Objective:To evaluate the clinical efficacy and safety of neuro-endoscopic evacuation and microsurgery via keyhole approach in early spontaneous supertentorial intracerebral hemorrhage (ICH). Methods:A prospective multi-center randomized controlled trial was performed; 114 patients with spontaneous supertentorial ICH (time from onset to surgery<6 h) admitted to Departments of Neurosurgery, Shunde Hospital of Southern Medical University, Jiangmen Central Hospital, Affiliated Hospital of School of Medicine of Yanbian University from January 2019 to December 2021 and met the surgical indications were selected. They were divided into endoscopic group (evacuation of intracerebral hematoma under neuroendoscope, n=71) and microscopic group (microsurgery of intracerebral hematoma via keyhole approach, n=43) according to different surgical methods. After 1:1 propensity score matching of the general data, surgical time, hematoma clearance rate, early postoperative re-bleeding rate, Glasgow coma scale (GCS) scores 7 d after surgery, activity of daily living (ADL) scores 6 months after surgery, mortality, and surgery-related complications of 66 patients (33 from each group after matching) were compared. Results:The difference of surgical time between endoscopic group and microscopic group was statistically significant (125[102, 157] mins vs. 175[125, 260] mins, P<0.05). However, hematoma clearance rate (93.00%[80.88%, 96.52%] vs. 93.31%[88.15%, 96.03%]), early postoperative re-bleeding rate (15.2% vs. 9.1%), GCS scores 7 d after surgery (13[10, 15] vs. 12[8, 14]), ADL scores 6 months after surgery (65[45, 85] vs. 55[0, 85]), mortality rate (18.2% vs. 21.2%) and incidences of postoperative intracranial infection and acquired pulmonary infection were not statistically significant between the two groups ( P>0.05). Conclusion:Comparing with microsurgery via keyhole approach, neuro-endoscopy could shorten the surgical time, but not improve the prognosis or safety in early spontaneous supertentorial ICH patients.

Objective:To investigate the occurrence of inadequate specimens of thyroid nodule fine needle non-aspiration cytology and its possible influencing factors.Methods:Clinical data of 1571 patients with FNAC of 1638 thyroid nodules were analyzed retrospectively, according to whether the FNAC specimen were adequate or not, all cases were divided into adequate group and inadequate group. The related influencing factors on inadequate specimen were analyzed by univariate analysis and multivariate logistic regression.Results:Inadequate specimens occurred in 301 of 1638 (18.4%) nodules. Logistic regression analysis showed that the influencing factors of overall specimen adequacy included operator experience ( P=0.00) , nodules size≤0.5 cm ( P=0.00) , eggshell calcification ( P=0.00) , and cystic ( P=0.00) . Excluding the impact of operator experience, the influencing factors of specimen adequacy included nodules size≤0.5 cm ( P=0.00) , eggshell calcification ( P=0.00) , and cystic ( P=0.00) . Conclusions:Operator experience, nodules size≤0.5 cm, cystic, together with eggshell calcification are influencing factors of specimen adequacy of fine needle non-aspiration cytology in thyroid nodules. For experienced operators, what restrict specimen adequacy is the limitation of FNAC technique. For inexperienced operators, what restrict specimen adequacy is operator’s experience.

Objective:To investigate the effect of epidermal growth factor receptor tyrosine kinase inhibitor on the radiosensitivity of human non-small cell lung cancer cells and its possible mechanism.Methods:Human non-small cell lung cancer cells H1299 were cultured in vitro. CCK-8 was used to detect the toxic effects of erlotinib on H1299 cells, IC 50 and IC 20 were calculated, and IC 20 was utilized as the drug concentration for subsequent experiments. The colony formation assay was performed to identifiy the effect of X-ray combined with erlotinib on H1299 cells, the radiosensitivity parameters were calculated, and the cell survival curves were delineated. Flow cytometry was conducted to detect the cell cycle distribution and apoptosis. Western blot analysis was used to detect the expression of EGFR/PI3K/AKT pathway and apoptosis-related proteins. Results:Erlotinib exerted inhibitory effect upon the proliferation of H1299 cells, IC 50 was calculated as 27.3 μmol/L, and 3.3 μmol/L for IC 20. X-ray combined with IC 20 concentration of erlotinib could reduce the cloning ability of H1299, increased the proportion of G 0/G 1 phase and G 2/M phase, decreased the proportion of S phase, aggravated cell apoptosis, down-regulated the expression of pEGFR and pAKT proteins, and up-regulated the expression of apoptosis-related proteins including Active Caspase 3 and Cleaved PARP. Conclusions:Erlotinib exerts a radiosensitizing effect on H1299. The possible mechanism is that erlotinib combined with radiation can suppress the EGFR/PI3K/AKT pathway, reduce the ability of repairing cell damage, change cell growth cycle and induce cell apoptosis.

For effective resistance to virus attack and infection, reducing virus transmission chance, it is extremely important for the medical staff and related workers to have their own safe protection. This paper summarizes the development causes, common locations, and prevention ways about the device related pressure injuries on the face resulted from wearing medical-grade protective equipment for a long working time. The paper proposes the nursing strategy for device related pressure injuries and other nursing strategy is proposed to take care efficiently the device related pressure injuries. Meantime, a corresponding nursing strategy is also suggested to deal with the correlative skin diseases during the application of medical-grade protective equipment. These paper aims to provide reference for the prevention of device related pressure injuries and the care of skin-related diseases for clinical working staff, especially to the respectable personnel in front line of fighting against Corona virus disease 2019.

For effective resistance to virus attack and infection and reducing virus transmission chance, it is extremely important for the medical staff and related workers to have their own safe protection. The paper summarizes the occurrence causes, common locations, and prevention ways about the device related pressure ulcers on the face resulted from wearing medical-grade protective equipment for a long working time. The paper proposes the prevention and nursing strategies for device related pressure ulcers and other related skin injuries during application of medical-grade protective equipment. The paper aims to provide reference for the prevention and nursing of device related pressure ulcers and related skin diseases for clinical medical staff, especially to the respectable personnel in front line of fighting against coronavirus disease 2019.

Objective To evaluate the clinical efficacy and safety of simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) to the tumor center in the treatment of bulky cervical cancer with massive bleeding in the first course radiotherapy.Methods Twenty-one cases with bulky cervical cancer complicated with massive vaginal bleeding were enrolled.At the first three times of external irradiation,a high dose radiotherapy (15 Gy/3 fractions) was delivered to the tumor center (the region retracted 2 cm from the periphery of cervical mass),followed by conventional irradiation (2 Gy/fraction) in the posterior course.Conventional dose irradiation (46 Gy/23 fractions) was given to the tumor periphery and pelvic lymphatic drainage area throughout the whole course.Concurrent chemotherapy by cisplatin at a dose of 25 mg/m2 was delivered weekly.After the external irradiation,intracavitary radiotherapy was given (20 Gy/4 fractions).Results Within 24 h after the first course radiotherapy,the volume of vaginal bleeding was significantly decreased by 50％ and the bleeding was almost stopped within one week.The hemostasis rate was 100％.Conclusions SIB-IMRT into the center of bulky cervical cancer is an efficacious treatment of massive vaginal bleeding.

Objective To discuss the sensitization effect of celecoxib in the radiotherapy and chemotherapy of patients with esophageal cancer,and its clinical application value.Methods According to the digital table,60 patients with esophageal cancer were randomly divided into observation group and control group,30 cases in ecah group.The control group was given conventional radiation and chemotherapy,the observation group received combination with celecoxib for radiotherapy sensitization.The clinical effect was compared between the two groups.Results The total effective rate of the observation group was 46.67％ (14/30),which was higher than 20.00％ (6/30) of the control group,the difference between the two groups was statistically significant (x2 =4.343,P ＜ 0.05).In the observation group,radioactive pneumonia occurred in 1 case,radioactive esophagitis in 2 cases,radioactive myocarditis in 1 case.In the control group,radioactive pneumonia occurred in 2 cases,radioactive esophagitis in 1 case,radioactive myocarditis in 2 cases,the differences between the two groups were statistically significant (x2 =0.350,0.350,0.350,all P ＞0.05).In the observation group,7 cases occurred nausea and vomiting,diarrhea in 1 case,bone marrow suppression in 5 cases,renal toxicity in 2 cases.In the control group,8 cases had nausea and vomiting,diarrhea happened in 2 cases,bone marrow suppression in 3 cases,renal toxicity in 1 case,there were no statistically significant differences between the two groups (x2 =0.088,0.350,0.576,0.350,all P ＞ 0.05).Conclusion Application of celecoxib in patients with esophageal cancer during the process of radiation and chemotherapy has sensitization effect,it can promote the esophageal cancer treatment effect,without increase in adverse reactions,it is worthy of popularization and application in clinic.

PURPOSE: Endothelial progenitor cells (EPCs) play a key role in tissue repair and regeneration. Previous studies have shown that infusion of human umbilical cord blood-derived endothelial colony-forming cells improves outcomes in mice subjected to experimental traumatic brain injury (TBI). However, the efficiency of cell transplantation is not satisfactory. Oxidative stress plays a significant role in the survival of transplanted cells following ischemic reperfusion injury. This observational clinical study investigated the correlation between the number of circulating EPCs and plasma levels of superoxide dismutase (SOD) and malonyldialdehyde (MDA). MATERIALS AND METHODS: Peripheral blood samples were collected from 20 patients with mild TBI at day-1, day-2, day-3, day-4, and day-7 post TBI. The number of circulating EPCs and the plasma levels of SOD and MDA were measured. RESULTS: The average of circulating EPCs in TBI patients decreased initially, but increased thereafter, compared with healthy controls. Plasma levels of SOD in TBI patients were significantly lower than those in healthy controls at day-4 post-TBI. MDA levels showed no difference between the two groups. Furthermore, when assessed on day-7 post-TBI, the circulating EPC number were correlated with the plasma levels of SOD and MDA. CONCLUSION: These results suggest that the number of circulating EPCs is weakly to moderately correlated with plasma levels of SOD and MDA at day-7 post-TBI, which may offer a novel antioxidant strategy for EPCs transplantation after TBI.
Animals ; Brain Injuries* ; Cell Transplantation ; Clinical Study ; Endothelial Progenitor Cells* ; Humans ; Malondialdehyde ; Mice ; Oxidative Stress* ; Plasma ; Regeneration ; Reperfusion Injury ; Superoxide Dismutase ; Transplants ; Umbilical Cord

Objective:To study the relationship between IL-1β and TNFα expression and cell apoptosis in gingival tissue of the subjects with diabetes associated periodontitis(DAP).Methods:20 cases of DAP(group DAP) and 20 cases of health controls(group H)were included.The cell apoptosis and the ultrastructural changes in gingival tissue were observed by Tunnel staining and transmission electron microscope (TEM).IL-1β and TNFα expression in gingival tissue were detected by immunohistochemical staining.SBI,GI,PD and AL of the subjects were measured.The relationship between the level of IL-1β,TNFα and the cell appotosis was analyzed.Results:Apoptosis was obvious in prickle cells and basal cells of gingival tissue of DAP group.The percentage of apoptosis cells of DAP group was significantly higher than that of group H(P＜0.01).The expression of IL-1β and TNFα in group DAP was significant higher than that of group H (P＜0.01),and the mainly positive expression cells were macrophages,plasmocytes and lymphocytes.Conclusion:IL-1β and TNFα play a role in cell apoptosis in the gingival tissue of the patients with DAP.

Objective To find frontal lobe-amygdala functional connections in different age paragraph female patients with bipolar disorder. Methods The FMRI date were acquired from 30 patients with bipolar disorder aged 13 to 25 years old and 30 age-and education level-and gender-matched health controls.FMRI was also conducted on 30 patients with bipolar disorder aged 26 to 45 years old and 30 age-and education level-and gender-matched health controls.The date was calculated by using MATLAB based DPARSF software. Results Compared with corresponding health controls, the lobe-amygdala functional connections significantly decreased in patients aged 13 to 25 years but remained unchanged in patients aged 26 to 45 years old. Conclusions The decrease in the frontal lobe-amygdala functional connections decreased in female patients aged 13 to 25 years old may be related to the underdevelopment in vulnerable immature brain.In contrast, the frontal lobe-amygdala functional connections in female patients aged 26 to 45 years old remain intact.