目的 探讨弥漫性轴索损伤（diffuse axonal injury，DAI）的发病机制、临床特点、诊断及治疗方法，以提高治愈率，降低致残、致死率。 方法 回顾性分析200６年6月-2010年3月间65例临床诊断为DAI患者的受伤机制、临床特征、影像学表现、治疗及预后。 结果 DAI最常见原因为车祸伤70.7%，其次为坠落、坠物伤（10.7%），其他（18.6%）。按格拉斯哥昏迷分级（GCS）评分结果3~5分18例，6~8分15例，9~12分32例；治愈43例，轻残15例，中残8例，重残或植物生存7例，死亡7例。 结论 DAI具有诊断、治疗困难，预后差等特点，交通事故是导致DAI的主要原因，格拉斯哥昏迷分级（GCS）评分、昏迷时间和瞳孔变化是判定预后的重要指标。目前尚无特效治疗方法，由于80％以上患者往往是多发伤，故早期气管切开、呼吸机辅助呼吸、促醒、亚低温治疗、防治并发症、钙离子拮抗剂应用等综合治疗可显著改善预后。
Objective To construct human brain-derived neurotrophic factor retroviral vector-pLXSN (hBDNFpLXSN), and to evaluate the bioactivity of hBDNF. Methods The genome mRNA was extracted from embryonic brain tissue of a 5-month-old infant, the hBDNF gene sequence was obtained with RT-PCR technology, and hBDNF-pLXSN constructed in vitro was used to infect the fibroblasts (NIH/3T3). The expression of hBDNF was identfied by the immunohistochemistry method, and the NIH/3T3 and BDNF biological activities were determined by culture of the PC12 cells and dorsal root gangl ia. Results The hBDNF-pLXSN was constructed successfully by sequencing analyses. The infected NIH/3T3 showed positive expression of hBDNF. The infected NIH/3T3 could product hBDNF. Bioactivity of the products could support the PC12cell survival and neurite growth in the primary cultures of dorsal root gangl ia neurons of mice. Conclusion hBDNF-pLXSNvirus has the abil ity to infect NIH/3T3 and make it expressed and secreted hBDNF with the biological activity. It can be used to treat facial paralysis as a gene therapy.
Objective To evaluate the feasibility of sentinel lymph node (SLN) mapping after 99Tcm sulfur colloid (99Tcm-sc) and carbon nanoparticles injection in patients with colon cancer. Methods Forty patients with colon cancer underwent complete mesocolic excision between August 2015 and July 2016 at Qingdao Central Hospital were considered for prospective inclusion. Before resection, SLN mapping was performed with injection of 99Tcm-sc and carbon nanopar-ticles, then all dissected lymph nodes were detected by pathological examination. Results A total of 660 cases of lymph nodes were found in the 40 patients (average of 16.5 cases per patient). Of them, 88 nodes (average of 2.2 cases per patient) were identified as SLN in 36 of 40 patients, with a successful detection rate of 90.0% (36/40). The diagnostic accuracy, sensitivity, and false-negative rate were 87.5% (35/40), 96.2% (25/26), and 3.8% (1/26) respectively. Conclusion 99Tcm-sc and carbon nanoparticles suspension injection for mapping SLN is a feasiblely diagnostic method for predicting local lymph node metastasis in the patient with colon cancer.
Present study used diffusion tensor image and tractography to construct brain white matter networks of 15 cerebral palsy infants and 30 healthy infants that matched for age and gender. After white matter network analysis, we found that both cerebral palsy and healthy infants had a small-world topology in white matter network, but cerebral palsy infants exhibited abnormal topological organization: increased shortest path length but decreased normalize clustering coefficient, global efficiency and local efficiency. Furthermore, we also found that white matter network hub regions were located in the left cuneus, precuneus, and left posterior cingulate gyrus. However, some abnormal nodes existed in the frontal, temporal, occipital and parietal lobes of cerebral palsy infants. These results indicated that the white matter networks for cerebral palsy infants were disrupted, which was consistent with previous studies about the abnormal brain white matter areas. This work could help us further study the pathogenesis of cerebral palsy infants.
ObjectiveTo study the clinical and pathological characteristics and imaging manifestations of pulmonary mucosa associated lymphoid tissue (MALT) lymphoma.MethodsThe clinical and multidetector computed tomography (MDCT) imaging data of 17 patients with pathological proven pulmonary MALT lymphoma were reviewed retrospectively.ResultsThe MDCT manifestations were divided into 4 types: ① pneumonia/consolidation, ② mass/nodule type, ③ bronchovascular lymphatic type, ④ mixed type. The imaging features included air bronchiectasis in 13 cases and bronchiectasis in 9 cases. Multiple small pulmonary nodules were found in 11 cases, ground glass opacity in 9 cases, 4 cases of pleural effusion, pulmonary hilar and mediastinal lymph node enlargement in 3 cases. Among these 17 cases, 4 had extra-pulmonary involvement and 2 without obvious symptoms. The main clinical symptoms including cough, expectoration, dyspnea, fever, chest pain, hemoptysis, night sweats. The pathological manifestation is the infiltration of a large number of B lymphocytes and nuclear heterocells.ConclusionsThe clinical manifestations of pulmonary MALT lymphoma are not specific, but the progress is slow, and may be associated with autoimmune diseases. The main MDCT findings of pulmonary MALT lymphoma include consolidation, nodules or masses with air bronchogram. Lymph node enlargement is rare. Clinical diagnosis should also be based on pathological results.
Mild cognitive impairment (MCI) is a clinical transition state between age-related cognitive decline and dementia. Researchers can use neuroimaging and neurophysiological techniques to obtain structural and functional information about the human brain. Using this information researchers can construct the brain network based on complex network theory. The literature on graph theory shows that the large-scale brain network of MCI patient exhibits small-world property, which ranges intermediately between Alzheimer's disease and that in the normal control group. But brain connectivity of MCI patients presents topologically structural disorder. The disorder is significantly correlated to the cognitive functions. This article reviews the recent findings on brain connectivity of MCI patients from the perspective of multimodal data. Specifically, the article focuses on the graph theory evidences of the whole brain structural and functional and the joint covariance network disorders. At last, the article shows the limitations and future research directions in this field.
Objective To explore the effect of exogenous estrogen receptor β1 (ERβ1) gene on the expression of p53 as well as the changes of apoptosis in MDA-MB-231 cell line and to investigate the biological role of ERβ1 in breast cancer. Methods Recombinant eukaryotic expressing vector containing ERβ1 cDNA was transfected into human breast cancer cell MDA-MB-231 by using cationic liposome LipofectamineTM 2000. The expression levels of p53 and ERβ1 in mRNA and protein were evaluated by real-time PCR and Western blot, respectively. Cell growth curve was used to detect the changes of cell proliferation ability. Cell apoptosis was detected by flow cytometry. Results After transfected with vector containing ERβ1 cDNA, proliferation ability of MDA-MB-231 cell decreased and the expression levels of both ERβ1 and p53 in both mRNA and protein increased (Plt;0.01). Rate of cell apoptosis increased in ERβ1 upregulation groups （Plt;0.01）. Conclusion ERβ1 can induce apoptosis and inhibit the growth of MDA-MB-231 cells by upregulating p53 expression.
ObjectiveTo verify the feasibility of a self-designed magnetic anchoring and traction device (MATD) for assisting two-port video-assisted thoracoscopic esophagectomy.MethodsThree Beagle dogs were selected as animal models with age ranging from 1-6 years and weight ranging from 8-12 kg, and they underwent two-port video-assisted thoracoscopic esophagectomy after general anesthesia. We used the MATD to retract the esophagus to different directions, which assisted mobilizing esophagus, detecting the nerves along esophagus and dissecting paraesophagus lymph nodes. The operation time, blood loss and feasibility of the MATD were recorded.ResultsWith the aid of the MATD, we successfully retracted and mobilized the esophagus, detected the nerves and dissected the lymph nodes in three Beagle dog models. During the operation, the MATD provided sufficient and steady traction of esophagus to achieve a good exposure of the operative field, effectively decreasing the interference between working instruments. The MATD worked well. The mean operation time was 30 min, and the mean intraoperative blood loss was about 10 mL.ConclusionIt is effective to use the MATD to assist retracting esophagus during video-assisted thoracoscopic esophagectomy. The magnetic anchoring and traction technique can assist to expose the surgical field, decrease the interference between the working instruments and have the potential clinical application.
Objective To systematically review the efficacy and safety of glucocorticoids for severe COVID-19 and to provide references for the treatment strategy of severe COVID-19 patients. Methods PubMed, EMbase, The Cochrane Library, Web of Science, ClinicalTrials.gov, WanFang Data and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) that reported glucocorticoid therapy for severe COVID-19 patients from inception to August 26th, 2021. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.3 software. Results A total of 7 RCTs involving 6 236 patients were included. The meta-analysis results showed that compared with usual care, glucocorticoids significantly reduced the all-cause mortality of severe COVID-19 (RR=0.84, 95%CI 0.77 to 0.91, P<0.000 1), whereas no significant difference was found in the progression of complex diseases between the two groups (RR=0.84, 95%CI 0.69 to 1.01, P=0.06). Glucocorticoids did not increase adverse effects in severe COVID-19 compared with usual care (general adverse events: RR=1.15, 95%CI 0.66 to 2.03, P=0.62; serious adverse events: RR=1.13, 95%CI 0.54 to 2.38, P=0.75). Conclusion Current evidence suggests that glucocorticoids are effective in treating severe COVID-19 without significantly increasing adverse events. However, due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the conclusion.
Objective To explore the relationship between preoperative fasting plasma glucose (FPG) and postoperative pulmonary complications (PPCs) in type 2 diabetic patients undergoing elective thoracoscopic lung resection, and provide a reference for prediction and prevention of PPCs in the clinic. Methods A retrospective analysis was performed on the type 2 diabetic patients who underwent elective thoracoscopic lung resection for the first time in our hospital from January 2017 to March 2021. According to the level of FPG one day before the operation, the patients were divided into three groups: a hypoglycemia group (<6.1 mmol/L), a medium level blood glucose group (≥6.1 mmol/L and <8.0 mmol/L) and a high blood glucose group (≥8.0 mmol/L). Besides, the patients were divided into a PPCs group and a non-PPCs group according to whether PPCs occurred. The risk factors for PPCs were analyzed by logistic regression analysis, and the predictive value of preoperative FPG level on PPCs was estimated by the area under the receiver operating characteristic curve (AUC). Results A total of 130 patients were included, including 75 (57.7%) males and 55 (42.3%) females with an average age of 63.5±9.0 years. Logistic regression analysis showed that compared to non-PPCs patients, the level of preoperative FPG (P=0.023) and smoking history ratio (P=0.036) were higher and the operation time was longer (P=0.004) in the PPCs patients. High FPG level on preoperative day 1 and longer operation time were associated with PPCs risk. Besides, the preoperative FPG of 6.79 mmol/L was the threshold value to predict the occurrence of PPCs [AUC=0.653, 95%CI (0.559, 0.747), P=0.003]. Conclusion There is a certain correlation between preoperative FPG level and postoperative PPCs, which may be used as an index to predict the occurrence of PPCs.