Objective: To investigate the reduction effect of hoding cricoarytenoid joint reduction with visual laryngoscope under intravenous anesthesia. Methods: The therapeutic effects of 40 patients with arytenoid dislocation(AD)treated by closed reduction in the single center from January 2020 to September 2021 were retrospectively analyzed, including 21 males and 19 females, median age 48 years. The etiology, symptoms, preoperative evaluation methods, reduction mode, reduction times, and the recovery of arytenoid cartilage movement and sound after reduction were evaluated and analyzed. Results: All patients had obvious hoarseness and breath sound before treatment. Under stroboscopic laryngoscope or electronic nasopharyngoscope, different degrees of vocal cord movement disorder and poor glottic closure can be seen. There were 28 cases of left dislocation, 9 cases of right dislocation and 3 cases of bilateral dislocation. The etiology of dislocation of cricoarytenoid joint: 25 cases (62.5%) of tracheal intubation under general anesthesia were the most common causes, was as follows by laryngeal trauma, gastroscopy, cough, vomiting and so on. Among them, 28 cases of reduction were initially diagnosed in our department, and 12 cases were diagnosed later after failure of reduction treatment. Of the 40 patients, 6 underwent reduction 24 hours after dislocation; 18 cases from 3 days to 1 month; 7 cases from 1 to 3 months; 6 cases were reset in 3~6 months; Over 6 months in 3 cases. After one reduction, 10 cases (10/40, 25%) recovered normal pronunciation, 14 cases (14/40, 35%) recovered normal pronunciation after two reduction, 10 cases (10/40, 25%) recovered normal pronunciation after three times, 2 cases (2/40, 5%) recovered normal pronunciation after four times, and 1 case (2.5%) recovered normal pronunciation after five times. Thin slice CT scan of larynx and cricoarytenoid joint reconstruction showed the types of AD: subluxation in 37 cases (92.5%) and total dislocation in 3 cases; 28 cases of left dislocation, 9 cases of right dislocation and 3 cases of bilateral dislocation; 29 cases (72.5%) had posterior dislocation and 11 cases (27.5%) had anterior dislocation. All patients were treated by intravenous anesthesia with arytenoid cartilage clamped by cricoarytenoid joint reduction forceps under visual laryngoscope. The curative effect was evaluated by stroboscopic laryngoscope and/or voice analysis at 1-2 weeks after operation. The vocal cord movement returned to normal and the pronunciation was good in 37 cases (92.5%). Conclusions: Hoding cricoarytenoid joint reduction with the vision laryngoscope under intravenous anesthesia is easy to operate and the reduction effect is more stable. It is a effective method for AD.
Anesthesia, Intravenous/adverse effects* ; Arytenoid Cartilage/injuries* ; Female ; Humans ; Intubation, Intratracheal/adverse effects* ; Joint Dislocations/therapy* ; Laryngeal Diseases/etiology* ; Laryngoscopes/adverse effects* ; Male ; Middle Aged ; Retrospective Studies

OBJECTIVE: To investigate the effect of suppressing high-mobility group box 1 (HMGB1) on neuronal autophagy and apoptosis in rats after intracerebral hemorrhage (ICH) in rats. METHODS: Rat models of ICH induced by intracerebral striatum injection of 0.2 U/mL collagenase Ⅳ were treated with 1 mg/kg anti-HMGB1 mAb or a control anti-IgG mAb injected via the tail immediately and at 6 h after the operation (n=5). The rats in the sham-operated group (with intracranial injection of 2 μL normal saline) and ICH model group (n=5) were treated with PBS in the same manner after the operation. The neurological deficits of the rats were evaluated using modified neurological severity score (mNSS). TUNEL staining was used to detect apoptosis of the striatal neurons, and the expressions of HMGB1, autophagy-related proteins (Beclin-1, LC3-Ⅱ and LC3-Ⅰ) and apoptosis-related proteins (Bcl-2, Bax and cleaved caspase-3) in the brain tissues surrounding the hematoma were detected using Western blotting. The expression of HMGB1 in the striatum was detected by immunohistochemistry, and serum level of HMGB1 was detected with ELISA. RESULTS: The rat models of ICH showed significantly increased mNSS (P < 0.05), which was markedly lowered after treatment with anti- HMGB1 mAb (P < 0.05). ICH caused a significant increase of apoptosis of the striatal neurons (P < 0.05), enhanced the expressions of beclin-1, LC3-Ⅱ, Bax and cleaved caspase-3 (P < 0.05), lowered the expressions of LC3-Ⅰ and Bcl-2 (P < 0.05), and increased the content of HMGB1 (P < 0.05). Treatment with anti-HMGB1 mAb obviously lowered the apoptosis rate of the striatal neurons (P < 0.05), decreased the expressions of Beclin-1, LC3-Ⅱ, Bax and cleaved caspase-3 (P < 0.05), increased the expressions of LC3-Ⅰ and Bcl-2 (P < 0.05), and reduced the content of HMGB1 in ICH rats (P < 0.05). CONCLUSION Down- regulation of HMGB1 by anti-HMGB1 improves neurological functions of rats after ICH possibly by inhibiting autophagy and apoptosis of the neurons.
Animals ; Apoptosis ; Apoptosis Regulatory Proteins/metabolism* ; Autophagy ; Beclin-1 ; Caspase 3/metabolism* ; Cerebral Hemorrhage/therapy* ; Proto-Oncogene Proteins c-bcl-2/metabolism* ; Rats ; Rats, Sprague-Dawley ; bcl-2-Associated X Protein/metabolism*

BACKGROUND: With the continuous development of finite element method in biomechanics of orthopedics, the study of spine-related diseases by finite element method has become the main research direction nowadays. Especially, the stress analysis of internal fixation of the spine, the mechanical effect of different internal fixation and the development of new internal fixation are the current hot spot. Spondylolysis is a common disease of the spine. Especially when anatomical bone defects occur, the pathological model and biomechanics of the spine after surgery have corresponding mechanical changes. OBJECTIVE: To review the method of establishing spondylolysis models, the verification of the models and the pplication of finite element models of spondylolysis in various fields, and to summarize the application prospect and value of finite element modeling in lumbar spondylolysis. METHODS: The first author used computer to search the PubMed database and China Journal Full-text Database from January 1998 to December 2016 for related articles. Key words were "finite element, lumbar spine, isthmus, model". A total of 123 related articles were retrieved and 53 articles met the inclusion criteria. RESULTS AND CONCLUSION: (1) At present, finite element analysis of spondylolysis can well reflect the mechanical condition of internal bone. The finite element model of spondylolysis can be used to evaluate the structure and shape of lumbar spine (such as the defect isthmus), the material properties of different anatomical sites (lamina terminalis, cancellated bone and cortical bone) as well as the load of the spine under different exercise states. In particular, stress analysis of the internal structure of the vertebral body and the ancillary structures of the spine (such as disc and articular process) has obvious advantages. (2) In addition, the reconstruction data of the finite element model are derived from the original CT of the patient,and the simulation is high.Compared with the in vitro experiments,the finite element simulation of spondylolysis is reliable and can reduce the damage to the experimental subjects caused by external forces and radiation, and can effectively avoid medical ethics problem.

Objective To investigate the protection mechanism of dexmedetomidine against retinal ischemia-reperfusion injury (RIRI) in mice.Methods Forty-eight male C57BL/6 mice born 8 weeks were randomly into sham group,model group and experimental group.Each group had 16 mice.Mice model of RIRI were prepared.Before modeling 15 min,dexmedetomidine 25 μg · L-1 was injected into the abdominal cavity in experimental group,and the same dose of 0.9％ normal saline was injected into the abdominal cavity in sham group and model group.The RIRI model was established successfully then these mice were killed after reperfusion 24 h.The superoxide dismutase (SOD) was detected by WST-1 method,the malondialdehyde (MDA) was detected by TBA method,and the glutathione peroxidase (GSH-PX) was determined by colorimetry.The tumor necrosis factor alpha (TNF-α),interleukin-6 (IL-6),1-methylcyclopropene (MCP-1) and interleukin-10 (IL-10) were detected by ELISA.Results Compared with the sham group,the levels of SOD (45.47 ± 8.16) U · mg-1 and GSH-PX (264.64 ± 27.31) U · mg-1 in the retinal tissue of the model group were decreased significantly (P ＜ 0.05).While MDA (1.56±0.41) nmol · mg-1,TNF-α (2.67±0.23) ng · mL-1,IL-6 (2.84±0.34) ng · mL-1,MCP-1 (0.68 ±0.06) ng · mL-1 and IL-10 (0.21 ±0.02) ng · mL-1 in the retinal tissue of the model group were decreased significantly (P ＜ 0.05).Compared with the model group,the levels of SOD (71.05 ± 9.34) U · mg-1,GSH-PX (382.20 ±31.56) U · mg-1 and IL-10 (0.44 ±0.07) ng · mL-1 in the retina tissue of the experimental group were decreased significantly (P ＜ 0.05).while MDA (1.02 ± 0.23) nmol · mg-1,TNF-α (1.53 ± 0.20)ng· mL-1,IL-6 (1.6 ±0.07) ng · mL-1 and MCP-1 (0.41 ±0.07) ng · mL-1 of the experimental group experimental group were decreased significantly (P ＜ 0.05).Conclusion Dexmedetomidine can significantly reduce RIRI,the mechanism may be related to inhibit oxygen free radical-induced lipid peroxidation injury and inhibit the secretion of inflammatory cytokines.

OBJECTIVETo determine the effectiveness and safety of Xinfeng Capsules (XFC) for the treatment of rheumatoid arthritis (RA) patients with decreased pulmonary function.

METHODSThis was a randomized controlled clinical trial of 80 RA patients. Participants were assigned to the trial group (40 cases) and the control group (40 cases) by block randomization. The trial group was treated with XFC, three pills each time three times daily for 2 months. The control group was treated with tripterygium glycoside (TPT), two pills each time three times daily for 2 months. Both groups were followed up after 2 months. The clinical effects, changes in joint and pulmonary function, and quality of life before and after treatment were observed; safety indices were also evaluated.

RESULTSPain, swelling, tenderness, and duration of morning stiffness of joints were obviously decreased after treatment in both the trial and the control groups compared with baseline (P<0.01). Compared with before treatment, hand grip strength increased significantly after treatment in the trial group (P=0.0000); pulmonary function parameters such as forced expiratory volume in the first second of expiration/forced vital capacity (FEV1/FVC), 50% of the expiratory flow of forced vital capacity (FEF50), carbon monoxide diffusing capacity (DLco) were increased (P<0.01 or P<0.05); measures of quality of life such as role-physical, body pain, vitality and mental health were also improved after treatment in the trial group (all P<0.05). Joint swelling in the trial group decreased compared with the control group (P=0.0043), while hand grip strength was increased after treatment (P=0.0000). The increase in FEF50, DLco, and the dimensions of quality of life such as vitality and mental health were all significantly greater in the trial group than the control group (P<0.05 or P<0.01).

CONCLUSIONSXFC not only relieved joint pain in RA patients, but also significantly improved the ventilation and diffusion function of the lungs. Therefore, XFC could improve the whole body function and enhance the quality of life of RA patients.

Adult ; Aged ; Arthritis, Rheumatoid ; blood ; drug therapy ; pathology ; physiopathology ; Blood Sedimentation ; C-Reactive Protein ; Capsules ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Joints ; pathology ; Male ; Middle Aged ; Quality of Life ; Respiratory Function Tests ; Surveys and Questionnaires ; Treatment Outcome

OBJECTIVETo investigate the therapeutic efficacy of double-mutated oncolytic adenovirus AxdAdB-3 in combination with gemcitabine for treating bladder cancer in an orthotopic nude mouse model.

METHODSThe susceptibility to the adenovirus was evaluated in bladder cancer cell lines YTS-1, T24, 5637 and KK47, and normal cell lines HCV29 and WI38. The cells were infected with AxCAlacZ and stained with 5-bromo-4-chloro-3-indolyl-β-galactoside (X-Gal). Immunostaining against adenoviral hexon protein was performed to determine the selective replication of AxdAdB-3 in the cancer cells. Flow cytometry was used to determine the YTS-1 cells in S phase of cell cycle after adenovirus infection. Cell viability after AxdAdB-3 and/or gemcitabine was measured by CCK-8 assay. Orthotopic bladder cancer model was established in nude mice, and the inhibitory efficacy of intravesical instillation therapy with AxdAdB-3 or/and gemcitabine was assessed.

RESULTSGene transduction efficiency was different among the cell lines, and correlated with expression of CAR. 5637 and KK47 cells with high expression of CAR were more susceptible to the adenovirus, whereas YTS-1 and T24 cells with little CAR expression were resistant to adenoviral infection. Immunostaining showed that the expression levels of hexon protein varied among the cell lines. Normal cells infected with AxdAdB-3 expressed little hexon protein. The proportion of S-phase cells was (39 ± 3) % and (49 ± 5) % in the AxCAlacZ- and AxdAdB-3-infected bladder cancer cells, respectively. AxdAdB-3 effectively induced S-phase entry of cell cycle (P < 0.05). AxdAdB-3 combined with gemcitabine significantly inhibited the growth of bladder cancer cell lines. In vivo, the mean weight of the bladder tumors in mice treated with intravesical instillation of AxCAlacZ, gemcitabine, AxdAdB-3, and AxdAdB-3 + gemcitabine were 400.6, 126.4, 82. 0, 40.4 mg, respectively. Either AxdAdB-3 (P < 0.0001) and gemcitabine (P < 0.0001) suppressed the tumor growth in nude mice, and the combination therapy reduced tumors more effectively than either AxdAdB-3 (P < 0.0001) or gemcitabine (P < 0.0001) alone.

CONCLUSIONSIntravesical instillation therapy with AxdAdB-3 in combination with gemcitabine can effectively inhibit the orthotopic bladder cancer in nude mouse, and further relevant clinical studies are guaranteed.

Adenoviridae ; genetics ; Administration, Intravesical ; Animals ; Antimetabolites, Antineoplastic ; administration & dosage ; pharmacology ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; pharmacology ; therapeutic use ; Deoxycytidine ; administration & dosage ; analogs & derivatives ; pharmacology ; therapeutic use ; Galactosides ; Indoles ; Mice ; Mice, Nude ; Models, Animal ; Urinary Bladder Neoplasms ; drug therapy

Animals ; Atherosclerosis ; diet therapy ; physiopathology ; Humans ; Plaque, Atherosclerotic ; drug therapy

Objective To investigate the efficacy of erythropoietin (EPO) on cerebral ischemia of patients after intracranial aneurysm surgery.Methods Sixty patients with cerebral ischemia after operation of intracranial aneurysm,admitted to our hospital from May 2006 to August 2010,were randomly divided into control and treatment groups (n=30).Control group received conventional treatment,while the other group,on the basis of conventional therapy,was hypodermically given EPO at a dosage of 3000 IU for a consecutive 3 days.U.S.National Institutes of Health Stroke Scale (NIHSS) was used to score the patients on the admission day,1,2,3,4 and 5 weeks after EPO treatment; and diffusion-weighted imaging (DWI) of MRI was used in determining the changes of cerebral ischemic area on the ischemic day and l,2,3,4 and 5 weeks after ischemic.Results NIHSS scores of the EPO group (9.4±1.9,11.3±2.3,8.7±1.7) at 3,4 and 5 weeks after treatment were significantly higher as compared with those in the control group (10.8±2.2,7.9±1.6,10.1±2.3) (P＜0.05).Similarly,3,4 and 5 weeks after treatment,the reducing percentage of cerebral ischemia area in the EPO group (21.6±4.1,27.5±5.3,32.8±5.5)％ was larger than that in the control group (16.8±3.1,18.9±3.3,19.5±3.4)％ (P＜0.05).Conclusion EPO may play an effective role in cerebral ischemia of patients after intracranial aneurysm operation.

The different biological functions were studied in mouse bone marrow-derived endothelial progenitor cells isolated by differential time attachment to obtain the optimal adherent time in this study. Density gradient centrifugation-isolated bone marrow mononuclear cells were seeded on the fibronectin-coated dish. The 1-day cultured unattached cells were seeded on the second dish for 2 more days. Then unattached cells in the second dish were seeded on the third dish. The cells on 3 dishes were defined as 1-day adherent cells, 3-day adherent cells and 3-day unattached cells, respectively. After 20-day culture, the biological functions, such as the percentage of biomarkers, the ability of adhesion, and the ability of forming tubes in vitro were analyzed. The results showed that the percentages of positive CD34, FLK-1, and CD34/FLK-1 expressions in 1-day attached cells were significantly increased compared to those in the 3-day adherent or unattached cells (P < 0.01), which showed the strongest adhesion ability. The expression of eNOS in 1- or 3-day adherent cells was significantly higher than that in 3-day unattached cells (P < 0.01). The expression of VEGF in 3-day adherent cells was significantly higher than that in 1-day adherent cells or 3-day unattached cells (P < 0.01). These results suggest the biological functions of 1-day adherent cells are significantly stronger than that of 3-day adherent or unattached cells. VEGF expression in 3-day adherent cells is higher than that in 1-day adherent cells or 3-day unattached cells. The expression of eNOS in 1-day adherent cells or 3-day adherent cells is higher than that in 3-day unattached cells. The optimal adherent time to obtain mouse bone marrow-derived endothelial progenitor cells is 1-3 d.
Animals ; Bone Marrow Cells ; cytology ; Cell Culture Techniques ; methods ; Cell Differentiation ; Cell Separation ; methods ; Cells, Cultured ; Endothelial Cells ; cytology ; metabolism ; Leukocytes, Mononuclear ; cytology ; Male ; Mice ; Mice, Inbred C57BL ; Nitric Oxide Synthase Type III ; metabolism ; Stem Cells ; cytology ; metabolism ; Time Factors ; Vascular Endothelial Growth Factor A ; metabolism

Objective To investigate prognostic factors of medullary thyroid carcinoma.Methods By using univariate analysis and multivariate analysis,the prognostic factors were investigated in 102 patients with medullary thyroid carcinoma treated at this hospital.Results Overall survival rates of 5-year,10-year and 15-year were 87.4%,74.6%and 54.2%respectively by Kaplan-Meier method analysis.In univariate analysis,gender,age,bilateral thyroid lobe tumors,tumor size＞4 cm,invasion of thyroid capsule,distant metastasis,and non-radical tumor resection were significant poor prognostic factors.In multivariate analysis,tumor size＞4 cm(X2=7.43,P=0.0035),distant metastasis(X2=23.50,P=0.0000),and non-radical tumor resection(X2=25.90,P=0.0000)remained as independent pmgnostic factors.Conclusions Tumor size＞4 cm,distant metastasis,and non-radical tumor resection are the independent predictors of patients survival.Early diagnosis and early therapy can improve significantly the prognosis of medullary thyroid carcinoma.