Objective To explore the risk of venous thromboembolism (VTE), especially lower-extremity deep vein thrombosis (DVT) and pulmonary embolism (PE), for stroke patients in rehabilitating, and the functional outcome. Methods A total of 3 557 stroke patients in the neurological rehabilitation center of Beijing Bo'ai Hospital for stroke rehabilitation from January, 2015 to October, 2020 were reviewed through the electronic medical record system. Demographic characteristics, stroke characteristics (type and location), laboratory data (D-dimer polymer and arterial partial pressure of oxygen), motor function (Brunnstrom stage, Fugl-Meyer Assessment of motor and balance, modified Ashworth Scale score of triceps crus, and Holden Walking Ability Classification), activities of daily living (Barthel Index), and anticoagulant/antiplatelet treatment data were collected and analyzed. Results The incidence of DVT and PE was 28.5% and 1.29%, respectively. Most were found 30 days later after onset. The incidence of PE was higher after ischemic stroke (χ2 = 12.49, P < 0.001) rather than hemorrhagic stroke. The patients with hemispheric stroke, severe lower-extremity paralysis, and poor activities of daily living were more prone to complications associated with VTE. After rehabilitation, the function of stroke patients with PE could be improved (|t| > 4.302, P < 0.001). Conclusion The risk of DVT and PE in patients during stroke convalescence may not be negligible, and those with older age, previous history of thrombosis, severe stroke, and severe limb paralysis may be stratified in high-risk. Following anticoagulation treatment, early individualized comprehensive rehabilitation can be done for patients with PE to improve their function and activities of daily living.

Objective To investigate the incidence of Holmes tremor (HT) after stroke and its outcome after medication and rehabilitation. Methods Patients diagnosed as HT after stroke in the ward of neurorehabilitation department from October, 2019 to September, 2021 were reviewed the clinical features, imaging manifestations, drug treatment plan, rehabilitation evaluation scales scores, rehabilitation plan and outcome. Results There were five inpatients with HT (0.7%, 5/715), and all were hemorrhagic stroke, accounting for 1.7% of hemorrhagic stroke. The lesions were located in the midbrain and pons in three cases, cerebellum in one case and thalamus in one case. The tremor appeared 1.5 to seven months after stroke, limited on head and limbs, with other neurological dysfunction. After the comprehensive treatment of drugs and rehabilitation, tremor improved in four cases, and ineffective in one case. The motor and balance function improved less, and the activities of daily living improved somehow. Conclusion The incidence of Holmes tremor is low in stroke patients. The tremor might respond to the treatment, but motor function would not.

Objective:To investigate the morphological characteristics and operative methods of mixed total anomalous pulmonary venous connection (TAPVC), and to analyze the risk factors of postoperative death.Methods:From January 2011 to January 2019, 17 cases of mixed TAPVC were operated in Department of Cardiovascular Surgery, Beijing Children′s Hospital, Capital Medical University, with 10 males and 7 females.The average age was (4.4±3.8) months (1-15 months) and the average body mass was (5.6±1.7) kg (3.5-10.0 kg), including 1 case of ventricular septal defect, 17 cases of atrial septal defect and 15 cases of ductus arteriosus.Preoperative pulmonary vein stenosis was discovered in 4 cases and severe pulmonary hypertension was in 10 cases.A total of 5 cases needed ventilator support before operation, and 2 cases needed emergency operation.The diagnosis was confirmed by color Doppler ultrasound and CT before operation.There were 2 cases of type Ⅰ (type 2+ 2), 13 cases of type Ⅱ (type 3+ 1), and 2 cases of type Ⅲ (anatomic variant).Results:All the patients were treated through operation.The principle of operation was to correct all pulmonary veins to the left atrium.The cardiopulmonary bypass time was (182.3±122.8) min, the aortic occlusion time was (84.3±15.9) min, the postoperative ventilator support time was (92.9±70.0) h, and the monitoring room time was (6.9±4.9) d. In this group, 3 cases died in hospital (17.6%) and 1 case died out of hospital (5.9%).Conclusions:The mortality of mixed TAPVC type Ⅲ was high, while preoperative pulmonary vein stenosis, severe pulmonary hypertension and the combination of sub-cardiac type were the important risk factors of death.The operation mode depends on the anatomic drainage mode, so individualized operation is recommended.

Objective:To investigate the diagnosis, surgical methods, perioperative treatment and surgical results of Kommerell's diverticulum with double aortic arch in infants.Methods:From December 2014 to December 2019, 22 cases of double aortic arch combined with Kommerell diverticulum were operated in our hospital, 14 males and 8 females, with an average age of (13.7±11.6) months (1-36 months) and mean body mass of (9.8±3.4)kg (5-20 kg). The children had respiratory symptoms such as asthmatic suffocation, shortness of breath, repeated respiratory tract infection and chronic cough before operation. All patients underwent cardiac CT examination. The average diverticulum was 8 mm×9 mm, in the trachea The average compression degree of the lower segment was 56%±16% (30%-80%). The distal part of the left arch was atresia and Kommerell's diverticulum was found in all patients. The operation methods were left aortic arch separation, ligament separation and diverticulectomy. In one case, tracheal stent was placed simultaneously during the operation because of severe tracheal malacia.Results:The average time in the ward was(1.4±0.8)days (1-4)days, and the average time in hospital was (6.7±2.8)days (4-13 days). The average follow-up period was (25.5±16.9) months (2-60 months). During the follow-up period, 18 children had no persistent respiratory symptoms, and 4 children had only slight respiratory symptoms.Conclusion:Kommerell's diverticulum can also be combined with double aortic arch. The operation method is to separate the aortic arch and ligament at the atresia end and resect the diverticulum at the same time. It has a good early prognosis and may eliminate the residual symptoms and late complications.

Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related deaths, characterized by highly hypoxic tumor microenvironment. Hypoxia-inducible factor-1α (HIF-1α) is a major regulator involved in cellular response to changes of oxygen levels, supporting the adaptation of tumor cells to hypoxia. Bruceine D (BD) is an isolated natural quassinoid with multiple anti-cancer effects. Here, we identified BD could significantly inhibit the HIF-1α expression and its subsequently mediated HCC cell metabolism. Using biophysical proteomics approaches, we identified inhibitor of β-catenin and T-cell factor (ICAT) as the functional target of BD. By targeting ICAT, BD disrupted the interaction of β-catenin and ICAT, and promoted β-catenin degradation, which in turn induced the decrease of HIF-1α expression. Furthermore, BD could inhibit HCC cells proliferation and tumor growth in vivo, and knockdown of ICAT substantially increased resistance to BD treatment in vitro. Our data highlight the potential of BD as a modulator of β-catenin/HIF-1α axis mediated HCC metabolism.

BACKGROUND:Cryotherapy plays a positive role in the treatment of delayed-onset muscle soreness caused by high intense exercise. OBJECTIVE: To investigate the effects of different crypotherapy programs on the levels of interleukin-6 and prostaglandin 2 in long distance race-walkers after 15-day training, and to determine a rational treatment program for delayed-onset muscle soreness. METHODS:Sixteen male race-walkers in Liaoning Province were randomly divided into cryotherapy and cryo/heat therapy groups, and received 10-minute cryotherapy and 2.5-minute cryo/heat therapy (2.5-mintue cryotherapy and 2.5-minute heat therapy alternately for 10 minutes), respectively, after 15-day training. The serum levels of interleukin-6 and prostaglandin 2 were detected at six different time points to compare the efficacy between two methods. RESULTS AND CONCLUSION: Compared with the cryo/heat therapy group, the serum levels of interleukin-6 and prostaglandin 2 in the cryotherapy group were significantly decreased. That is to say, cryotherapy is more available for alleviating delayed-onset muscle soreness after intensive eccentric training or in intensive seasons.

Endoscopy ; Humans ; Myosarcoma ; diagnosis ; surgery ; Nasal Cavity ; Nose Neoplasms ; diagnosis ; surgery ; Paranasal Sinuses ; Skull Base ; Skull Base Neoplasms ; diagnosis ; surgery

OBJECTIVETo explore the effects of uterine adenomyosis on the clinical outcomes of infertility patients treated with in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET).

METHODSA retrospective study was conducted of 61 IVF/ICSI-ET cycles as the study group, diagnosed with uterine adenomyosis by transvaginal ultrasound, and 164 IVF/ICSI-ET cycles of patients with tubal infertility as the control group. The baseline characteristics, ovary response and clinical outcomes were compared between the two groups.

RESULTSThe implantation rate, clinical pregnancy rate and live birth rate decreased significantly in the study group (P<0.05), and early abortion rate increased significantly (P<0.05). For patients with adenomyosis, GnRH-antagonist cycles tended to decrease clinical pregnancy rate and increase abortion rate (25.0% vs 45.0%, P=0.184; 66.7% vs 27.8%, P=0.247), and significantly decrease live birth rate (0% vs 30.8%, P=0.025), compared with GnRHa agonist cycles.

CONCLUSIONUterine adenomyosis decreases implantation rate, clinical pregnancy rate and birth rate, and increases abortion rate significantly in patients with IVF/ICSI-ET. GnRH-antagonist cycles have adverse effects on the outcomes of adenomyosis; GnRH agonist long protocol cycles may increase clinical pregnancy rate and decrease abortion rate.

Adenomyosis ; complications ; Embryo Implantation ; Embryo Transfer ; Female ; Fertilization in Vitro ; Gonadotropin-Releasing Hormone ; agonists ; antagonists & inhibitors ; Hormone Antagonists ; Humans ; Infertility, Female ; Pregnancy ; Pregnancy Complications ; physiopathology ; Pregnancy Rate ; Retrospective Studies ; Sperm Injections, Intracytoplasmic

OBJECTIVE: To assess the long-term clinical efficacy of endoscopic surgery of primary sinonasal malignant neoplasms and find out the potential postoperative prognostic factors. METHOD: Forty-three clinical cases of primary sinonasal malignant neoplasms treated under endoscopy were analyzed retrospectively. RESULT: Fifteen patients died. The 1-year, 2-year, 3-year and 5-year survival rates were 83. 7% (36/43), 74. 4% (32/43), 69. 8% (30/43) and 65. 1% (28/43), respectively. Kaplan-Meier single-variable analysis showed that gender, T grade, TNM stage and pathological types of olfactory neuroblastoma were statistically significant prognostic factors (P< 0. 05). COX Pro-Portional hazard models showed that TNM stage was an independent prognostic factors. CONCLUSION Endoscopic surgery for primary sinonasal malignant neoplasms is a safe and effective minimally invasive surgical treatment, and it is an important supplement to the traditional surgery. Gender, T grade, TNM stage and pathological types of olfactory neuroblastoma might be significant prognostic factors.
Endoscopy ; Esthesioneuroblastoma, Olfactory ; surgery ; Humans ; Nasal Cavity ; pathology ; surgery ; Nose Neoplasms ; surgery ; Proportional Hazards Models ; Retrospective Studies ; Survival Rate ; Treatment Outcome

Objective To explore the developmental potential of embryos at different developmental days and provide evidence for blastocyst culture of non-top quality cleavage stage embryos in frozen-thawed embryo transfer (FET) cycles. Methods The clinical data of 687 FET cycles were retrospectively analyzed. According to the embryo freezing time, the patients were divided into day 5 (D5) blastocyst group (n=87), day 6 (D6) blastocyst group (n=111) and day 3 cleavage-stage embryo (D3) group (n=489) with hormone replacement cycles or natural cycles for endometrial preparation. The clinical pregnancy rates, miscarriage rates, and implantation rates were compared between the 3 groups. Results The clinical pregnancy rate, miscarriage rate and implantation rate per transfer were 58.6%, 9.8%, and 42.9% in D5 group, 32.4%, 19.4%, and 23.3% in D6 group, and 44.9%, 16.4%, and 26.9%in D3 group, respectively. The clinical pregnancy rate and implantation rate were significantly higher in D5 group than in the other two groups (P<0.05). Conclusion The D5 blastocysts derived from non-top quality D3 embryos after cryopreservation can have better clinical outcomes than those derived from D3 cleavage-stage embryos and D6 blastocysts, and are therefore a better option than D3 cleavage-stage embryos in FET cycles.