Objective To investigate the influence of RNA interference targeting c-Jun gene on the proliferation of rat vascular smooth muscle cells (VSMCs). Methods The experiment was performed with c-Jun siRNA （c-Jun siRNA group）, control reverse sequence siRNA (control siRNA group) or no siRNA (control group). VSMCs were transfected with siRNA targeting c-Jun gene by liposome. Effects of c-Jun siRNA on mRNA and protein expressions of c-Jun were examined by RT-PCR analysis and Western blot respectively. MTT test and 3H-TdR incorporation were used to detect VSMCs proliferation. Cell cycle analysis of VSMCs in vitro was determined by flow cytometer. Results The expression levels of mRNA and protein of c-Jun in c-Jun siRNA group were significantly lower than those in control group （P＜0.05， P＜0.01). There was no significant difference between control group and control siRNA group （Pgt;0.05）. Proliferation activity of VSMCs decreased significantly in c-Jun siRNA group compared with that in control group （P＜0.05） and VSMCs was blocked in the G0/G1 phase of cell cycle significantly （P＜0.05）. There was no significant difference between control group and control siRNA group （Pgt;0.05）. Conclusion c-Jun gene silenced by RNA interference can inhibit VSMCs proliferation effectively in vitro.
Bone metastasis is one of the common complications of lung cancer, which seriously affects the quality of life and survival of patients. At present, the clinical diagnosis of bone metastasis of lung cancer mainly depends on imaging methods, but due to its lack of sensitivity and potential radiation risk, about half of patients have already had bone-related events when they are diagnosed clearly. The treatment of bone metastasis of lung cancer mainly depends on surgery, radiotherapy and chemotherapy, targeted therapy, immunotherapy, etc. Although the treatment of bone metastasis of lung cancer has made some progress in recent years, there are still some problems such as high risk of other distant metastasis. This article mainly reviews the pathogenesis, diagnostic biomarkers and treatment progress of bone metastasis of lung cancer, in order to provide reference for the diagnosis and treatment of bone metastasis of lung cancer.
Objective To explore the feasibility，safety and clinical applicability of combined complete thoracoscopicand laparoscopic esophagectomy for the treatment of esophageal carcinoma. Methods Clinical data of 34 patients with esophageal carcinoma who underwent combined complete thoracoscopic and laparoscopic esophagectomy in the Departmentof Thoracic Surgery of our hospital from January 2012 to June 2013 were analyzed retrospectively. There were 33 males and1 female with their age of 63 （41-76） years. Results One patient received conversion to laparotomy and 1 patient diedpostoperatively. Mean operation time was 362.1 （300-560） minutes，including 90.6 （60-220） minutes for thoracoscopicprocedure in 34 patients and 61.1 （45-85） minutes for laparoscopic procedure in 33 patients. Mean intraoperative blood loss was 206.5 （100-500） ml. Average number of dissected lymph nodes was 18.0 （13-31） for each patient with positivemetastatic rate of 44.1% （15/34）. Postoperative pathological diagnosis was squamous cell carcinoma in 33 patients and smallcell carcinoma in 1 patient. Postoperative pathological staging was stageⅠB in 1 patient，stageⅡA in 1 patient，stageⅡB in 15 patients，stageⅢA in 11 patients，stageⅢB in 3 patients and stageⅢC in 3 patients. Postoperative hospital stay was 15.2 （6-35） days. Two patients received bedside bronchoscopic sputum suction. Postoperative complications occurred in32.4% （11/34） of all patients，including pulmonary infection in 4 patients （11.8%），respiratory failure in 2 patients （5.9%），chylothorax in 1 patient （2.9%），cervical anastomotic leak in 4 patients （11.8%） and hoarseness in 2 patients （5.9%）. We followed up 33 patients for 1-16 months. Two died，Two were lost. The other 29 patients survived. Conclusion Combined complete thoracoscopic and laparoscopic esophagectomy is a minimally invasive，feasible and safe surgical procedure for the treatment of esophageal carcinoma with quick postoperative recovery，and is worthy of furtherclinical application.
ObjectiveTo evaluate the correlation between positive end-expiratory pressure (PEEP) level and postoperative pulmonary complications (PPCs) in patients undergoing thoracoscopic lung surgery. MethodsThe clinical data of patients who underwent elective thoracoscopic lung surgery at West China Hospital of Sichuan University from January 2022 to June 2023 were retrospectively analyzed. Patients were divided into 2 groups according to intraoperative PEEP levels: a PEEP 5 cm H2O group and a PEEP 10 cm H2O group. The incidence of PPCs in the two groups after matching was compared using a nearest neighbor matching method with a ratio of 1∶1, setting the clamp value as 0.02. ResultsA total of 538 patients were screened, and after propensity score-matching, a total of 229 pairs (458 patients) were matched, with an average age of 53.9 years and 69.4% (318/458) females. A total of 118 (25.8%) patients had PPCs during hospitalization after surgery, including 60 (26.2%) patients in the PEEP 5 cm H2O group and 58 (25.3%) patients in the PEEP 10 cm H2O group, with no statistically significant difference between the two groups [OR=0.997, 95%CI (0.495, 1.926), P=0.915]. Multivariate logistic regression analysis showed that PEEP was not an independent risk factor for PPCs [OR=0.920, 95%CI (0.587, 1.441), P=0.715]. ConclusionFor patients undergoing thoracoscopic lung surgery, intraoperative PEEP (5 cm H2O or 10 cm H2O) is not associated with the risk of PPCs during hospitalization after surgery, which needs to be further verified by prospective, large-sample randomized controlled studies.
目的 探討應用負壓輔助愈合治療系統（V.A.C. Therapy）在胸、腹、背部斷層皮片游離移植術后加壓固定的有效性。 方法 2010年10月－2011年10月，應用V.A.C. Therapy加壓固定游離斷層皮片修復21例胸、腹、背部皮膚軟組織缺損患者。男15例，女6例；年齡21～63歲，平均43歲。其中瘢痕切除后創面13例，皮瓣切取后供瓣區形成的創面8例。創面位于胸部7例，腹部9例，背部5例。皮膚及軟組織缺損范圍12 cm×10 cm～18 cm×15 cm。游離移植的斷層皮片厚度為0.6 mm，在缺損部位移植斷層皮片后，使用V.A.C. Therapy固定皮片，壓力范圍100～125 mm Hg （1 mm Hg=0.133 kPa）。 結果 住院時間19～32 d，平均24 d。21例植皮均成活，受區創面Ⅰ期愈合；供皮區創面Ⅰ期愈合。隨訪時間6～12個月，平均8個月。游離移植皮膚色澤與周圍皮膚色澤相似，無破潰，無明顯凹陷。 結論 應用V.A.C. Therapy加壓固定的游離斷層皮片，成活率高，效果可靠，是一種安全實用的固定方法。
ObjectiveTo investigate the effects of rehabilitation exercise on exercise tolerance and cardiovascular risk factors in patients with non-acute coronary syndrome (non-ACS) after interventional therapy.MethodsA total of 102 patients with coronary heart disease and non-ACS in our hospital from December 2018 to June 2019 were selected and randomly divided into a control group (n=51, 30 males and 21 females with an average age of 56.1±4.8 years) and a trial group (n=51, 34 males and 17 females with an average age of 55.1±4.9 years). The control group received routine treatment, while the trial group received regular supervised rehabilitation exercise on the basis of routine treatment. Patients were followed up for 6 months to compare the differences in cardiovascular risk factors (blood pressure, blood lipid, fasting blood glucose), 6-minute walking distance (6MWD), adverse lifestyle changes and treatment compliance between the two groups after treatment.ResultsThe difference of 6MWD between the two groups was statistically significant (P<0.05). In the trial group, 6MWD increased after intervention compared with that before intervention, and the difference was statistically significant (P<0.05). Comparison of total cholesterol (TC), high density liptein cholesterol (HDL-C), low density liptein cholesterol (LDL-C) and fasting blood glucose in the trial group before and after intervention showed statistically significant differences (P<0.05). The differences in TC, HDL-C and LDL-C in the control group before and after intervention were statistically significant (P<0.05). It was statistically significant in dietary compliance rate, smoking cessation rate and alcohol cessation rate between the two groups (P<0.05); the differences in the dietary compliance and drug compliance of the trial group before and after intervention were statistically significant (P<0.05).ConclusionRegular supervised rehabilitation exercise can significantly improve the exercise tolerance and cardiovascular risk factors of non-ACS patients after coronary intervention treatment, so as to improve the quality of life and long-term prognosis of non-ACS patients, which is worthy of clinical application.
Objective To explore the pain after discharged in patients with radical total gastrectomy under painless ward management, and to analyze the causes of pain in order to guide the treatment strategy after discharge. Methods Retrospective analysis was performed on the pain data of 82 patients who underwent radical total gastrectomy in The First Affiliated Hospital of Air Force Military Medical University from December 2015 to April 2017, and the situation of pain was followed-up at 2 weeks, 1 month, 2 months, and 3 months after discharged. Results Mild pain occurred in 25 patients at the 2 weeks after discharged; mild pain occurred in 38 patients and moderate pain occurred in7 patients at the first month after discharged; mild pain occurred in 31 patients and moderate pain occurred in 4 patients at the second month after discharged; 19 patients had mild pain at the third month after discharged. There was no significant difference in pain scores between male patients and female patients, <60 years old patients and ≥60 years old patients, patients’ operative time<180 min and patients’ operative time ≥180 min, patients’ intraoperative blood loss<200 mL and patients’ intraoperative blood loss ≥200 mL at the all time points, including the second week, the first, the second, and the third month after discharge ( P>0.05). Conclusion Painless ward management can effectively control the degree of pain in discharged patients who underwent radical total gastrectomy.
Objective To investigate the efficacy and safety of the ketogenic diet (KD) treatment in refractory epilepsy (RE) with myoclonic seizures as the predominant seizure type. Methods Clinical data were collected from 34 pediatric patients with RE characterized by myoclonic seizures who underwent KD treatment at the Department of Neurology, Jinan Children's Hospital from January 2021 to October 2023. The classic KD protocol was applied, and seizure frequency and adverse reactions were monitored at 1, 3, and 6 months post-treatment. Results Among the 34 patients, intention-to-treat (ITT) analysis revealed seizure-free rates of 11.8%, 17.6%, and 14.7% at 1, 3, and 6 months KDT, respectively. Seizure control response rates were 41.2%, 52.9%, and 38.2%. Proximal protocol (PP) analysis showed the KDT treatment achieved seizure-free rates of 11.8%, 25%, and 5% at 1, 3, and 6 months, respectively, with seizure control efficacy rates of 41.2%, 75%, and 86.7%. Subgroup analysis: Among 34 patients, 16 had epilepsy syndrome (ES) and 18 had myoclonic epilepsies (MEs). Comparing efficacy rates, the ES group showed significantly higher efficacy than the MEs group at 1 month (P=0.045), with no significant differences observed at 3 or 6 months. Adverse reactions occurred in some patients: 6 developed gastrointestinal adverse events, 2 experienced somnolence, and 2 had urinary system adverse reactions during KD treatment. Conclusion KD treatment is an effective treatment for RE with predominant myoclonic seizures. Short-term application demonstrates good safety, but adherence issues require attention.
Objective To investigate the effects of long time different negative pressures on osteogenic diffe-rentiation of rabbit bone mesenchymal stem cells (BMSCs). Methods The rabbit BMSCs were isolated and cultured by density gradient centrifugation. Flow cytometry was used to analyze expression of surface markers. The third passage cells cultured under condition of osteogenic induction and under different negative pressure of 0 mm Hg (control group), 75 mm Hg (low negative pressure group), and 150 mm Hg (high negative pressure group) (1 mm Hg=0.133 kPa), and the negative pressure time was 30 min/h. Cell growth was observed under phase contrast microscopy, and the growth curve was drawn; alkaline phosphatase (ALP) activity was detected by ELISA after induced for 3, 7, and 14 days. The mRNA and protein expressions of collagen type I (COL-I) and osteocalcin (OC) in BMSCs were analyzed by real-time fluorescence quantitative PCR and Western blot. Results The cultured cells were identified as BMSCs by flow cytometry. The third passage BMSCs exhibited typical long shuttle and irregular shape. Cell proliferation was inhibited with the increase of negative pressure. After induced for 4 days, the cell number of high negative pressure group was significantly less than that in control group and low negative pressure group (P<0.05), but there was no significant difference between the low negative pressure group and the control group (P>0.05); at 5-7 days, the cell number showed significant difference between 3 groups (P<0.05). The greater the negative pressure was, the greater the inhibition of cell proliferation was. There was no significant difference in ALP activity between groups at 3 days after induction (P>0.05); the ALP activity showed significant difference (P<0.05) between the high negative pressure group and the control group at 7 days after induction; and significant difference was found in the ALP activity between 3 groups at 14 days after induction (P<0.05). The greater the negative pressure was, the higher the ALP activity was. Real-time fluorescence quantitative PCR and Western blot detection showed that the mRNA and protein expressions of COL-I and OC protein were significantly higher in low negative pressure group and high negative pressure group than control group (P<0.05), and in the high negative pressure group than the low negative pressure group (P<0.05). Conclusion With the increase of the negative pressure, the osteogenic differentiation ability of BMSCs increases gradually, but the cell proliferation is inhibited.