ObjectiveTo study the local vascular remodeling, inflammatory response, and their correlations following acute spinal cord injury (SCI) with different grades, and to assess the histological changes in SCI rats.MethodsOne hundred and sixteen adult female Sprague Dawley rats were randomly divided into 4 groups (n=29). The rats in sham group were received laminectomy only. A standard MASCIS spinal cord compactor was applied with drop height of 12.5, 25.0, or 50.0 mm to establish the mild, moderate, or severe SCI model, respectively. Quantitative rat endothelial cell antigen 1 (RECA1) and CD68 positive areas and the correlations were studied by double immunofluorescent (DIF) staining at 12 hours, 24 hours, 3 days, 7 days, and 28 days following SCI. Moreover, qualitative neurofilament-H (NF-H) and glial fibrillary acidic protein (GFAP) positive glial cells were studied by DIF staining at 28 days. ELISA was used to detect the levels of tumor necrosis factor α (TNF-α), interleukin 1β (IL-1β), and IL-6 in spinal cord homogenates at 12 hours, 24 hours, and 3 days, and the correlations between TNF-α, IL-1β, or IL-6 levels and microvascular density (RECA1) were accordingly studied. Moreover, the neural tissue integrity and neuron damage were assessed by HE staining at 12 hours, 24 hours, 3 days, 7 days, and 28 days, and Nissl’s staining at 28 days following SCI, respectively.ResultsDIF staining revealed that the ratio of RECA1 positive area was the highest in moderate group, higher in mild and severe groups, and the lowest in sham group with significant differences between groups (P<0.05). The ratio of CD68 positive area was the highest in severe group, higher in moderate and mild groups, and the lowest in sham group with significant differences between groups (P<0.05), except the comparisons between mild and moderate groups at 24 hours and 28 days after SCI (P>0.05). There was no significant correlation between the RECA1 and CD68 expressions in sham group at different time points (P>0.05). At 12 and 24 hours after SCI, the RECA1 and CD68 expressions in mild and moderate groups showed significant positive correlations (P<0.05), while no significant correlation was found in severe group (P>0.05). No significant correlations between the RECA1 and CD68 expressions was shown in all SCI groups at 3 days and in severe group at 7 days (P>0.05), while the negative correlations were shown in mild and moderate groups at 7 days, and in all SCI groups at 28 days (P<0.05). In mild, moderate, and severe groups, the axons became disrupted, shorter and thicker rods-like, or even merged blocks with increased injury, while the astrocytes decreased in number, unorganized and condensed in appearance. ELISA studies showed that TNF-α, IL-1β, and IL-6 levels in sham group were significantly lower than those in other 3 groups at different time points (P>0.05). The differences in TNF-α, IL-1β, and IL-6 levels between SCI groups at different time points were sinificant (P<0.05), except IL-1β levels between the mild and moderate groups at 12 hours (P>0.05). Three inflammatory factors were all significantly correlated with the microvascular density grades (P<0.05). Histological analysis indicated that the damage to spinal cord tissue structure correlated with the extent of SCI. In severe group, local hemorrhage, edema, and infiltration of inflammatory cells were found the most drastic, the grey/white matter boundary was disappeared concurrently with the formation of cavity and shortage of normal neurons.ConclusionIn the acute stage following mild or moderate SCI, progressively aggravated injury result in higher microvessel density and increased inflammation. However, at the SCI region, the relation between microvessel density and inflammation inverse with time in the different grades of SCI. Accordingly, the destruction of neural structures positively relate to the grades of SCI and severity of inflammation.
Objective To investigate the clinical significance and expression of T helper cell secretory cytokines in esophageal squamous cell carcinoma tissues, which provide theoretical basis of reasonable and effective therapy for patients with esophageal carcinoma. Methods Fifty-six specimens of patients who underwent esophageal carcinoma resection were divided into two groups. Group A (n=28) included grade Ⅰand Ⅱ specimens of esophageal squamous cell carcinoma, group B (n=28) included grade Ⅲ and Ⅳ specimens of esophageal squamous cell carcinoma. Control group included 6 specimens of esophagitis. The expression of tumor necrosis factor alpha (TNF-α), interleukin 10 (IL-10) and transforming growth factor beta (TGF-β) in all specimens were detected. Results The positive expression of TNF-α,TGF-β and IL-10 in group A and group B were significantly higher than those in control group(Plt;0.01); the positive expression of TNF-α in group A was higher than that in group B, while the positive expression of TGF-β and IL-10 were lower than those in group B (Plt; 0.01). There was negative correlation between the positive expression of TNF-α and IL-10, TGF-β(Plt;0.01), and positive correlation between TGF-β and IL-10 (Plt; 0.01). The positive expression of TNF-α in patients of survival period in 3 years was lower than that exceed 3 years(F=36.25 ,Plt;0.01),while the positive expression of IL-10 and TGF-β in the patients of survival period in 3 years were higher than those exceed 3 years(F=29.29,26.69;Plt;0.01). Conclusion By the way of changing the level of cytokines secretion from T helper cells, esophageal squamous cell carcinoma tissues destroyed the balanced condition of patient’s immune system, which made esophageal carcinoma tissues escape the attack from the patient’s immune system and promote the invasion into surrounding tissues.
ObjectiveTo investigate the feasibility and safety of non-intubation anesthesia in thoracic surgery.MethodsFrom September 2017 to December 2019, 296 patients were operated at department of thoracic surgery in our hospital. There were 167 males and 129 females with an average age of 50.69±12.95 years, ranging from 16 to 76 years. The patients were divided into two groups according to whether they were intubated: 150 patients were in a non-intubation group, including 83 males and 67 females with an average age of 49.91±13.59 years, ranging from 16 to 76 years, and 146 patients were in an intubation group including 84 males and 62 females with an average age of 51.49±12.26 years, ranging from 16 to 74 years. Intraoperative data, postoperative recovery, inflammatory response of the two groups were compared.ResultsThere was no statistical difference between the two groups in operation time, blood loss, the lowest oxygen saturation or other indicators (P>0.05). But the highest partial pressure of carbon dioxide of the non-intubation group was higher than that of the intubation group (P=0.012). The non-intubation group was superior to the intubation group in postoperative recovery and inflammatory response (P<0.05).ConclusionThe non-intubation anesthesia is safe and maneuverable in thoracic surgery, and it has some advantages in accelerating postoperative rehabilitation.
Objective To explore the accuracy of contrast-enhanced magnetic resonance imaging (MRI) in predicting pathological complete remission (pCR) in breast cancer patients after neoadjuvant therapy (NAC). Methods The clinicopathological data of 245 patients with invasive breast cancer who had completed the surgical resection after NAC in the Affiliated Hospital of Southwest Medical University from March 2020 to April 2022 were collected retrospectively. According to the results of hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) detected by immunohistochemistry, all patients were divided into four subgroups: HR+/HER2–, HR+/HER2+, HR–/HER2+ and HR–/HER2–. The value of MRI in evaluating the efficacy of NAC was analyzed by comparing the postoperative pathological results as the gold standard with the residual tumor size assessed by preoperative MRI. Meanwhile, the sensitivity, specificity and positive predictive value (PPV) of pCR predicted by the evaluation results of enhanced MRI were analyzed, and further analyzed its predictive value for pCR of different subtypes of breast cancer. Results There were 88 cases (35.9%) achieved radiological complete response (rCR) and 106 cases (43.3%) achieved pCR in 245 patients. Enhanced MRI in assessing the size of residual tumors overestimated and underestimated 12.7% (31/245) and 9.8% (24/245) of patients, respectively. When setting rCR as the MRI assessment index the specificity, sensitivity and PPV were 84.2% (117/139), 62.3% (66/106) and 75.0% (66/88), respectively. When setting near-rCR as the MRI assessment index the specificity, sensitivity and PPV were 70.5% (98/139), 81.1% (86/106), and 67.7% (86/127), respectively. The positive predictive value of both MRI-rCR and MRI-near-rCR in evaluating pCR of each subtype subgroup of breast cancer was the highest in the HR–/HER2+ subgroup (91.7% and 83.3%, respectively). In each subgroup, compared with rCR, the specificity of near-rCR to predict pCR decreased to different degrees, while the sensitivity increased to different degrees. Conclusions Breast contrast-enhanced MRI can more accurately evaluate the efficacy of localized breast lesions after NAC, and can also more accurately predict the breast pCR after NAC. The HR–/HER2+ subgroup may be a potentially predictable population with pCR exemption from breast surgery. However, the accuracy of the evaluation of pCR by breast enhancement MRI in HR+/HER2– subgroup is low.
Objective To study the inflammation response and the biocompatibil ity of valved bovine jugular vein conduit (BJVC) and valved bovine jugular vein patch (VBJV-P) in treating complex congenital heart disease (CHD). Methods From December 2007 to March 2008, 16 patients with complex CHD were treated. Of 16 patients, 6 underwent conjunction right ventricular to pulmonary artery with BJVC and broaden right ventricular outflow tract (RVOT) with VBJV-P (BJVC group), and 10 underwent broaden RVOT with self pericardial patch (control group). In BJVC group, there were 3 males and 3 females, aging (5.6 ± 3.6) years, and including 1 case of type I truncus arteriosus, 1 case of type I truncus arteriosus with ventricular septal defect and patent foramen ovale, 1 case of congenital pulmonary atresia with ventricular septal defect and patent arterial duct, and 3 cases of Fallot’s tetrad. In control group, there were 5 males and 5 females, aging(4.3 ± 3.1) years, all being Fallot’s tetrad. The periphery vein blood of the two groups was collected during operation and after operation, and the levels of cytokine were detected with ELISA method. Meanwhile the cl inical data of the two groups were collected. Results There were no significant differences at levels of TNF-α and IL-6 between BJVC group and control group 1 week after operation (P gt; 0.05), and there was significant difference at level of IL-10 [(25.7 ± 5.0) pg/mL vs (19.5 ± 4.7) pg/ mL, P lt; 0.05]. There were no significant differences at levels of IL-6 and IL-10 within groups both in control group and in BJVC group (P gt; 0.05) between 1 week after operation and the anesthesia inducing period. And there was significant difference at level of TNF-α in BJVC group [(77.0 ± 1.6) pg/mL vs (82.9 ± 1.3) pg/mL, P lt; 0.05] and in control group [(78.6 ± 3.4) pg/mL vs (83.1 ± 1.9) pg/mL, P lt; 0.05] between 1 week after operation and the anesthesia inducing period. There were no statistically significant differences (P gt; 0.05) in leukocyte count and body temperature between BJVC group and control group. The X-ray films showed no abnormal ity in BJVC group and control group before operation and after operation. No hepatic and renal dysfunction occurred in control group; and 2 patients had hepatic dysfunction, which may be caused by antibiotics. Conclusion BJVC has a good biocompatibil ity in treating complexty CHD.
Objective To analyze the protective effects of heat-shock response on the retinae of the rats after retinal ischemic reperfusion injury.Method Twenty Wistar rats (20 eyes) were divided into 4 groups: intracameral perfusion group (group P), intracameral perfusion after quercetin injection group (group P+Q), intracameral perfusion after heat shock group (group P+H), and in tracameral perfusion after quercetin injection and heat shock group (group P+Q+H ). According to the standard program established by International Society for Clinical Visual Electrophysiology, we recorded the results of the dark-adapted electroretinogram (D-ERG ),oscillatory potentials (OPs),and light-adapted ERG (L-ERG) of the rats with intraocular hypertension after induced by heat shock response. The expressions of HSP 70 of the rats in all groups were observed by Western blotting.Results The expression of HSP 70 of the rats in group P+H was the highest in all groups, but the expressions of HSP70 in group P+Q and P+Q+H were inhibited significantly. The amplitudes of a and b wave of ERG and O2 wave of OPs decreased, and the delitescence of them were delayed significantly in rats after intracameral perfusion. The amplitude of b wave of D-ERG and O2 wave of OPs in group P+H were higher than which in group P. Zero hour after perfusion, the amplitudes of all waves in group P+H increased significantly (Plt;0.05). Twenty-four hours after perfusion, the retinal functional resumption of the rats in group P+H was better than which in group P. In group P+Q and P+Q+H, the delitescences of all waves of ERG and O2 wave of OPs were the longest and the amplitudes were the lowest, and some waves even disappeared.Conclusions The heat-shock response may improve the recovery ability of the retinal cells after injury of ischemic reperfusion.(Chin J Ocul Fundus Dis，2003，19：117-120)
【Abstract】ObjectiveTo explore the mechanisms of anabolism intensified by recombination human growth hormone (GH) on the basis of total parenteral nutrition (TPN) during postoperative in gastrointestinal carcinoma patients. MethodsNinety-four gastrointestinal carcinoma patients undergone operation were randomly divided into TPN group and TPN+GH group. The levels of TNF-α, IL-1, IL-6 and CRP were detected in the first, third, seventh postoperative day. ResultsThe levels of TNF-α, IL-1, IL-6 and CRP were significantly lower in TPN+GH group than those in the TPN group at the first, third, seventh postoperative day （P＜0.01）. The levels of TNF-α, IL-1, IL-6 and CRP were significantly higher at the indicated time of postoperative days than the pre-operative days in the two groups (P＜0.01）. ConclusionBy inhibiting TNF-α, IL-1, IL-6 and CRP production in gastrointestinal carcinoma patients undergone operation and blocking high catabolism induced by inflammatory cytokines, GH promotes the synthesis of anabolism.
Acute pancreatitis is a common and critical disease in clinical practice, and clinical treatment has formed a multidisciplinary and collaborative model of traditional Chinese and Western medicine. However, its etiology and pathogenesis are complex and varied, and immune response is crucial in the occurrence and development of the disease. Therefore, based on the thinking of the pathological and physiological basis of immune response in the different stages of acute pancreatitis disease progression and related complications, and based on the biological characteristics and laws of the disease, this article summarizes a reasonable and phased implementation of Chinese and Western medicine collaborative management strategy, which is proposed to achieve optimal and precise treatment of the disease.
In order to characterize the characteristics of pathological tremor of human upper limb, a simulation system of pathological tremor of human arm was provided and its dynamic response was analyzed. Firstly, in this study, a two-degree-of-freedom human arm dynamic model was established and linearized according to the arbitrary initial angle of joints. After solving the analytical solutions of steady-state responses of the joints, the numerical solution was used to verify it. The results of theoretical analysis show that the two natural frequencies of the developed dynamic model are 2.9 Hz and 5.4 Hz, respectively, which meet the characteristic frequency range of pathological tremors. Then, combined with the measured parameters of human arm, a tremor simulation system was built, and the measured results of joint responses are in good agreement with the theoretical and simulation analysis results, which verifies the effectiveness of the theoretical model. The results show that the human arm pathological tremor simulation system designed in this paper can characterize the frequency and response amplitude of the human upper limb pathological tremor. Moreover, the relevant research lays a theoretical foundation and experimental conditions for the subsequent development of wearable tremor suppression devices.
Although great progress has been achieved in the techniques and materials of cardiopulmonary bypass (CPB), cardiac surgery under CPB is still one of the surgeries with the highest complication rate. The systemic inflammatory response is an important cause of complications, mainly characterized by activation of innate immune cells and platelets, and up-regulation of inflammatory cytokines. After activation, a variety of molecules on the membrane surface are up-regulated or down-regulated, which can amplify tissue inflammatory damage by releasing cytoplasmic protease and reactive oxygen species, and activate multiple inflammatory signaling pathways in the cell, ultimately leading to organ dysfunction. Therefore, the expression of these cell membrane activation markers is not only a marker of cell activation, but also plays an important role in the process of vital organ injury after surgery. Identification of these specific activation markers is of great significance to elucidate the mechanisms related to organ injury and to find new prevention and treatment methods. This article will review the relationship between these activated biomarkers in the innate immune cells and vital organ injuries under CPB.