomly divided into 3 groups: control group ( n = 8), model group ( n = 10) and treatment group ( n = 8). Rats in the control group were fed with regular diet, and the model group and the treatment group were fed a high-fat diet. At the 12th week, two rats in the in the model group were sacrificed to verify whether model was successful established. Subsequently, treatment group rats were given a gavage of berberine at a dose of 150 mg·kg -1·d -1 for 4 weeks, and the control and the model group rats were given the same dose of normal saline. Rats were sacrificed at week 16th. HE staining was used to observe the changes in the intestinal mucosa of rats. Sudan black B staining was used to observe the fatty changes in liver. Immunohistochemical staining was used to observe the expression level of occludin protein in the intestinal epithelium. A real-time 16S rDNA PCR method was used to measure the number of escherichia coli, bacteroides and faecalibacterium prausnitzii in the feces of rats. Results:Model group had a higher serum levels of endotoxin (0.288 ± 0.045) and tumor necrosis factor (TNF)-α (1.07 ± 0.11) than the control group (0.192 ± 0.049, 0.94 ± 0.07) ( P < 0.05). Berberine intervention had significantly reduced endotoxin (0.213 ± 0.025) and TNF-α level (0.93 ± 0.07) ( P < 0.05). The expression level of occludin protein was significantly lower in the intestinal mucosa of model group than that of control group (0.166 ± 0.014), and berberine had promoted the expression of occludin protein in intestinal mucosa (0.055 ± 0.009), but the difference was not statistically significant ( P > 0.05). At the same time, compared with the model group (7.29 ± 0.47), the number of bacteroidetes in the control group (9.49 ± 0.59) was decreased, while the number of bacteroidetes in the treatment group was increased (9.77 ± 0.87). The number of escherichia coli (6.92 ± 0.77) and faecalibacterium prausnitzii (8.70 ± 0.62) in the model group were increased than control group (5.42 ± 0.63, 9.49 ± 0.59), while the number of escherichia coli (6.34 ± 0.71) and faecalibacterium prausnitzii (9.77 ± 0.87) ( P < 0.05) was reduced with the intervention of berberine. Conclusion:Berberine could effectively protect the intestinal barrier function in rats with NAFLD and the possible mechanism of action behind it may be the regulation of intestinal flora.

Objective: To elucidate the clinicopathological characters and prognostic factors of invasive micropapillary carcinoma of the breast (IMPC) by compared with invasive ductal carcinoma, not otherwise specified of the breast (IDC). Methods: The retrospective study was performed with female patients who had undergone curative resection for breast cancer without neoadjuvant chemotherapy from June 2008 to April 2016 in Breast Center of Beijing Hospital. Forty-seven mixed or pure IMPC patients and 93 pure IDC patients(admitted in the same center from October 2008 to January 2016 ) were matched for tumor stage, nodal status and age. Follow-up was done every 3 to 6 months postoperatively. The deadline was July 31, 2016. The curves of disease free survival and overall survival were drawn by the Kaplan-Meier method, and survival rates were compared by means of the Log-rank test. Potential prognostic variables that were identified on univariate analysis were analyzed with Cox′s proportional hazards regression model for multivariate analysis. The χ² test or Fisher′s exact test was used to compare distributions across 2 groups and the Mann-Whitney U test or t test was used to analyze the medians or means of 2 groups. Results: With exact matches, the rates of lymphovascular invasion (LVI) (29.8% vs. 12.9%, χ²=5.885, P=0.015)and histological grade 3 (40.4% vs. 21.5%, χ²=-2.690, P=0.007) were both significantly higher in patients with IMPC than that in IDC group, but the survival between the two pathological types were not significantly different (all P>0.05). The percent of IMPC component didn′t influence the clinicopathologic characters (all P >0.05), but a significantly longer median disease free survival (χ²=11.731, P=0.001) when the patients had more than 50% of IMPC component was found. Conclusions Higher rates of LVI and histological grade 3 were found in IMPC than that in IDC, but the survival was comparable between the two groups. A longer DFS occurred in patients with IMPC component more than 50%.

Objective: To analyze the differences of clinicopathological characters and prognostic factors between invasive micropapillary carcinoma of the breast (IMPC) and invasive ductal carcinoma (IDC) not otherwise specified of the breast. Methods: Patients who were treated from June 2008 to April 2016 in Breast Center of Beijing Hospital were retrospectively analyzed to evaluate the differences between IMPC (n=59) and IDC (n=1 080). Follow-up was done every 3 to 6 months postoperatively with a deadline of July 31, 2016. The curves of disease free survival (DFS) and overall survival (OS) were drawn by Kaplan-Meier method, and survival rates were compared by means of the Log-rank test. Potential prognostic variables which were identified on univariate analysis were analyzed with Cox′s proportional hazards regression model for multivariate analysis. Results: More lymph nodes were involved in IMPC group (χ²=12.168, P=0.007) which led to more later stage in this group (χ²=8.950, P=0.011). IMPC group displayed a significantly increased rate of lymphovascular invasion (LVI) compared to IDC group (χ²=13.511, P = 0.001). The expression rate of estrogen receptor (ER) and progesterone receptor (PR) was higher in IMPC group than that in IDC group (89.8% vs. 76.3% and 88.1% vs. 70.7%, respectively, χ²=5.786, 8.332, all P<0.05). In multivariate analysis performed with the variables found significant in univariate analysis, the only variable found significantly affecting DFS of IMPC group was the T stage (T1-2 and T3-4, OR=5.217, 95%CI: 1.401 to 19.430, P=0.014), while in IDC group, pathological stage (stage Ⅰ to Ⅱ and stage Ⅲ to Ⅳ, OR=1.870, 95% CI: 1.262 to 2.771, P=0.002), lymph node positive ratio (LNR) (OR=2.222, 95%CI: 1.561 to 3.162, P=0.000), PR (OR=1.856, 95%CI: 1.118 to 3.082, P=0.017), and age (<50 years old and ≥50 years old, OR=0.695, 95%CI: 0.488 to 0.989, P=0.043) were prognostic factors. There were two variables found significantly affecting OS of IMPC group, which were T stage (OR=3.713, 95%CI: 1.539 to 8.959, P=0.004) and LNR (OR=2.850, 95%CI: 1.033 to 7.862, P=0.043). While in IDC group, LNR was the only variable found significantly affecting OS (OR=2.129, 95%CI: 1.324 to 3.425, P=0.002). Compared with IDC, the patients with IMPC were more likely to have local or regional recurrence (P=0.006). Although the median DFS interval was longer in IDC group (χ²=9.739, P=0.002), the median OS interval was comparable between the two groups (χ²=0.787, P=0.375). Conclusion Although IMPC has lymphotropic feature, tendency of LVI and local or regional recurrence, it has an OS which is comparable with IDC.

Objective To assess the efficacy and safety of mifepristone combined with oral or vaginal misoprostol for termination of pregnancy between 8 and 16 weeks of gestation. Methods This was a randomized, multi-center, open clinical trial. A total of 625 women at 8-16 weeks of gestation were randomized to receive 200 mg oral mifepristone followed by either oral misoprostol 400 μg every 3 hours or vaginal misoprostol 400μg every 6 hours for a maximum of 4 doses 36-48 hours later. There were 417 women in oral group with 198 at 8-9 weeks and 219 at 10-16 weeks, while 208 women in vaginal group with 99 at 8-9 weeks and 109 at 10-16 weeks. The outcome measures were the success abortion rate, induction to abortion interval, the amount of bleeding, reoccurrence of menstruation and adverse events. Results Abortion rate was significantly higher in vaginal group [98.1% (202/206)] than that in oral group [94.0%(390/415), P=0.023]; concerning termination of pregnancy at 8-9 weeks and 10-16 weeks respectively, there were no significant differences between oral and vaginal groups (P=0.156, P=0.073). The induction to abortion interval was no significant difference in oral and vaginal group in different gestational weeks ( P=0.238, P=0.273). The average induction to abortion interval was (4.1 ± 6.6) hours and (6.0 ± 4.5) hours respectively in terminating 8-9 weeks and 10-16 weeks of gestation. Concerning the amount of bleeding within 2 hours of placenta expulsion, there was significant difference between oral group [(63±46) ml] and vaginal group [(55 ± 45) ml] in terminating 8-9 weeks of gestation (P=0.047), while there was no significant difference between groups in terminating 10-16 weeks of gestation [oral group (76 ± 52) ml versus vaginal group (76 ± 61) ml, P=0.507]. The reoccurrence of menstruation was about 37 days in both oral and vaginal groups. Two cases of incomplete abortion were serious adverse events (SAE) relating to treatment. The common adverse events (AE) of nausea and vomiting were significantly higher in oral group [57.2% (239/417), 36.3% (151/417)] than those in vaginal group [45.4% (94/208), 26.1% (54/208); P=0.005, 0.011]. Conclusion Oral or vaginal misoprostol combined with mifepristone, is effective and safe for termination of pregnancy between 8 and 16 weeks of gestation.

Objective To compare the pulmonary complications between the double lumen tube and the single lumen tube,and to determine whether there are objective advantages of one over the other in one-lung ventilation during minimally invasive esophagectomy(MIE).Methods From January 2012 to November 2013,165 patients with esophageal cancer received combined thoracoscopic and laparoscopic esophagectomy with anastomosis in the neck.All clinical data were retrospectively reviewed.Results Between the single lumen tube and the double lumen tube:patients with pulmonary infection is 11 (16.42％),34(34.69％) (P =0.010).The average intubation time is(1.45 ±0.22)min,(6.53 ±0.59) min,P =0.000.The number of harvested lymph nodes of total is (42.76 ± 18.11) and (34.32 ± 15.80),P =0.002.The number of harvested lymph nodes of the cervix and the left laryngeal recurrent nerve chain was (3.19 ± 2.53) and (1.30 ± 2.14),P =0.000.Conclusion In the minimally invasive esophagectomy,single lumen tube is simpler and easier than the double lumen tube,and with the low incidence of postoperative pulmonary complications,at the same time there are more advantageous in the meditational lymph nodes cleaning.

Objective To explore the association of interleukin (IL)-1 genotypes with Alzheimer′s disease (AD). Methods Using polymerase chain reaction and restriction fragment length polymorphism, the IL-1A (-889) and IL-1B (+3953) genotypes in 84 cases of AD and 139 controls were detected and analyzed. Results The frequencies of IL-1A(- 889) C/C, C/T and T/T genotypes were 72.6% and 84.2%, 23.8% and 14.4%, 3.6% and 1.4% in AD cases and controls respectively. The genotypes frequencies of IL-1A (-889) C/C, C/T and T/T in AD cases were similar to that of controls (χ2=4.53, P＞0.05), but the frequencies of IL-1A (-889) T allele were significantly higher in AD cases than in controls (15.5% vs. 8.6%, χ2=4.93, P＜0.05). The frequencies of IL-1B (+3953) C/T genotypes and T allele were also significantly higher in AD cases than in controls (16.7% vs. 6.5%, 8.3% vs. 3.2%, χ2=5.88,5.56, both P＜0.05). Conclusions IL-1 genotypes are associated with AD. IL-1 genotypes may play an important role in the development of AD.