Objective:To investigate the effect of the ratio of the maximum diameter of aneurysm sac to age (R) on the long-term efficacy of endovascular aneurysm repair (EVAR) and open surgical repair (OSR) in patients with infrarenal abdominal aortic aneurysm (IAAA).Methods:This is a retrospective cohort study.The clinical data of 317 patients with IAAA who underwent surgical repair in the Department of Vascular Surgery,the Third Affiliated Hospital of Sun Yat-Sen University from January 2016 to October 2022 were retrospectively collected.There were 266 males and 51 females,aged (69.7±8.3) years (range:37 to 87 years).The R value of the patient was calculated and the receiver operating characteristic(ROC) curve was used to establish a model to calculate the optimal cut-off value.The propensity score matching method was used to match the baseline data of patients in the EVAR and OSR group by 3∶1 (the caliper value was 0.05),and the patients were stratified according to the cutoff value of R, and the postoperative efficacy and survival of the patients were analyzed.The primary endpoint was the total mortality rate,and the secondary endpoints included the occurrence of postoperative complications and reintervention.Pearson χ2 or Fisher ′s exact test was used for categorical variables, and independent sample t test or Wilcoxon rank sum test was used for continuous variables to compare differences between groups.The survival curves of the two groups were described by Kaplan-Meier method. Results:After propensity score matching,198 cases were in the EVAR group and 66 cases were in the OSR group.The ROC model showed that the best cut-off value of R value was 0.90,and the two groups were divided into two layers:R<0.90 and R≥0.90.Among them,112 patients with R<0.90 (84 cases of EVAR,28 cases of OSR);there were 152 patients with R≥0.90 (114 cases of EVAR and 38 cases of OSR).The follow-up time was (23.6±1.6) months (range:1 to 70 months).In the R≥0.90 stratification,the total mortality (26.3% vs.5.3%, χ2=7.600， P=0.006),complication rate (44.7% vs.26.3%, χ2=4.025， P=0.045), and secondary intervention rate (31.6% vs.13.2%, χ2=4.910， P=0.027) in the EVAR group were higher than those in the OSR group.In the R<0.90 stratification,there was no significant difference in the total mortality rate (13.1% vs.10.7%, χ2=0.109， P=0.741), complication rate (28.6% vs.35.7%, χ2=0.507， P=0.477) and secondary intervention rate (14.3% vs.21.4%, χ2=0.353， P=0.552) between the two groups. Conclusions:When R≥0.90 in IAAA patients,OSR maybe more beneficial to patients in terms of survival rate,postoperative complication rate and secondary intervention rate than EVAR.When R<0.90,there are no significant differences in survival rate,complication rate and secondary intervention rate between the two surgical methods.

Objective:To investigate the effect of the ratio of the maximum diameter of aneurysm sac to age (R) on the long-term efficacy of endovascular aneurysm repair (EVAR) and open surgical repair (OSR) in patients with infrarenal abdominal aortic aneurysm (IAAA).Methods:This is a retrospective cohort study.The clinical data of 317 patients with IAAA who underwent surgical repair in the Department of Vascular Surgery,the Third Affiliated Hospital of Sun Yat-Sen University from January 2016 to October 2022 were retrospectively collected.There were 266 males and 51 females,aged (69.7±8.3) years (range:37 to 87 years).The R value of the patient was calculated and the receiver operating characteristic(ROC) curve was used to establish a model to calculate the optimal cut-off value.The propensity score matching method was used to match the baseline data of patients in the EVAR and OSR group by 3∶1 (the caliper value was 0.05),and the patients were stratified according to the cutoff value of R, and the postoperative efficacy and survival of the patients were analyzed.The primary endpoint was the total mortality rate,and the secondary endpoints included the occurrence of postoperative complications and reintervention.Pearson χ2 or Fisher ′s exact test was used for categorical variables, and independent sample t test or Wilcoxon rank sum test was used for continuous variables to compare differences between groups.The survival curves of the two groups were described by Kaplan-Meier method. Results:After propensity score matching,198 cases were in the EVAR group and 66 cases were in the OSR group.The ROC model showed that the best cut-off value of R value was 0.90,and the two groups were divided into two layers:R<0.90 and R≥0.90.Among them,112 patients with R<0.90 (84 cases of EVAR,28 cases of OSR);there were 152 patients with R≥0.90 (114 cases of EVAR and 38 cases of OSR).The follow-up time was (23.6±1.6) months (range:1 to 70 months).In the R≥0.90 stratification,the total mortality (26.3% vs.5.3%, χ2=7.600， P=0.006),complication rate (44.7% vs.26.3%, χ2=4.025， P=0.045), and secondary intervention rate (31.6% vs.13.2%, χ2=4.910， P=0.027) in the EVAR group were higher than those in the OSR group.In the R<0.90 stratification,there was no significant difference in the total mortality rate (13.1% vs.10.7%, χ2=0.109， P=0.741), complication rate (28.6% vs.35.7%, χ2=0.507， P=0.477) and secondary intervention rate (14.3% vs.21.4%, χ2=0.353， P=0.552) between the two groups. Conclusions:When R≥0.90 in IAAA patients,OSR maybe more beneficial to patients in terms of survival rate,postoperative complication rate and secondary intervention rate than EVAR.When R<0.90,there are no significant differences in survival rate,complication rate and secondary intervention rate between the two surgical methods.

Objective To explore the effect and related mechanism of Zuogui Jiangtang Jieyu Prescription on neuroinflammation of nucleus accumbens in rats with diabetes mellitus(DM)complicated with depression based on dopamine receptor.Methods DM,depression and DM complicated with depression models were respectively established through a combination of high-fat feeding and streptozotocin intraperitoneal injection,as well as chronic unpredictable mild stress+solitary cage feeding.The rats were divided into control group,depression group,DM group,DM complicated with depression group,positive group,D1R agonists group,D2/3R agonists group and Zuogui Jiangtang Jieyu Prescription group.Depression and learning and memory abilities in rats were assessed using open field experiments,forced swimming experiments and water maze experiments.Neuronal damage in nucleus accumbens was detected through HE and Nissl staining.Serum contents of 5-hydroxytryptamine(5-HT),dopamine(DA),interleukin(IL)-1β and IL-18 were detected by ELISA.The expressions of D1R,D2R,D3R and Iba1/NLRP3 in nucleus accumbens were detected by immunofluorescence.The protein expressions of D1R,D2R,D3R,NLRP3,ASC,Caspase-1 p20 and IL-1β in nucleus accumbens were detected by Western blot.Results Compared with the control group,the changes of fasting blood glucose(FBG)in rats of DM complicated with depression group significantly increased(P<0.01),the total distance and number of activities in the open field experiment,the time ratio of staying in the original platform quadrant and the number of times crossed the original platform in the water maze experiment significantly decreased(P<0.05,P<0.01),the forced swimming immobility time and the escape latency period in the water maze experiment were prolonged(P<0.05,P<0.01),the contents of serum 5-HT and DA significantly decreased(P<0.01),the contents of IL-1β and IL-18 significantly increased(P<0.05,P<0.01),neurons in the nucleus accumbens showed nuclear condensation,degeneration,and increased necrotic cells,with loss of Nissl bodies,the expressions of D1R,D2R and D3R were significantly decreased(P<0.01),while the expressions of NLRP3,ASC,Caspase-1 p20 and IL-1β protein significantly increased(P<0.05,P<0.01).Compared with the DM complicated with depression group,the changes of FBG significantly decreased in the Zuogui Jiangtang Jieyu Prescription group,learning and memory abilities were enhanced,depression-like behavior was improved,and the damage to neurons in the nucleus accumbens was reduced,the contents of serum 5-HT and DA significantly increased(P<0.01),the contents of IL-1β and IL-18 significantly decreased(P<0.01),the expressions of D1R,D2R and D3R in the nucleus accumbens increased(P<0.05,P<0.01),and the expressions of NLRP3,ASC,Caspase-1 p20 and IL-1β protein decreased(P<0.05,P<0.01).Conclusion The dopaminergic system dysfunction and neuroinflammation are the key mechanisms of DM complicated with depression.Zuogui Jiangtang Jieyu Prescription may improve neuroinflammation by regulating the dopamine receptor to inhibit the activation of microglial NLRP3 signaling in the nucleus accumbens.

Objective:To automatically synthesize Al 18F-fibroblast activation protein inhibitor (FAPI)-74, and explore its value of clinical application. Methods:Al 18F-FAPI-74 was synthesized automatically by the commercial synthesis module CFN-MPS-100, and its yield, radiochemical purity and stability were determined. Sixteen normal Kunming (KM) mice were randomly divided into 4 groups and euthanized at 10, 30, 60 and 90 min after Al 18F-FAPI-74 injection, and the biodistribution was measured. MicroPET/CT dynamic scanning (60 min) was performed in 5 rat pancreatic tumor-bearing BALB/c nude mice to observe the tumor uptake. Al 18F-FAPI-74 PET/CT imaging was performed on 3 volunteers (1 male, 2 females; age: 37, 41, 43 years) to evaluate the clinical application value of Al 18F-FAPI-74. Results:The automated synthesis time of Al 18F-FAPI-74 was about 35 min, with the synthesis yield of (21.34±3.86)% (without attenuation correction, n=5) and the radiochemical purity more than 99%. The radiochemical purity was still more than 96% after placement at 37 ℃ for 6 h. Biodistribution in normal mice and microPET/CT dynamic scanning in tumor-bearing nude mice showed that consistently high uptake in the kidneys and bladder, and the tumor uptake was the highest at 20 min, and the maximum tumor-to-muscle ratio was 3.16±0.01 at 60 min. PET/CT imaging on volunteers showed that there was a small amount of uptake in myocardium, most organs such as the liver and lung had background uptake, and the maximum SUV max of persistent high uptake of tumor was 17.08. Conclusions:Al 18F-FAPI-74 has the advantages of simple synthesis, high yield, stable quality and good imaging performance in mice and volunteers. It is a kind of imaging agent that meets the requirements of clinical diagnosis.

Venous thromboembolism ( VTE) is characteristic of high incidence and fatality rate, forming a severe challenge for medical quality management by hospitals and urgently calling for a long-term management mechanism of VTE prevention and treatment. To tackle this problem, the hospital has built a VTE-oriented clinical decision support system, with optimized information platform for the control. The system features automatic scoring of Caprini evaluation model and suggestion of VTE control measures, green ultrasonography channel for VTE high risk patients, and a refined evaluation system. The establishment of an IT control information system has improved VTE awareness and diagnosis level of clinicians. This system can keep track of the risk of VTE occurrence dynamically, significantly improving the number of diagnosed cases and treatment rate, effectively reducing inpatients′ VTE incidence and mortality, and improving quality of care in the end.

Eukaryota ; Molecular Dynamics Simulation ; Permeability ; Protein Conformation ; Sodium ; metabolism ; Substrate Specificity ; Voltage-Gated Sodium Channels ; chemistry ; metabolism

Objective To examine the hemostatic effect of oxytocin in laparoscopic myomectomy,and to clarify the optimal dosage of oxytocin in laparoscopic myomectomy. Methods From January 2016 to July 2017, ninety patients with myoma of uterus who underwent laparoscopic myomectomy in Tangshan Union Medical College Hospital were divided into two groups: group A and group B,45 cases in each group. In group A,the patients were given 20U oxytocin and 5％ glucose injection 250 ml via intravenous drip, and in group B, the patients were injected with 20U oxytocin on the muscular wall of uterus myoma during operation. The preoperative, postoperative basic situation, intraoperative blood loss, operation time, intraoperative and postoperative adverse reactions and the time of hospitalization were compared between the two groups. Results The average amount of blood loss during operation in group B was (76. 5±15. 8) ml,significantly lower than that in group A((99. 8±20. 7) ml),and the operation time in group B was (71. 2±10. 7) min,shorter than that in group A ((90. 1±18. 4) min) The difference was statistically significant (t=1. 788、2. 878,P<0. 05). At 5 minutes,30 minutes and 180 minutes after medication, the systolic blood pressure of patients in group A was (132. 2±1. 4) mmHg,(120. 7±5. 3) mmHg,(110. 9±1. 8) mmHg and the diastolic blood pressure was (80. 9 ±12. 5) mmHg,(71. 4±12. 6)mmHg,(70. 1±2. 8) mmHg,while the systolic blood pressure in the group B was (140. 4±11. 1) mmHg,(131. 2±4. 5) mmHg,(121. 4±11. 2) mmHg and the diastolic blood pressure was (93. 4±8. 1) mmHg,(86. 4±7. 1) mmHg,(81. 1±1. 5) mmHg,the differences were statistically significant (systolic blood pressure:Ftime=68. 57,P<0. 001;FgrouP=16. 54,P<0. 001;Finteraction=4. 34,P=0. 011;diastolic blood pressure:Ftime=45. 16,P<0. 001;FgrouP=10. 79,P=0. 024;F interaction=4. 16,P=0. 037);at the same treatment time,the systolic blood pressure and diastolic blood pressure in group B were higher than those in group A,the differences were statistically significant (P<0.05).Conclusion Laparoscopic uterine myomectomy with oxytocin hemostasis, intrauterine myoma wall injection method can significantly reduce intraoperative blood loss and shorten the operation time,the effect is obviously better than intravenous drip,and it is conducive to the operation.

Objective To investigate the hemostatic effect of different administration Methods of hemabate in laparoscopic myomectomy, and to clarify the best mode of hemabate in laparoscopic myomectomy.Methods Ninety patients were randomly divided into two groups,group A and group B,45 patients in each group,group A was given intramuscular injection of hemabate 0.25 mg 30 minutes before operation,and in group B,the patients were injected with hemabate 0.25 mg at the muscular wall of uterine leiomyoma during operation.The preoperative,postoperative basic situation,intraoperative blood loss,operation time,intraoperative and postoperative adverse reactions and length of hospital stay were compared between the two groups.Results The average amount of blood loss during operation in the group B was(67.6±17.6)ml, significantly less than that in the group A((88.7±21.6)ml),the operation time in the group B was(68.1 ±18.1)min,shorter than that in the group A(83.1 ± 17.5)min(t=1.877,2.787,P<0.05).The systolic blood pressure of patients in the group A after 15,30,45 and 180 minutes of medication were(155.6±10.31) mmHg,(141.2±5.7)mmHg,(138.6±10.3)mmHg,(127.5±7.4)mmHg,respectively and the diastolic blood pressure were(90.5±8.8)mmHg,(85.5±8.0)mmHg,(80.6±6.3)mmHg,(72.2±7.1)mmHg,while the systolic blood pressure were(141.1±8.3)mmHg,(120.5±6.1)mmHg,(125.7±4.6)mmHg,(118.8±5.5) mmHg and diastolic blood pressure were(81.2 ± 11.4)mmHg,(70.4 ± 10.1)mmHg,(71.5 ± 5.8)mmHg, (66.5±1.2)mmHg in the group B,the differences were statistically significant(systolic blood pressure,Ftime=79.75,P<0.001;FgrouP=25.45,P<0.001; Finteraction=5.48,P=0.041; diastolic blood pressure,Ftime=46.61,P<0.001;FgrouP=11.97,P=0.021,Finteraction=4.05,P=0.034).Conclusion The application of hemabate for hemostasis in laparoscopic myomectomy surgery and uterine fibroids at the muscle wall injection medication can significantly reduce the amount of blood loss during operation,shorten the operation time,and at the same time,the effect on blood pressure was lower than that by preoperative hemabate,is beneficial to the development of operation,with obvious advantages.

Objective To detect the expression of kisspeptin-1 (KISS-1),matrix metallopmteinase-2 (MMP-2) and vascular endothelial growth factor (VEGF) in the tissue of colon cancer,and analyze the relativity between KISS-1,MMP-2,VEGF and pathological characteristics of colon cancer.Methods A total of 60 colon cancer patients and 60 patients with benign colorectal disease who received surgical treatment in our hospital from January 2009 to June 2010 were selected as observation group and control group respectively.The cancer tissue samples and excision samples collected from them were used to detect KISS-1,MMP-2 and VEGF with immunohistochemistry.Results The positive rates of KISS-l,MMP-2 and VEGF were 31.7％,58.3％ and 78.3％ in observation group,and 73.3％,16.7％ and 33.3％ in control group.The positive rate of KISS-1 in observation group was lower than that in control group (x2=23.489,P＜0.001),and the positive rates of MMP-2 and VEGF in observation group were higher than those in control group (x2=27.469,P＜ 0.001;x2=25.817,P＜0.001).The expressions of KISS-1,MMP-2 and VEGF were significantly related with the histological grade and TNM stage of colon cancer (x2=8.997,P=0.011;x2=6.163,P=0.013;x2=8.519,P=0.014;x2=9.160,P=0.002;x2=16.577,P＜0.001;x2=10.523,P=0.001).Conclusion It is helpful to understand the differentiation and clinical stage of colon cancer and provide evidence for clinical diagnosis and prognosis prediction by detecting KISS-1,MMP-2 and VEGE

Objective To investigate the expression of excision repair cross-complementation group 1 (ERCC1) and ribonucleotide reductase subunit M1 (RRM1) in patients with esophageal squamous cell carcinoma,and the relationship between the expression of ERCC1 and RRM1 genes and chemotherapy sensitivity.Methods A total of 77 patients with esophageal squamous cell carcinoma admitted in hospital from Jan.2008 to Dec.2012 were recruited.ERCC1 and RRM1 mRNA levels in the cancerous tissue were detected by real-time fluorescent quantitative RT PCR.The relationship between short-term effects of chemotherapy and ERCC1 and RRM1 mRNA levels was analyzed.Results Levels of mRNA in stages Ⅰ a,Ⅰ b,Ⅱ a,and Ⅱ b were (0.578±0.081),(0.560±0.084),(0.521±0.080),(0.464±0.091) for ERCC1 and(0.511±0.089),(0.539± 0.086),(0.584±0.092),(0.637±0.101)for RRM1,respectively.As the clinical stage advanced,the ERCC1 mRNA level declined and the RRM1 mRNA level increased (t=2.679 and 2.952,P =0.034 and 0.025,respectively).Levels of mRNA in patients with complete remission,partial remission,stable disease and progressive disease were (0.487 ± 0.097,0.511 ± 0.095,0.552 ± 0.086,0.568 ± 0.088) for ERCC1 and(0.504±0.091,0.544±0.095,0.595±0.093,0.616±0.097) for RRM1,respectively.The clinical effect of chemotherapy was negatively correlated with mRNA expression of ERCC1 and RRM1 (r=0.567,P=0.032).Conclusions Levels of ERCC1 and RRM1 mRNA expression are correlated with the staging of esophageal squamous cell carcinoma and chemotherapy sensitivity,and can be used as a predictive parameter for chemotherapy sensitivity in patients with esophageal squamous cell carcinoma.