[Objective]To explore how hyperthyroidism induces ventricular remodeling via activating β-catenin/FoxO1 in rat cardiomyocytes.[Methods]Hyperthyroidism-induced ventricular remodeling rat models were established by intraperitoneal injection of levothyroxine(T4)at 0.1 mg/kg for 30 days.β-catenin inhibitor MSAB(14 mg/kg)was admin-istrated for 30 days.We used western blot to detect the expression of myocardial hypertrophy marker ANP,β-catenin and FoxO1;immunofluorescence to examine the expression and intracellular distribution of β-catenin and FoxO1.Hyperthy-roidism-induced cardiomyocyte hypertrophy rat models were established by treatment of triiodothyronine(T3)into cul-tured primary neonatal rat cardiomyocytes for 24 hours.β-catenin siRNA(30 nmol/L)was used to down-regulate β-catenin expression in cardiomyocytes.Western blot and immunofluorescence were used to analyze the effects of β-catenin inhibition on the hyperthyroidism-induced cardiomyocyte hypertrophy.[Results]Following Wnt/β-catenin activation,β-catenin was found increased nuclear expression,to bind to the nuclear transcriptional factors and regulate the gene ex-pression.β-catenin nuclear expression was significantly increased in the hyperthyroidism-induced ventricular remodeling rats,but no change was found in the expression of typical transcriptional factor TCF7l2.Our results revealed that inhibiting β-catenin by MSAB attenuated the hyperthyroidism-induced rat ventricular remodeling.Further analysis indicated that β-catenin/FoxO1 expression was significantly increased in hyperthyroidism-induced myocardial hypertrophy which could be attenuated by suppressing β-catenin/FoxO1 in cardiomyocytes.[Conclusions]β-catenin/FoxO1 is activated in hyperthy-roidism-induced myocardial hypertrophy and β-catenin/FoxO1 inhibition attenuates hyperthyroidism-induced cardiomyo-cyte hypertrophy.

Objective    To investigate the clinical effect of thoracoscopic lobectomy versus segmentectomy in the treatment of T1bN0M0 non-small cell lung cancer (NSCLC). Methods    Clinical data of 181 patients with T1bN0M0 NSCLC admitted to our hospital from 2012 to 2015 were retrospectively analyzed. They were divided into a lobectomy group and a segmentectomy group according to surgical methods. There were 117 patients in the lobectomy group (46 males and 71 females aged 61.32±8.94 years) and 64 patients in the segmentectomy group (20 males and 44 females aged 58.55±12.57 years). Perioperative indicators and prognosis were compared between the two groups. Results    The segmentectomy group had longer operation time, less intraoperative blood loss, shorter postoperative hospital stay and more preservation of lung function compared with the lobectomy group (P<0.05). The lobectomy group had higher consolidation tumor ratio, bigger tumor diameter, and more lymph node sampling compared with the segmentectomy group (P<0.05). There was no statistical difference in 5-year overall survival or recurrence-free survival between the two groups (P<0.05). Conclusion    For patients with T1bN0M0 NSCLC, thoracoscopic segmentectomy and lobectomy have similar prognosis, but segmentectomy has advantages with less injury and faster recovery over lobectomy.

Objective:To explore the effect of nursing intervention based on leadership life cycle theory in patients with swallowing dysfunction after acoustic neuroma surgery.Methods:From February 2017 to March 2020, 100 patients with swallowing dysfunction after acoustic neuroma surgery in our hospital were selected as the research object. According to a random number table, a randomized controlled study was used to divide all patients into an observation group and a control group, 50 cases in each group. Patients in the control group received routine postoperative rehabilitation nursing, and the observation group adopted nursing intervention based on the leadership life cycle theory. After the intervention, the Water swallow test was used to evaluate the recovery of swallowing dysfunction in the two groups. A swallowing dysfunction rehabilitation training compliance questionnaire was used to evaluate rehabilitation compliance. The Swallowing Quality of Life scale (SWAL-QOL) was used to evaluate the quality of life of patients. At the same time the occurrence of aspiration pneumonia was recorded.Results:After the intervention, the result of drinking water test rating was better in the observation group compared the control group, the difference was statistically significant ( Uc=2.053, P <0.05). The participation in compliance, monitoring compliance and learning compliance scores were 16.94±2.46, 6.96±1.24, 5.66±2.11 in the observation group, significantly higher than in the control group (12.36±2.59, 4.80±1.20, 4.48±1.49), the difference was statistically significant ( t value was 9.058, 8.851, 3.236, P <0.05). After a one-month follow-up, the scores of psychological burden, eating time, appetite, swallowing symptom frequency, food choice, language communication, eating fear, mental health, social interaction, fatigue sleep were 8.06±1.39, 7.14±1.76, 10.92±1.79, 58.26±6.41, 6.38±1.81, 7.00±1.07, 15.82±2.41, 21.86±1.81, 16.80±1.81, 18.96±3.24, significantly higher than those of the control gorup (6.76±2.17, 4.80±1.83, 7.84±1.74, 37.30±5.07, 3.72±1.23, 4.98±1.33,12.06±2.97, 16.96±1.67, 11.00±1.76, 1.84±3.05), the differences were statistically significant ( t value was 6.945-18.142, P <0.05). The incidence of aspiration pneumonia in the observation group were 6.00% (3/50), lower than that in the control group 20.00% (10/50), the difference was statistically significant ( χ2 value was 4.332, P<0.05). Conclusions:Nursing intervention based on the leadership life cycle theory is beneficial to promote the recovery of swallowing dysfunction in patients with swallowing dysfunction after acoustic neuroma surgery, improve the compliance of rehabilitation training, improve the quality of life of patients, and reduce the occurrence of aspiration pneumonia.

Objective: To evaluate the diagnostic value and feasibility of narrow-band imaging in detection of recurrent nasopharyngeal carcinoma (NPC). Methods: One thousand three hundred and sixty-four NPC patients who had completed NPC treatment were enrolled. All patients were followed-up with imaging, serological examination of EB virus and nasopharyngeal endoscopy(WL and NBI mode), in which (1) both white light (WL) and NBI modes were done; (2) positive endoscopic patients were given nasopharyngeal biopsy; (3) using histologic finding as criterion standard, the sensitivity, specificity, accuracy and Yonden′s index of two modes were compared. Kappa index was used to evaluate the consistency between the two modes and pathological results respectively; (4) the positive rates of WL and NBI in patients with early recurrent (stage Ⅰ+ Ⅱ) were compared. Results: A total of 265 cases were suspected as having recurrent lesions by endoscopy in WL mode and 68 cases of them were pathologically diagnosed as having NPC; and 82 cases were suspected as having recurrent lesions by endoscopy in NBI mode and 74 cases of them were pathologically diagnosed as having NPC. The sensitivity, specificity, accuracy and Yonden′s index of WL mode were 91.89%, 0, 25.09% and -0.0811, respectively, with a kappa of -0.045; the sensitivity, specificity, accuracy and Yonden′s index of NBI mode were 100.00%, 95.94%, 97.05% and 0.9594, respectively. Conclusion NBI has higher sensitivity, specificity, early diagnosis rate and Yonden′s index than WL.

Objective: To explore the psychological distress status of HIV-infected pregnant women and analyze the possible influencing factors. Methods: A total of 483 HIV-infected pregnant women were enrolled for this study by a cluster random sampling method from Sept. 2014 to Apr. 2017. Participants completed questionnaires including Distress Thermometer (DT), Berger HIV Stigma Scale (BHSS), HIV/AIDS Stress Scale (SS-HIV), Social Support Rating Scale (SSRS) and general questionnaire. Results: The detection rate of psychological distress was 68.1%, the detection rates of moderate, severe and extreme psychological pain were 49.7%, 17.6% and 0.8% respectively. The detection rate of continuing pregnancy (75.2%) was higher than the termination pregnancy (56.4%), the difference was statistically significant (χ²=18.44, P<0.01). There were significant differences in the detection rates between continuing pregnancies at different gestational ages (χ²=15.41, P<0.01), and the termination pregnancy varies little with pregnancy (χ²=0.03, P>0.05). The mean DT score was 4.85 ± 1.82. The score of continuing pregnancy (5.94 ± 1.73) was higher than the termination pregnancy (4.20 ±1.96), the difference was statistically significant (t=4.57, P<0.01). Logistic regression analysis showed that CD₄⁺ T lymphocyte count, infection route, perceived discrimination, related stress and social support were the common influencing factors of all pregnant women, factors affecting continuing pregnancy also include high risk pregnancy and gestational age. Conclusions HIV-infected pregnant women have higher incidence of psychological distress. The influencing factors are mainly related to the infection characteristics, pregnancy characteristics, BHSS, SS-HIV and SSRS, and has nothing to do with the general social demographic characteristics. The DT can be used as a screening tool to quickly identify psychological distress of the group.

OBJECTIVETo investigate the method of surgical treatment via trans-nasal endoscopic approach in osteoradionecrosis of skull base after radiotherapy for nasopharyngeal carcinoma.

METHODSFifteen patients with osteoradionecrosis of skull base after radiotherapy for nasopharyngeal carcinoma who underwent operation via trans-nasal endoscopic approach from 2008 to 2013 were retrospectively reviewed. The typical clinical manifestations included headache (NRS 6-9: 11 cases), foul odor (10 cases), epistaxis (4 cases), hearing loss (5 cases, 7 ears), tinnitus (4 cases, 5 ears). All patients underwent operation via trans-nasal endoscopic approach. During the operation, the diseased region was fully exposed, the necrotic tissue was resected, the necrotic bone was removed by high-speed electric drill, and the drainage was made unobstructed. The perioperative treatment and follow-up were carried out.

RESULTSAfter operation, all patients were diagnosed pathologically as osteoradionecrosis and mucosal chroinic inflammation, 1 case combined with fungal sphenoid sinusitis. Headache (9 cases) and foul odor (9 cases) resolved after operation. The follow-up was lasted 18-82 months, 13 cases were survival, 1 case lost to follow-up, 1 case died of cerebral hemorrhage.

CONCLUSIONSurgical treatment via trans-nasal endoscopic approach is safe and effective in osteoradionecrosis of skull base after radiotherapy for nasopharyngeal carcinoma, and is helping to improve the survival rate and survival quality.

Carcinoma ; Endoscopy ; Humans ; Nasopharyngeal Neoplasms ; radiotherapy ; Osteoradionecrosis ; surgery ; Retrospective Studies ; Skull Base ; surgery ; Survival Rate

Aim To study the effect of activating Sonic hedgehog( Shh) pathway on the function of endothelial progenitor cells ( EPCs ) in type 1 diabetic mice. Methods EPCs were isolated and cultured by density gradient method from diabetic mice. The effects of Shh N-terminal peptide and agonist SAG on EPCs prolifera-tion were evaluated by using the MTT colorimetric as-say. EPCs migration was measured by Transwell meth-od. EPCs tube formation ability was estimated by Matrigel . EPCs senescence activity was determined by β-galactosidase staining. Results Compared with control mice, the function of EPCs in type 1 diabetic mice was impaired. The proliferation, migration and tube formation of diabetic EPCs could be promoted by Shh peptide and agonist SAG. The senescence of dia-betic EPCs could be decreased by Shh peptide and ag-onist SAG. Conclusion Activating Shh signaling pathway can improve the impared function of diabetic EPCs in type 1 diabetic mice.

Objective To investigate the use of NBI (narrow band imaging) in early the diagnosis of nasopharyngeal carcinoma.Methods A total of 55 cases with nasopharyngeal lesions (including 9 cases of nasopharyngeal carcinoma after treatment) were examined and diagnosed by white and NBI endoscopy between October 2011 and March 2012,and their diagnosis efficacies were evaluated based on pathological diagnosis as a gold standard.Chi-square test was used to analyze data.Results Of 55 cases,12 cases were pathologically diagnosed as chronic mucosa inflammation and 43 as nasopharyngeal carcinoma including 6 recurrent cases,of 43 cases,40(93.0％) were diagnosed by NBI endoscopy and 18 (41.9％) by white endoscopy.Of 12 cases with early nasopharyngeal carcinoma (5 for stage Ⅰ and 7 for stage Ⅱ),5(100.0％) for stage Ⅰ,and 6 (85.7％) for stage Ⅱ were diagnosed by NBI endoscopy but only 1(14.3％) for stage Ⅱ by white endoscopy,with a statistically significant difference (x2 =10.000,P =0.008 ;x2 =7.143,P =0.029).Conclusion NBI endoscopy can be used in early diagnosis of nasopharyngeal carcinoma and check after treatment.

To investigate the effects of particle size, mPEG molecular weight, coating density and zeta potential of monomethoxyl poly(ethylene glycol)-poly(lactic-co-glycolic acid) (mPEG-PLGA) nanoparticles on their transportation across the rat nasal mucosa, mPEG-PLGA-NPs with different mPEG molecular weights (M(r) 1 000, 2 000) and coating density (0, 5%, 10%, 15%) and chitosan coated PLGA-NP, which loaded coumarin-6 as fluorescent marker, were prepared with the nanoprecipitation method and emulsion-solvent evaporation method, and determine their particle size, zeta potential, the efficiency of fluorescent labeling, in vitro leakage rate and the stability with the lysozyme were determined. The effects of physical and chemical properties on the transmucosal transport of the fluorescent nanoparticles were investigated by confocal laser scanning microscopy (CLSM). The result showed that the size of nanoparticles prepared with nanoprecipitation method varied between 120 and 200 nm; the size of nanoparticles prepared with emulsion-solvent evaporation method varied between 420 and 450 nm. Nanoparticles dispersed uniformly; the zeta potential of PLGA-NPs was negative; mPEG-PLGA-NPs was close to neutral; chitosan coated PLGA-NPs was positive; and the efficiency of fluorescent labeling were higher than 80%. In vitro leak was less than 5% within 4 h and nanoparticles were basically stable with lysozyme. The CLSM results show that the transportation efficiency of mPEG-PLGA-NPs with a high PEG coating density and high mPEG molecular weight was significantly higher than that of uncoated PLGA nanoparticles and also that of chitosan coated PLGA-NPs (P < 0.05). The hydrophilcity, zeta potential and particle size of nanoparticles play important roles on the efficiency of mPEG-PLGA nanoparticles to transport across the rat nasal mucosa.