Objective To observe the therapeutic effect and safety of inguinal intranodal lymphangiography in patients with abdominal and pelvic cavity traumatic lymphatic leakages.Methods Data of 12 patients with abdominal and pelvic cavity traumatic lymphatic leakages after ineffective conservative treatment and underwent inguinal intranodal lymphangiography were retrospectively analyzed.The clinical manifestations,therapeutic effects and complications were recorded.Results Totally 21 times of inguinal intranodal lymphangiography were performed in 12 patients,including 5 cases received 1 time,6 cases received 2 times and 1 case received 4 times,and the technical success rate of inguinal intranodal lymphangiography was 100%.After inguinal intranodal lymphangiography,7 cases(7/12,58.33%)were cured while 5 cases(5/12,41.67%)were not cured.The incidence of complications of inguinal intranodal lymphangiography was 14.29%(3/21),including chronic diarrhea after 2 times and puncture point pain in 1 case.No serious complication occurred.Conclusion Inguinal intranodal lymphangiography had certain therapeutic effect and high safety for abdominal and pelvic cavity traumatic lymphatic leakages.

Objective To explore the risk factors of anal fistula after incision and drainage surgery for perianal abscess,and establish an individualized predictive nomogram model.Methods A retrospective analysis was conducted on the clinical data of 224 patients with perianal abscess who underwent incision and drainage surgery in Affiliated Hospital of Shanxi University of Chinese Medicine from May 2020 to January 2023,according to whether anal fistula occurred within 3 months after surgery,there were 169 cases in the non anal fistula group and 55 cases in the anal fistula group.Single factor method and multivariate Logistic regression analysis were applied to analyze the influencing factors of anal fistula after incision and drainage of perianal abscess,a nomogram risk model was constructed using independent risk factors to predict the occurrence of anal fistula after incision and drainage of perianal abscess,and the consistency and differentiation of the model were verified.Results The proportions of male,diabetes,deep abscesses,intestinal origin of pathogenic bacteria,and abscesses in anal fistula group were higher than those in non anal fistula group(P＜0.05).Male,diabetes,deep abscess,intestinal origin of pathogenic bacteria,and history of abscess were independent risk factors for anal fistula after incision and drainage of perianal abscess(P＜0.05).The ideal curve of the nomogram model fitted well with the correction curve,indicated that the measured values were basically consistent with the predicted values.The area under the receiver operating characteristic(ROC)curve was 0.946(95％CI=0.914-0.979),indicated that the column plot model has good predictive discrimination.Conclusion The independent risk factors for anal fistula after incision and drainage surgery of perianal abscess include male,diabetes,deep abscess,intestinal origin of pathogenic bacteria,and history of abscess.The construction of related nomogram model can guide clinical screening of high-risk groups to a certain extent.

AIM: To investigate the mechanism of baicalin-induced apoptosis in human laryngeal cancer cells. METHODS: AMC-HN-8 cells were selected for the study, and baicalin was applied to the cells at different concentrations (0, 10, 30, 100, and 300 μmol/L), and the half-inhibitory concentration (IC50) was measured by the CCK-8 method. Bax, cleaved-caspase-3, Cyto-c, IRF4 protein expression by protein blotting (Western blot); miR-125b-5p and IRF4 expression by RT-qPCR. Dual-luciferase reporter gene validation of Targetscan prediction (binding of miR-125b-5p to IRF4-3'UTR); apoptosis and necrosis inhibitors explore the way baicalein induces death in laryngeal cancer cells. AMC-HN-8 was then divided into blank group, baicalein (IC50), miR-125b-5p inhibitor group, baicalein + inhibitor NC group, baicalein+miR-125b-5p inhibitor group, and cell invasion and clone formation assays to detect cell invasion and proliferation ability, respectively. Apoptosis was detected by flow cytometry. RESULTS: Baicalein inhibited the proliferation of AMC-HN-8 cells in a dose-dependent manner with an IC50 value of 47.31 μmol/L. Compared with the blank group, 47.31 μmol/L baicalin induced apoptosis and inhibited cell invasion, while upregulating the expression of miR-125b-5p and suppressing the mRNA and protein levels of IRF4. The luciferase results showed that the miR-125b-5p mimic was able to inhibit the activity of the IRF4-3'UTR promoter relative to the NC mimic (mimic) group. Baicalein induces laryngeal cancer cell death in an apoptotic manner. In addition, the combination of 47.31 μmol/L baicalin and miR-125b-5p inhibitor affected the behavior of AMC-HN-8 cells, showing that compared with the blank group, the baicalin group showed a decrease in the number of cell clones, weakened invasion ability, and increased apoptosis; the miR - 125b-5p inhibitor group showed an increase in the number of cell clones, enhanced invasion ability and decreased apoptosis. The baicalin+ inhibitor NC group was consistent with baicalin, with no significant effect of inhibitor NC on cell behavior. The cloning, invasion, and apoptosis of cells in the baicalin+miR-125b-5p inhibitor group were intermediate between the baicalin and miR-125b-5p inhibitor groups. CONCLUSION: Baicalin inhibits the proliferation of AMC-HN-8 cells, and the mechanism may be related to miR-125b-5p targeting to inhibit the expression of IRF4, inducing the pro-apoptotic proteins Bax, cleaved-caspase3, and Cyto-c, and inhibiting the apoptosis suppressor protein Bcl-2 thereby inducing apoptosis.

Objective: Using computer-assisted navigation technology to guide the resection and reconstruction of mandibular ameloblastoma, evaluating its treatment effect. Methods : Twelve patients were selected from the Affiliated Stomatological Hospital of Nanjing University from January 2017 to May 2022. All 12 patients accepted same surgery which included resection of mandibular ameloblastoma and reconstruction by fibula musculocutaneous flap. Among them, 6 cases were included in the navigation group; 6 cases were in the non-navigation group. Advantages and disadvantages of computer-assisted navigation technology in this operation were evaluated with these cases. Results: The 12 operations were performed by the same operator. The average time for fixing the navigation bracket and performing navigation in the navigation group was about 15 minutes. Compared with the non-navigation group, the average operation time in the navigation group was shortened by about 10 minutes. In the navigation group, the mandible resection range matched the fibula musculocutaneous flap well, and the occlusal relationship recovered well. Conclusion Using the mandibular reference frame, under the guidance of computer-assisted navigation technology, the resection and reconstruction of mandibular ameloblastoma can be performed quickly and accurately.

Unlike healthy, non-transformed cells, the proteostasis network of cancer cells is taxed to produce proteins involved in tumor development. Cancer cells have a higher dependency on molecular chaperones to maintain proteostasis. The chaperonin T-complex protein ring complex (TRiC) contains eight paralogous subunits (CCT1-8), and assists the folding of as many as 10% of cytosolic proteome. TRiC is essential for the progression of some cancers, but the roles of TRiC subunits in osteosarcoma remain to be explored. Here, we show that CCT4/TRiC is significantly correlated in human osteosarcoma, and plays a critical role in osteosarcoma cell survival. We identify a compound anticarin-β that can specifically bind to and inhibit CCT4. Anticarin-β shows higher selectivity in cancer cells than in normal cells. Mechanistically, anticarin-β potently impedes CCT4-mediated STAT3 maturation. Anticarin-β displays remarkable antitumor efficacy in orthotopic and patient-derived xenograft models of osteosarcoma. Collectively, our data uncover a key role of CCT4 in osteosarcoma, and propose a promising treatment strategy for osteosarcoma by disrupting CCT4 and proteostasis.

Objective:To observe the incidence of infection related complications after percutaneous nephrolithotripsy.Methods:One hundred and forty-two patients with renal calculi who were treated in the First Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine from January 2017 to December 2018 were divided into control group (71 cases) and experimental group (71 cases) by random number method. Among them, the control group was treated with common sheath, the experimental group was treated with negative pressure lithotomy, and the patients were followed up for 1 year after the operation to count the recurrence. The patients in the two groups were compared in terms of perioperative indexes, intraoperative complication rate, postoperative complication rate, recurrence rate in 1 year′s follow-up and quality of life in 1 year′s follow-up.Results:The operation time in two groups had no significant difference ( P>0.05). The amount of bleeding in the experimental group was significantly higher than that in the control group [(12.15 ± 1.06) ml vs. (13.03 ± 1.17) ml], the length of hospitalization was significantly shorter than that in the control group [(5.13 ± 0.67) d vs. (6.02 ± 0.78) d], and the differences were statistically significant ( P<0.01). The incidence of intraoperative complications in two groups had no significant difference ( P>0.05). The incidence of postoperative complications in the experimental group was significantly lower than that in the control group [1.41%(1/71) vs. 11.27%(8/71)], the recurrence rate in the follow-up period of 1 year was significantly lower than that in the control group [1.14%(1/71) vs. 9.86%(7/71)], and the differences were statistically significant ( P<0.05). The scores of postoperative World Health Organization Quality of Life Questionaire BREF (WHOQOL-BREF) of the two groups had no significant difference ( P>0.05). At 1 year′s follow-up, the scores of WHOQOL-BREF in the experimental group were significantly higher than those in the control group ( P<0.01). Conclusions:With the help of vacuum lithotripsy in percutaneous nephrolithotripsy, but the incidence of postoperative complications can be significantly reduced, the length of stay can be shortened, the follow-up recurrence can be reduced, and the quality of life can be improved.

Objective: To evaluate the feasibility and safety of transanal lateral lymph node dissection for mid-low rectal cancer. Methods: A descriptive case series research method was used. Clinical and pathological data of 5 mid-low rectal cancer patients who underwent transanal lateral lymph node dissection at Department of Colorectal Surgery, the Sixth Affiliated Hospital of Sun Yat-sen University from November 2018 to May 2019 were retrospectively collected and analyzed. Of 5 cases, 4 were male and 1 was female with mean age of (43.2±13.2) years and mean body mass index of (21.2±2.6) kg/m²; the mean diameter of tumor was (3.2±2.4) cm; the mean distance between tumor and anus was (6.3±2.5) cm; 3 received preoperative neoadjuvant chemotherapy. In preoperative TNM staging, 2 cases were T3N1M0, 1 was T3cN2aM0, 1 was T3cN2bM0, and 1 was T2N1M0. All the patients had no intestinal obstruction before operation. Surgical methods: (1) total mesorectal excision: using general transanal and transabdominal methods to mobilize and resect total mesorectum, and dissect No.252, No.253 lymph nodes; (2) transanal lateral lymph node dissection: dissect the adipose lymphoid tissue on the surface of the iliococcygeal muscle, the coccygeal muscle, and the obturator muscle (the No.283 lymph nodes) upward, and dissect No.263d and No.263p lymph nodes with fat tissue sequentially till the bifurcation of the internal and external iliac artery; (3) take out the specimen from anus, and make anastomosis between proximal colon and anal canal. Intraoperative and postoperative variables was observed. Results: All the 5 patients completed surgery successfully, and no patient needed to convert to open approach. The mean operative time was (295.6±97.7) minutes, and the median intraoperative blood loss was 70 (50-500) ml. The mean length of specimen was (12.9±3.0) cm, and the mean number of harvested lymph node was 30.4±9.9. The positive lateral lymph nodes were founder in 4 patients. The median distance between tumor and distal resection margin was 1.5 (1.2-8.0) cm. The resection margin in all the patients was negative. The mean time to postoperative flatus was (4.2±1.6) days, the mean postoperative spontaneous urination was (3.0±1.9) days, time to drainage tube removal was (5.6±1.9) days, and the mean postoperative hospital stay was (9.4±2.1) days. The postoperative TNM staging by pathology was 1 case with T1N0M0, 1 with T2N1M0, 1 with T3N2bM0, and 2 with T3N2M0. Five patients were moderately differentiated adenocarcinoma. Only 1 patient developed postoperative abdominal bleeding, who was healed after conservative treatment. The other 4 patients did not develop any perioperative complications, such as incision infection, presacral abscess, pelvic abscess, anastomotic leakage, or anastomotic stricture. Four patients underwent postoperative chemotherapy. All the patients were followed up for 2 to 28 weeks after surgery and they all felt well. The patients with stoma had fluent bowel. Conclusions Transanal lateral lymph node dissection is feasible and safe in the treatment of mid-low rectal cancer, which can achieve the purpose of extended radical resection of mid-low movement rectal cancer. Moreover, this procedure is a new method to treat rectal cancer patients with lateral lymph node metastasis.

Objective To investigate the effects of xenogenic bone with chitosan/norvancomycin sustained-release biomaterials in treating infectious bone defects in rabbits.Methods Xenogenic bone with chitosan/norvancomycin sustained-release biomaterials was made by electrospinning technique.Rabbit infectious bone defect models were made by Methicillin-resistant Staphylococcus aureus.A successful model was evaluated with the standard of more than three points in Norden score assessment.All models were divided into two groups by random number table method,with eight models in each.The control group was treated with surgical debridement,and the experimental group was implanted with bone particles of xenogenic bone with chitosan/norvancomycin sustained-release system after debridement.Postoperatively,general conditions,X-ray,histological results of HE staining,and bacteriological examination results of the rabbits were observed.Results X-ray showed significant bone defects,sequestration,periosteal reaction,and soft tissue swelling after one month of modeling,with Norden score of (3.84 ± 0.52) points.The general conditions were good and the sinus tracts were healed in experimental group after two months of treatment.The control group demonstrated generally poor conditions with swollen sinus and purulent discharge.Two rabbits were died of sepsis.The pathological scores of tibial were (0.41 ± 0.08) points in experimental group,and (3.27 ± 0.26) points in control group by gross observation.The pathological score of experimental group was significantly lower than control group(P ＜ 0.05).The bone defects were basically repaired in experimental group.The longest diameter of bone defect in experimental group was (0.11 ± 0.02)cm,significantly smaller than (0.48 ± 0.06) cm in control group (P ＜ 0.05).There were no obvious signs of osteomyelitis and the bone defects were well repaired in experimental group.Periosteal reaction,soft tissue swelling,a substantial number of bone destruction,and sequestration were observed in control group.The Norden score was (1.32 ± 0.23) points in experimental group,lower than (5.21 ± 0.48) points in control group(P ＜ 0.05).HE staining showed a large amount of trabecular bone formation,bone cell formation,and fibrous hyperplasia in experimental group,with no obvious signs of infection.On the other hand,infiltration of inflammatory cells,necrotic tissue,and sequestration were observed in control group.The histological score was(0.61 ± 0.10) points in experimental group,lower than (4.21 ± 0.41) points in control group (P ＜0.05).The negative rate of bacterial culture in experimental group was 33％,lower than 100％ in control group (P ＜ 0.05).Conclusion Xenogenic bone with ehitosan/norvancomycin sustained-release biomaterials has excellent effect in infection clearance and bone defect reparation in treatment of infectious bone defects in rabbits.

Objective To investigate the value of RDW for predicting death risk in the patients with acute pancreatitis (AP) and its correlation with the Ret parameters.Methods A total of 164 patients with AP in the emergency surgery of Second Xiangya Hospital of Central South University from March 2015 to May 2015 were selected ,including 151 survival cases and 13 death cases , and other 175 healthy people were selected as the control group.The venous blood was collected for detecting whole blood RDW and Ret parameters by using the Sysmex XN-1000 automatic blood analyzer.The inter-group comparison was performed by Mann-Whitney U and Kruskal-Wallis H tests ;the diagnostic value of RDW for AP death risk was evaluated by receiver operating charac-teristic(ROC) curve and area under curve(AUC).Results The RDW level in the AP death group was[15.7% (14.1% -21.8% )] , which was significantly higher than that of AP survive group [13.3% (12.7% -14.5% )] ,the difference was statistically significant (Z=40.02 ,P<0.05);AUC of RDW ROC curve for diagnosing death risk was 0.835(95% CI:0.786-0.951);With the cutoff val-ue of RDW for diagnosing the AP death risk as ≥14.5% ,the sensitivity was 71.43% (95% CI:41.90% -91.60% )and specificity was 89.40% (95% CI:83.40% -93.80% );the RDW level of AP patients was positively correlated with Ret% ,IFR ,MFR and HFR(r=0.376 ,0.502 ,0.468 ,0.475 ,P<0.01) ,and was negatively correlated with LFR (r= -0.502 ,P<0.01).Conclusion The RDW level is a good indicator for early predicting AP death risk ,its elevated degree is closely correlated with Ret generation.

Objective To evaluate the feasibility and safety of embedding the totally implantable venous access port (TIVAP) via the access of right brachiocephalic vein (BCV).Methods The clinical data of 493 patients,who underwent the placement of TIVAP by using right BCV route during the period from March 2013 to December 2015,were retrospectively analyzed.The patients included 137 males and 356 females,with a mean age of (47.3±13.2) years old (ranging from 29 to 78 years old).The puncture success rate and TIVAP indwelling procedure-related complications were analyzed.Results The technical success rate was 100％,the success rate of initial puncturing was 99％ (488/493).The mean operation time was (22.5± 8.3) minutes (range of 18-35 minutes).Mis-puncturing of artery happened in 3 patients (0.61％,3/493);and no severe complications such as hemothorax or pneumothorax occurred.After implantation,the patients carried TIVAP for 124-986 days,with a mean of (271.1±53.8) days.The incidence of complications was 2.25％ (11/488),including hemorrhage at port site (n=2),catheter-related infection (n=l),partial thrombosis (n=2),and formation of fibrous protein sheath (n=6).No serious complications such as displacement or rupture of catheter,or catheter pinch-off syndrome (POS),etc.were observed.Conclusion The implantation of TIVAP by using right BCV route has high puncturing success rate,the technique is safe and reliable,and it can provide another option of catheter access for the clinical performance of TIVAP implantation.