Objective:The pain-relieving effect and safety of compound aminopyrine phenacetin tab-lets,tramcontin(tramadol hydrochloride sustained-release tablets)and dolantin in the early stage of au-tologous tendon reconstruction of the anterior cruciate ligament(ACL)of the knee joint were compared.Methods:Retrospective analysis of postoperative pain and drug analgesia in 45 patients performed by the same group from November 2018 to February 2019.The random area group design was divided into two groups according to whether ACL rupture was combined with meniscal injury,group A was 24 patients with ACL reconstruction of knee joint and group B was 21 patients with ACL fracture combined with me-niscus injury.The two groups were divided into three subgroups respectively according to the actual treat-ment of postoperative analgesic drugs received by the patients,including 4 cases of compound aminopy-rine phenacetin tablets,11 cases of oral tramcontin,9 cases of intramuscular dolantin combined with phenergan in group A;3 cases of compound aminopyrine phenacetin tablets,10 cases of oral tramcontin,and 8 cases of intramuscular dolantin combined with phenergan in group B.When the early postoperative patients complain about pain and actively ask for analgesia.When the patients complained about pain af-ter the operation and actively asked for analgesia,they were randomly given painkillers,tramcontin or do-lantin combined with phenergan to relieve pain.Pain visual analogue scale(VAS)was used to evaluate pain relief and observe the occurrence of adverse reactions.Results:There were no significant dif-ferences in gender,age,body mass index,and time of hospital stay between the two groups of patients(P＞0.05).In the patients who used tramcontin and dolantin combined with phenergan to relieve pain judging by VAS score before and 1 h after taking the drug,it was found that the pain situation of the pa-tient was significantly relieved,and the difference before and after taking the drug had statistical signifi-cance(P＜0.05).Pairwise comparisons of the three drugs applied in the two groups showed significantly greater pain relief in the dolantin combined with phenergan group than in the remaining two drugs.There was no significant difference(P＞0.05).Dolantin was prone to nausea and vomiting,but the application of phenergan was also used to reduce side effects.In terms of adverse reactions,only 1 case of nausea oc-curred in the tramcontin group for simple ACL reconstruction,and none of the patients in the other groups showed serious complications and allergic reactions.Conclusion:Whether in cruciate ligament recon-struction alone or combined with meniscus molding or suture,compound aminopyrine phenacetin tablets,tramcontin,dolantin combined with phenergan can effectively relieve pain.Among the three drugs,do-lantin caused the largest pain relief.At the same time,the combination of phenergan effectively reduced the adverse reactions,such as vomiting and nausea,and increased the drug safety.

Objective To investigate the prevalence of Cryptosporidium infection and the distribution of parasite species and genotypes among HIV-positive individuals in Jiangxi Province. Methods HIV-positive individuals' sociodemographic and clinical data were collected from three AIDS designated hospitals in Jiangxi Province from January 2022 to March 2023. Subjects' stool samples were collected, and genomic DNA was extracted from stool samples. Nested PCR assay was performed based on the small subunit ribosomal RNA (SSU rRNA) gene of Cryptosporidium, and Cryptosporidium gp60 gene was amplified in stool samples positive for the SSU rRNA gene. The second-round PCR amplification product was checked with 1.5% agarose gel electrophoresis, and the products of suspected positive amplifications were sequenced, followed by sequence alignment. The phylogenetic tree was created using the Neighbor-Joining method with the software MEGA 11.0, to characterize the species, genotypes and sub-genotypes of Cryptosporidium. Results A total of 382 HIV-positive individuals were enrolled, with two cases identified with Cryptosporidium infection (0.52% prevalence), and both cases had no abdominal pain or diarrhea. Following sequencing and sequence alignment, the gene sequences of these two Cryptosporidium isolates shared 99.76% and 99.88% similarity with the gene sequence of C. meleagridis isolates. Phylogenetic analysis based on the Cryptosporidium SSU rRNA gene sequence identified the species of these two Cryptosporidium-positive stool samples as C. meleagridis. Following nested PCR amplification of the Cryptosporidium gp60 gene, sequencing and sequence alignment, the two C. meleagridis isolates were characterized as III eA17G2R1 and III bA25G1R1a sub-genotypes, and the sub-genotype III bA25G1R1a was firstly described in humans. Conclusion The prevalence of Cryptosporidium is low among HIV-positive individuals in Jiangxi Province. The likelihood of Cryptosporidium infection cannot be neglected among HIV-positive individuals without diarrhea.

Background::Visual inputs are critical for locomotor navigation and sensorimotor integration in the elderly; however, the mechanism needs to be explored intensively. The present study assessed the gait pattern after cataract surgery to investigate the effects of visual restoration on locomotion.Methods::The prospective study recruited 32 patients (70.1 ± 5.2 years) with bilateral age-related cataracts in the Department of Ophthalmology at Peking University Third Hospital from October 2016 to December 2019. The temporal-spatial gait parameters and kinematic parameters were measured by the Footscan system and inertial measurement units. Paired t-test was employed to compare data normally distributed and Wilcoxon rank-sum test for non-normally distributed. Results::After visual restoration, the walking speed increased by 9.3% (1.19 ± 0.40 m/s vs. 1.09 ± 0.34 m/s, P=0.008) and exhibited an efficient gait pattern with significant decrease in gait cycle (1.02 ± 0.08 s vs. 1.04 ± 0.07 s, P=0.012), stance time (0.66 ± 0.06 s vs. 0.68 ± 0.06 s, P=0.045), and single support time (0.36 ± 0.03 s vs. 0.37 ± 0.02 s, P=0.011). High amplitude of joint motion was detected in the sagittal plane in the left hip (37.6° ± 5.3° vs. 35.5° ± 6.2°, P=0.014), left thigh (38.0° ± 5.2° vs. 36.4° ± 5.8°, P=0.026), left shank (71.9° ± 5.7° vs. 70.1° ± 5.6°, P=0.031), and right knee (59.1° ± 4.8° vs. 56.4° ± 4.8°, P=0.001). The motor symmetry of thigh improved from 8.35 ± 5.30% to 6.30 ± 4.73% ( P=0.042). Conclusions::The accelerated gait in response to visual restoration is characterized by decreased stance time and increased range of joint motion. Training programs for improving muscle strength of lower extremities might be helpful to facilitate the adaptation to these changes in gait.

Plasticity in the glutamatergic synapses on striatal medium spiny neurons (MSNs) is not only essential for behavioral adaptation but also extremely vulnerable to drugs of abuse. Modulation on these synapses by even a single exposure to an addictive drug may interfere with the plasticity required by behavioral learning and thus produce impairment. In the present work, we found that the negative reinforcement learning, escaping mild foot-shocks by correct nose-poking, was impaired by a single in vivo exposure to 20 mg/kg cocaine 24 h before the learning in mice. Either a single exposure to cocaine or reinforcement learning potentiates the glutamatergic synapses on MSNs expressing the striatal dopamine 1 (D1) receptor (D1-MSNs). However, 24 h after the cocaine exposure, the potentiation required for reinforcement learning was disrupted. Specific manipulation of the activity of striatal D1-MSNs in D1-cre mice demonstrated that activation of these MSNs impaired reinforcement learning in normal D1-cre mice, but inhibition of these neurons reversed the reinforcement learning impairment induced by cocaine. The results suggest that cocaine potentiates the activity of direct pathway neurons in the dorsomedial striatum and this potentiation might disrupt the potentiation produced during and required for reinforcement learning.

Objective To investigate the application value of three-dimensional (3D) visualization technology in the resectability assessment and surgical planning for huge hepatic carcinoma.Methods The retrospective cross-sectional study was conducted.The clinical data of 48 patients with huge hepatic carcinoma who were admitted to the Zhujiang Hospital of Southern Medical University between January 2012 and June 2015 were collected.The preoperative image of computed tomography (CT) was converted to 3D reconstruction,visual observations and simulated surgery for assessing the tumor resectability through MI-3DVS,and corresponding treatments were performed according to the results of assessment.Observation indicators:(1) 3D reconstruction situations;(2) tumor resectability assessment through simulated surgery:tumor diameter,tumor volume,preoperative standard liver volume (SLV),tumor-free liver volume after simulated resection,future liver remnant (FLR) after simulated resection,hepatic resection rate (HRR);(3) surgical and postoperative situations:surgical procedures,resection extent,operation time,volume of intraoperative blood loss,complications,duration of postoperative hospital stay;(4) typical case analysis;(5) follow-up.Follow-up using outpatient examination and telephone interview was performed to detect the survival of patients and tumor recurrence or metastasis up to June 2016.Measurement data with normal distribution were represented as(-x) ± s.Results (1) Three-D reconstruction situations:48 patients with huge hepatic carcinoma received successful 3D reconstruction and visual observations.Portal vein branches and hepatic vein branches reached level 4 through 3D reconstruction,and spacial position relationship between tumor and intrahepatic vascular backbones or branches can be clearly observed,as well as location and degree of vascular compression and invasion.(2) Tumor resectability assessment through simulated surgery:of 48 patients receiving simulated hepatectomy,26 underwent hepatectomy and 22 didn't undergo hepatectomy based on the assessment of resectability.Tumor diameter,tumor volume,preoperative SLV,tumor-free liver volume after simulated resection,FLR after simulated resection and HRR through assessment of 3D reconstruction and simulated surgery were (12.3-± 2.0) cm,(838 ± 284) mL,(1 884 ± 391) mL,(494 ± 140) mL,(551 ± 184) mL,46％ ± 12％ in 26 patients with resectable tumor and (14.0 ± 2.0) cm,(1 877 ± 1 240) mL,(2 945 ± 1 194) mL,(666 ± 206) mL,(402 ± 86) mL,62％ ± 9％ in 22 patients with unresectable tumor,respectively.(3) Surgical and postoperative situations:26 patients with resectable tumor underwent hepatectomy,without occurrence of death.Of 26 patients,21 underwent anatomic hepatectomy,including 12 undergoing right hemihepatectomy,3 undergoing left hemihepatectomy,2 undergoing right lobectomy of the liver,2 undergoing right posterior lobectomy of the liver,1 undergoing left lobectomy of the liver and 1 undergoing resection of hepatic segment Ⅴ + Ⅵ.And 5 underwent non-anatomic hepatectomy,including 2 with reduced right hemihepatectomy,1 with resection of hepatic segment Ⅱ + Ⅲ and partial segment Ⅳ,1 with resection of hepatic segment Ⅵ + Ⅶ and partial segment Ⅴ and 1 with resection of hepatic segment Ⅴ + Ⅵ and partial segment Ⅶ.Operation time and volume of intraoperative blood loss in 26 patients were respectively (6.4 ± 1.3) hours and (712 ±633)mL.Three patients with postoperative pleural effusion and 1 with postoperative bile leakage were cured by symptomatic treatment,without the occurrence of hepatic dysfunction.Duration of postoperative hospital stay was (19 ± 8) days.Of 22 patients with unresectable tumor,14 underwent transcatheter hepatic arterial chemoembolization (TACE),4 underwent portal vein ligation,1 underwent portal vein embolization and 3 abandoned treatment.(4) Typical case analysis:results of 3D reconstruction through MI-3DVS showed that patients underwent portal vein right anterior branch-preserving expanded right posterior lobectomy of the liver,with a smooth recovery.Patients were followed up for 14.0 months,with a good survival and without tumor recurrence and metastasis.(5) Follow-up:40 of 48 patients were followed up for 6.0-33.0 months with a median time of 13.0 months,including 26 with surgery and 14 without surgery.During the follow-up,the median survival time of patients with and without surgery was 20.0 months and 10.5 months,respectively.Twelve patients with surgery had tumor recurrence and metastasis.Conclusion Three-dimensional visualization technology is safe and feasible in the resectability assessment and surgical planning for huge hepatic carcinoma,and it will benefit to reduce risk of surgery.

OBJECTIVETo investigate the anatomy of right portal vein based on three-dimensional (3D) visualization technology and provide a morphological basis for computer-assisted individualized liver segmentation and anatomical hepatectomy.

METHODSLiver CT data of 83 cases were segmented and reconstructed using the medical image three-dimensional visualization system (MI-3DVS), and 3D classifications of the right portal vein were established according to its branch number, direction and distribution. Individualized liver segmentation was performed based on the 3D typing results.

RESULTSThe reconstructed portal vein models were capable of visualizing the fourth-order portal branches. Generally, the third-order right portal branches were classified into P5, P6, P7 and P8 branches. According to the 3D distribution of the branches, P5 branches were classified into types A, B, C, D, and E [in 16 (19.3%), 5 (6%), 30 (36.1%), 7(8.5%), and 25 (30.1%) cases, respectively], P8 branches into types A, B, C, and D [in 29 (34.9%), 29 (34.9%), 10 (12.1%), and 15 (18.1%) cases, respectively], P6 branches into types A, B, C, and D [in 35 (42.2%), 12 (14.5%), 33 (39.7%), and 3 (3.6%) cases, respectively], and P7 branches into types A, B, C, D, E, and F [in 27 (32.5%), 11(33.3%), 27 (32.5%), 4(4.8%), 12 (14.5%), and 2 (2.4%) cases, respectively]. Individualized liver segmentation was achieved based on liver segments supplied by the third-order portal branches.

CONCLUSION3D classifications of the complex and highly variant anatomy of third-order right portal vein and individualized liver segmentation based on this classification before the operation facilitates successful performance of anatomical hepatectomy.

Hepatectomy ; methods ; Humans ; Imaging, Three-Dimensional ; Liver ; anatomy & histology ; surgery ; Portal Vein ; anatomy & histology ; Surgery, Computer-Assisted ; Tomography, X-Ray Computed

Objective To investigate the clinical value of the intrahepatic Glisson's sheath vascular disconnection approach for anatomical hepatectomy by three-dimensional (3D) laparoscope.Methods Twenty-two patients(11 liver cancer and 11 benign diseases)underwent hepatectomy in Zhujiang Hospital,Southern Medical University from November 2013 to March 2015 were involved.All patients were performed anatomical hepatectomy by 3D laparoscope with the intrahepatic Glisson's sheath vascular disconnection approach.The anatomical time of first hepatic portal,operation time,intraoperative bleeding,postoperation hospitalization and the complication incidences were observed.Results All the 22 cases were performed successfully with the intrahepatic Glisson's sheath vascular disconnection and the anatomic hepatectomy.The anatomical time of first hepatic portal,operation time,intraoperative bleeding,the postoperation hospitalization duration and complication incidence rate were (43 ± 14) minutes (22-74 minutes),(295 ± 89) minutes (105-480 minutes),(546 ± 390) ml(50-1 500 ml),(9.8 ±2.8) days(5-16 days) and 18.2％ (4/22)in 22 patients,respectively.There was no death.Conclusions With the help of 3D laparoscope,the anatomy of Glisson pedicle could perform precisely and the dissection of vessels would be easy and accuracy.The 3D laparoscope is feasible for performing the anatomical hepatectomy.

Objective To investigate the clinical value of the intrahepatic Glisson's sheath vascular disconnection approach for anatomical hepatectomy by three-dimensional (3D) laparoscope.Methods Twenty-two patients(11 liver cancer and 11 benign diseases)underwent hepatectomy in Zhujiang Hospital,Southern Medical University from November 2013 to March 2015 were involved.All patients were performed anatomical hepatectomy by 3D laparoscope with the intrahepatic Glisson's sheath vascular disconnection approach.The anatomical time of first hepatic portal,operation time,intraoperative bleeding,postoperation hospitalization and the complication incidences were observed.Results All the 22 cases were performed successfully with the intrahepatic Glisson's sheath vascular disconnection and the anatomic hepatectomy.The anatomical time of first hepatic portal,operation time,intraoperative bleeding,the postoperation hospitalization duration and complication incidence rate were (43 ± 14) minutes (22-74 minutes),(295 ± 89) minutes (105-480 minutes),(546 ± 390) ml(50-1 500 ml),(9.8 ±2.8) days(5-16 days) and 18.2％ (4/22)in 22 patients,respectively.There was no death.Conclusions With the help of 3D laparoscope,the anatomy of Glisson pedicle could perform precisely and the dissection of vessels would be easy and accuracy.The 3D laparoscope is feasible for performing the anatomical hepatectomy.

Objective To analyze the clinical feature and pathological characteristics of oral submucous fibrosis (OSF) coexisted with oral leukoplakia (OLK) or oral lichen planus (OLP),and summarize both the common and each clinical and pathological characteristics of two kinds of diseases.Methods The clinical and pathological data of 74 patients with OSF coexisted with OLK and 57patients with OSF coexisted with OLP were retrospectively reviewed.Results Most of patients with OSF coexisted with OLK or OLP were mainly young and middle-aged male patients,and all had the habit of eating betel quid chewing.Most of them had the habit of smoking and alcohol drinking; while their limitation of mouth opening were not obvious.Patients coexisted with unilateral OLK or OLP all had a unilateral mastication of chewing betel nut;the prevalence rate of erosive OLP was lower in the patients with OSF coexisted OLP than that of OLP patients never chew betel nut.The pathology of both OSF coexisted with OLK or OLP was with the respective characteristics of OLK or OLP on the basis of OSF,and the epithelium was thickened more than atrophic.No relationship was found between the degree of epithelial hyperplasia and the severity of fibrosis in patients with OSF coexisted with OLK.Conclusions OSF coexisted with OLK and OSF coexisted with OLP were the occurrence of OLK or OLP on the basis of OSF,which were not a simple superposition of two diseases,but combination with their own characteristics of OSF coexisted with OLK or OLP.

Objective To investigate the expressions of cytokeratin/keratin 4 in the buccal tissue of oral submucous fibrosis at the early,middle and advanced stages,explore which role keratin4 (K4) plays in the process and development of oral submucous fibrosis (OSF),and provide evidence for K4 being a promising biomarker to evaluate the development and prognosis of OSF.Methods Ten cases of normal tissues,and 10 cases of OSF tissues with typical early,middle and advanced stages,were selected,respectively.Detect the expression of K4 in the tissue mentioned above through immunohistochemistry and Westem blot.The data was analyzed by statistical means.Results The results of immunohistochemistry showed that K4 was mainly located in cytoplasm,and positive cells with brownish yellow granules were seen in whole epithelial layer of the normal mucosa.The expression of K4 was lower at all stages of OSF than that at the normal tissue with statistical significance (P ＜0.05).With the aggravation of OSF,the expression of K4 was decreased,difference between early and advanced stage was found to be statistically significant.The results of Western blot also showed that the expression of K4 was lower than that of early,middle and advanced stages of OSF (P ＜ 0.05).With the aggravation of OSF,the expression of K4 was decreased,but the differences between them had no significance (P ＞ 0.05).Conclusions The expression of K4 in OSF tissue of early,middle and advanced stages were decreased compared to normal tissue,respectively.It suggests that K4 might play and important role in the initiation and development of OSF.