[A prospective study of the perforator evaluation and eccentric design of anterolateral thigh flap based on superficial fascial perforators assisted by modified computed tomography angiography]

Objective: To explore the preoperative whole perforator evaluation and intraoperative eccentric design of anterolateral thigh flap (ALTF) based on superficial fascial perforators by modified computed tomography angiography (CTA), and the clinical effects were observed. Methods: A prospective observational study was adopted. Twelve patients with oral and maxillofacial tumors and 10 patients with open injury of the upper limb with large soft tissue defects were hospitalized in the Department of Hand & Microsurgery and Department of Oral & Maxillofacial Surgery of Affiliated Hospital of Binzhou Medical University from January 2021 to July 2022, with 12 males and 10 females, aged from 33 to 75 years, an average age of 56.6 years. The wounds of the patients with oral and maxillofacial tumors were reconstructed by ALTF after the extensive tumor resection and radical cervical lymph node dissection in the same stage; the wounds of the patients with skin and soft tissue defect on the upper limb were covered by ALTF in stage Ⅱ after debridement in stage Ⅰ. After debridement, the area of wound was 3.5 cm×3.5 cm-25.0 cm×10.0 cm and the area of the required flap area was 4.0 cm×4.0 cm-23.0 cm×13.0 cm. Modified CTA scan was performed on the donor site of ALTF before the operation, with the parameters of modified CTA being set to mainly reduce the tube voltage and tube current, and increase the contrast dose and the dual phase scan. The acquired image data were sent to GE AW 4.7 workstation and adopted the volume reconstruction function for visual reconstruction and evaluation of the whole perforator. The information of perforator and source artery was marked on the body surface before operation according to the above evaluation. During the operation, an eccentric flap centered on the visible superficial fascia whole perforator was designed and cut according to the desired flap area and shape. The donor sites of the flap were repaired by direct sutures or full-thickness skin grafts. The total radiation dose was compared between the modified CTA scan and the traditional CTA scan. The distribution of outlet point of perforator of double thighs, the length and direction of superficial fascia perforators based modified CTA were recorded. The type, number, and origin of the target perforator, distribution of of outlet point of perforator, and the diameter, course, and branch of the source artery observed before the operation were compared with those observed during the operation. The healing of donor site wound and the survival of flaps in recipient site were observed after operation. The texture and appearance of flap, oral and upper limb functions, and the functions of femoral donor sites were followed up. Results: The total radiation dose of modified CTA scan was lower than that of the traditional CTA scan. A total of 48 perforators of double thighs were observed, among which, 31 (64.6%) perforators went outward and downward, 9 (18.8%) perforators went inward and downward, 6 (12.5%) perforators went outward and upward, and 2 (4.2%) perforators went inward and upward, and the average length of superficial fascia perforators was 19.94 mm. The preoperative observed type, number, and source of the perforator, the distribution of the outlet point of the perforator, diameter, course, and branches of the source artery were basically consistent with the intraoperative exploration. The types of 15 septocutaneous (including musculoseptocutaneous) perforators and 10 musculocutaneous perforators observed before the operation was consistent with intraoperative exploration. The distance between the mark of the surface perforator point and the actual exit point of the perforator during operation was (0.38±0.11) mm. All flaps survived without vascular crisis. The donor site wounds of 5 cases of skin grafting and 17 cases of direct suturing wounds healed well. The postoperative follow-up was 2 months to 1 year, with an average of 8.2 months, the flaps were soft and slightly bloated; the function of diet and mouth closing was accessible in patients with oral and maxillofacial tumors, the speech function was mildly impaired in patients with tongue cancer, but they could complete basic oral communication; the wrist and elbow joints and forearm rotation function were not significantly limited in patients with upper limb soft tissue injuries; there was no obvious tightness in the donor sites, and the function of the hip and knee joints was not limited. Conclusions: The whole perforator and even the subcutaneous perforator of the donor site of ALTF can be evaluated by modified CTA, and the flap can be used in oral or maxillofacial reconstruction and repair of skin and soft tissue defects of upper limbs to achieve good results. By clarifying the type, number, and source of the perforator, the distribution of the outlet point of the perforator, diameter, course, and branches of the source artery before the operation, the eccentric design of the ALTF based on the superficial fascia perforator was realized. This study has strong guiding value.

[MRI/TRUS cognitive fusion combined with 12-core systematic transperineal prostate biopsy for the diagnosis of clinically significant prostate cancer: A report of 208 cases]

OBJECTIVE

To investigate the detection rate and complications of magnetic resonance imaging / transrectal ultrasonography (MRI/TRUS) cognitive fusion combined with 12-core systematic transperineal prostate biopsy (TPPB) in the diagnosis of clinically significant PCa (CS-PCa).

METHODS

This retrospective study included 208 patients undergoing first-time MRI/TRUS cognitive fusion combined with 12-core systematic TPPB from June 2015 to May 2019. The patients, aged 54－85 (67.6 ± 7.8) years, all received digital rectal examination, PSA detection, TRUS and prostate multiparametric MRI (mpMRI) before biopsy. We analyzed the mpMRI images, identified and marked the suspected signal areas, repeated TRUS for further observation of the prostate, conducted cognitive fusion based on the mpMRI images and determined the target before 12-core systematic TPPB and subjecting the samples obtained to pathological examination.

RESULTS

Of the 208 patients, 112 were diagnosed with CS-PCa (no case with tPSA < 4 μg/L, 21 cases with 4 μg/L ≤ tPSA < 10 μg/L, 47 cases with 10 μg/L ≤ tPSA < 20 μg/L, 40 cases with 20 μg/L ≤ tPSA < 100 μg/L, and 4 cases with tPSA ≥ 100 μg/L), 85 with BPH, 8 with chronic prostatitis, 2 with atypical prostatic hyperplasia, and 1 with prostatic intraepithelial neoplasia. Systemic inflammatory response syndrome occurred in 3 and gross hematuria and/or bloody stool in 12 cases after biopsy, which were all cured by anti-infection and hemostasis treatment.

CONCLUSIONS

MRI/TRUS cognitive fusion combined with 12-core systematic transperineal prostate biopsy can improve the detection rate of the initial diagnosis of clinically significant PCa with a low incidence of controllable complications.

[WGCNA screening of prognostic markers in medulloblastoma]

Objective: In this study, we used the Weighted gene co-expression network analysis (WGCNA) analysis to find the gene module that are specifically expressed in Medulloblastoma and screened the marker genes that may diagnose and treat Medulloblastoma. Methods: WGCNA was used to identify the gene modules that are specifically associated with suvival in Medulloblastoma. Cytoscape software was used to construct Co-expression Network. Survival analysis of hub genes using Kaplan Meier (KM) analysis method. Results: Based on the predicted co-expression network, we found that green module significantly associated with survival traits. Green module genes were analyzed and we identified the hub gene UBE2G1 by cytoscape software which have the most correlation with survival trait. Conclusions: Our results indicate that UBE2G1 may be served as a candidate diagnostic biomarker and a promising therapeutic target for Medulloblastoma.

[Study on the causes, prevention and treatment of complications after transsphenoidal pituitary tumor resection under neuroendoscope]

Objective: To analyze the causes of complications after endoscopic transsphenoidal pituitary adenoma resection and summarize the corresponding prevention and treatment measures. Methods: The pathological data of 120 patients with pituitary adenoma in hospital were analyzed retrospectively. All patients were treated surgically, five kinds of common complications were collected, the risk factors of complications were statistically analyzed, the causes of postoperative complications were determined, and then the specific prevention and treatment strategies were summarized. Results: Long operation time (P<0.05), hypopituitarism before operation (P<0.01) and large tumor (P<0.01) were the main inducing factors of CSF rhinorrhea after operation; long operation time (OR=1.394, P<0.01), lumbar cistern puncture (OR=1.531, P<0.01) and CSF rhinorrhea after operation (OR=3.861, P<0.01) were the independent risk factors of infection; Age, large tumor and preoperative hypophysis are the main factors of postoperative hypophysis; Postoperative hypophysis and intraoperative cerebrospinal fluid rhinorrhea are the main factors of postoperative diabetes insipidus; Postoperative hypophysis and giant adenoma are the main factors of postoperative hyponatremia. Conclusion: Endoscopic transnasal transsphenoidal resection of pituitary adenoma is the most minimally invasive method at present. There are still risk factors for postoperative complications. Targeted prevention of risk factors for complications and corresponding interventions can effectively reduce the incidence of postoperative complications of pituitary adenoma.

[Analysis of needlestick injuries and depression among the female medical staff in a city district in 2018]

Objective: To investigate needlestick injuries and depression among the female medical staff in a city district. Methods: Using cross-sectional survey methods, female medical staff from selected sixteen hospitals voluntarily participated in questionnaire survey on APP of mobile phone. They Data were uploaded assessment platform, saved by Excel, and analysed by SPSS 22.0 statistical software. Results: The lasted year, Incidence of needlestick injuries was 11.28%. Incidence of needlestick injuries was respectively 5.2%, 9.1% and 16.3% in Class-I hospital, Second-class Hospital and three levels of hospitals(χ(2)=28.900, P<0.01). And 6.3% Resting no more than 10 days of Incidence of needlestick injuries was 12.5%, others was 6.3%.Night shift no more than 5 days of Incidence of needlestick injuries was 8.5%, others was 15.1%. The rate of not less than 14 of BDI was respectively 18.6%, 29.1% and 32.7% in Class-I hospital, Second-class Hospital and three levels of hospitals (χ(2)=23.843, P<0.01). In recent one year, the rate of medical staff who have taken annual leave less than 10 days and higher than 10 days scoring over 14 in the Beck(Beck depression inventory, BDI) survey are respectively 29.1% and 17.8% (χ(2)=10.710, P<0.01). In recent one year, the rate of medical staff who worked in night shift less than 5 days and higher than 5 days each month scoring over 14 in the Beck survey are respectively 23.5% and 31.7%(χ(2)=8.886, P<0.01). In recent one year, the rate of medical staff who had needle injury and non-needle injury scoring over 14 in the Beck survey are respectively 35% and 25%(χ(2)=4.782, P<0.05). Conclusion: The needle injury rate, high score rate in Beck survey among the medical staff increased when the level of the hospital they worked for increased. Medical staff should improve their method of rest.

Inhibition of PRRX2 suppressed colon cancer liver metastasis via inactivation of Wnt/β-catenin signaling pathway

The aim of this study was to investigate whether PRRX2 may regulate the liver metastasis of colon cancer via the Wnt/β-catenin signaling pathway. PRRX2 and β-catenin in patients with the liver metastases of colon cancer was detected by immunochemistry. Colon cancer cells (CT-26 and CMT93) were divided into Normal, si-Ctrl, si-PRRX2 and si-PRRX2 +LiCl groups. Cell invasive and migrating abilities and the related proteins were detected. Liver-metastatic mice model was constructed consisting of Normal, NC shRNA and PRRX2 shRNA groups to examine the function of PRRX2 shRNA on liver metastasis. We found that PRRX2 and β-catenin positive rate was elevated in colon cancer tissues, especially in those tissues with liver metastasis, and there was a close relation between PRRX2 and the clinical staging, lymph node metastasis and numbers of liver metastases of colon cancer patients with liver metastasis. In vitro, the invasive and migrating abilities of CT-26 and CMT93 cells decreased apparently in the si-PRRX2 group, with down-regulation of PRRX2, p-GSK3β^Ser9/GSK3β, nucleus and cytoplasm β-catenin, TCF4 and Vimentin but up-regulation of E-cadherin. However, LiCl, the Wnt/β-catenin pathway activator, can reverse the inhibitory effect of si-PRRX2 on invasive and migrating ability of colon cancer cells. In vivo, the volume and weight of transplanted tumor and the number of liver metastases in the PRRX2 shRNA group were significantly reduced, with the similar protein expression patterns as in vitro. In a word, PRRX2 inhibition may reduce invasive and migrating abilities to hinder epithelial-mesenchymal transition (EMT), and suppress colon cancer liver metastasis through inactivation of Wnt/β-catenin pathway.

Scale law of complex deformation transitions of nanotwins in stainless steel

Understanding the deformation behavior of metallic materials containing nanotwins (NTs), which can enhance both strength and ductility, is useful for tailoring microstructures at the micro- and nano- scale to enhance mechanical properties. Here, we construct a clear deformation pattern of NTs in austenitic stainless steel by combining in situ tensile tests with a dislocation-based theoretical model and molecular dynamics simulations. Deformation NTs are observed in situ using a transmission electron microscope in different sample regions containing NTs with twin-lamella-spacing (λ) varying from a few nanometers to hundreds of nanometers. Two deformation transitions are found experimentally: from coactivated twinning/detwinning (λ < 5 nm) to secondary twinning (5 nm < λ < 129 nm), and then to the dislocation glide (λ > 129 nm). The simulation results are highly consistent with the observed strong λ-effect, and reveal the intrinsic transition mechanisms induced by partial dislocation slip.

[An analysis of the evaluation results of symptom checklist 90 for occupational females in different industries]

Objective: To evaluate the mental health of occupational females in different industries. Methods: We investigated the psychologic status of Chinese occupational females using symptom checklist 90. And statistical software was applied to analyze results of symptom checklist 90. Results: There were 41, 166 effec-tive questionnaires. The number of positive questionnaires was 14 361, and the positive rate was 34.89%. The positive rate of obsessive-compulsive factor was 24.07%. The positive rate of somatization factor was 16.12%. The positive rate of depression was 15.50%. The median positive item number was 20 (IQR: 34) , and the median split of positive symptoms was 2.11 (IQR: 0.37) . There were differences in the positive rate of SCL-90 scale among different age groups, different regions and different industries, the difference was statistically significant (P<0.05) . The positive rate of SCL-90 for the occupational females was 34.89%. The top three factors of the high-est positive SCL-90 were obsessive-compulsive symptoms, somatization and depression. Conclusion: There were differences in the psychological status of occupational females for different regions, different ages and different occupations.

[Prevalence of reproductive system diseases among female workers in a city and related occupational influencing factors: an analysis of 9944 cases]

Objective: To investigate the prevalence of reproductive system diseases among female workers in a city and related occupational influencing factors. Methods: From June to September, 2016, a cross-sectional survey was used to select 9 944 female workers from six districts of Beijing and then a face-to-face questionnaire survey was performed. Univariate analysis using chi-square test and multivariate logistic regression analysis were used to investigate the risk factors for reproductive system diseases. Results: The age of 9944 female workers ranged from 18 to 65 years (mean 35.53±9.52 years) , and among them, 7 351 (73.92%) were married. The overall prevalence rate of reproductive system diseases among these 9944 female workers during the past three months was 28.29%, and the prevalence rates of hyperplasia of mammary glands, vaginitis, and hysteromyoma were 15.54%, 11.25%, and 6.77%, respectively. After adjustment for age, marital status, education level, and annual family income, the multivariate logistic regression analysis showed that frequent overtime work (odds ratio[OR]=1.119, 95% confidence interval[CI]: 1.070-1.343) , frequent night shifts (OR=1.198, 95%CI: 1.054-1.361) , standing for a long time (OR=1.197, 95%CI: 1.063-1.347) , sitting for a long time (OR=1.327, 95%CI: 1.191-1.479) , heavy workload (OR=1.429, 95%CI: 1.262-1.615) , exposure to lead (OR=1.696, 95%CI: 1.307-2.201) , exposure to mercury (OR=1.452, 95%CI: 1.086-1.940) , and exposure to ionizing radiation (OR=1.679, 95%CI: 1.424-1.980) were associated with reproductive system diseases. Conclusion: The prevalence of reproductive system diseases among female workers in Beijing is not optimistic. Reproductive system diseases are associated with frequent overtime work, frequent night shifts, standing for a long time, sitting for a long time, heavy workload, and exposure to lead, mercury, and ionizing radiation.

[A meta-analysis of Symptom Checklist-90 assessment results in Chinese nurses]

Objective: To investigate the application of Symptom Checklist-90 (SCL-90) in Chinese nurses. Methods: We performed a literature search for articles in Chinese on the mental health of nurses investigated using the SCL-90 that were published from January 2007 to December 2016. A total of 129 articles were included, involving 178 groups of valid samples as well as 36316 subjects in 27 provinces or cities in China. The metafor package of R 3.2.1 software and Excel were used for meta-analysis and data statistics. Results: Heterogeneity was identified for the nine factors included in the literature data (Q test: P<0.05; I(2) test >40%) , so a random effects model was used. For all factors except interpersonal relationship factor, the 95% confidence intervals of the pooled effect sizes did not include 0. For all factors except interpersonal relationship factor (Egger test: P<0.05) , no significant asymmetry or incompleteness appeared in the funnel plots. The fail-safe number of each factor was much larger than 5k+10. The merger scores and mean values of nine factors were higher than the national norm. Conclusion: The SCL-90 is widely used in the study of mental status of Chinese nurses, but the SCL-90 norm for nurses is lacking.

Testes-specific protease 50 promotes cell invasion and metastasis by increasing NF-kappaB-dependent matrix metalloproteinase-9 expression

The high mortality in breast cancer is often associated with metastatic progression in patients. Previously we have demonstrated that testes-specific protease 50 (TSP50), an oncogene overexpressed in breast cancer samples, could promote cell proliferation and tumorigenesis. However, whether TSP50 also has a key role in cell invasion and cancer metastasis, and the mechanism underlying the process are still unclear. Here we found that TSP50 overexpression greatly promoted cell migration, invasion, adhesion and formation of the stellate structures in 3D culture system in vitro as well as lung metastasis in vivo. Conversely, TSP50 knockdown caused the opposite changes. Mechanistic studies revealed that NF-κB signaling pathway was required for TSP50-induced cell migration and metastasis, and further results indicated that TSP50 overexpression enhanced expression and secretion of MMP9, a target gene of NF-κB signaling. In addition, knockdown of MMP9 resulted in inhibition of cell migration and invasion in vitro and lung metastasis in vivo. Most importantly, immunohistochemical staining of human breast cancer samples strongly showed that the coexpression of TSP50 and p65 as well as TSP50 and MMP9 were correlated with increased metastasis and poor survival. Furthermore, we found that some breast cancer diagnosis-associated features such as tumor size, tumor grade, estrogen receptors (ER) and progesterone receptors (PR) levels, were correlated well with TSP50/p65 and TSP50/MMP9 expression status. Taken together, this work identified the TSP50 activation of MMP9 as a novel signaling mechanism underlying human breast cancer invasion and metastasis.

Selenoprotein dSelK in Drosophila elevates release of Ca2+ from endoplasmic reticulum by upregulating expression of inositol 1,4,5-tris-phosphate receptor

dSelK (G-rich), a homolog of human and mouse SelK, is one of three selenoproteins in Drosophila melanogaster. It is the only trans-membrane selenoprotein in D. melanogaster integrated into both the endoplasmic reticulum (ER) membrane and the Golgi apparatus. The gene expression profile of Drosophila Schneider 2 (S2) cells after the dsRNA interference (dsRNAi) targeting of dSelK was examined with the GeneChip Drosophila Genome 2.0 Array (Affymetrix), a high-density oligonucleotide microarray encompassing nearly the full Drosophila genome. The results showed that the transcriptional expression of eight genes whose proteins are located on (or related to) the ER or the Golgi apparatus was highly induced or repressed by the dsRNAi treatment. The mRNA levels of the inositol 1,4,5-tris-phosphate receptor (IP3 receptor), whose gene product is integrated into the ER membrane and regulates the release of Ca2+ from the ER to the cytosol, were significantly downregulated. In contrast, the expression of inositol 1,4,5-tris-phosphate kinase 1, which is a cytosolic protein with opposing functions to the IP3 receptor, was significantly upregulated. Quantitative real-time PCR verified these results. The concentration of intracellular free Ca2+ of the Drosophila S2 cells was significantly decreased after the knockdown of dSelK, whereas overexpression of dSelK significantly increased the intracellular free Ca2+ concentration. These results indicate that dSelK in D. melanogaster is involved in regulating the release of Ca2+ from the ER to the cytosol and may play important roles in the signal transduction pathways involving Ca2+ mobilization.

Distribution of radionuclides in the guano sediments of Xisha Islands, South China Sea and its implication

Several natural and anthropogenic radionuclides ((210)Pb, (226)Ra and (137)Cs) in guano-phosphatic coral sediments and pure guano particles collected from Ganquan, Guangjin, Jinqing and Jinyin Islands of the Xisha archipelago, South China Sea, were analyzed. The Constant Initial Concentration (CIC) model and the Constant Rate of Supply (CRS) model were applied for age calculation. The average supply rate of (210)Pb was 126 Bq m(-2) a(-1), very close to the flux of northern hemisphere average (125 Bq m(-2) a(-1)). The activities of anthropogenic radionuclides in the sediments were very low, indicating that human nuclear tests did not notably impact this region. The main source of radionuclides in the sediments was from atmospheric precipitation, and the organic matter derived from plant and produced by nutrient-rich guano could further enhance them.

Lead inhibited N-methyl-D-aspartate receptor-independent long-term potentiation involved ryanodine-sensitive calcium stores in rat hippocampal area CA1

Lead exposure is known to be associated with cognitive dysfunction in children. Impairment of the induction of long-term potentiation (LTP) has been reported in area CA1 of rat hippocampus following lead exposure in vivo and in vitro. The present study was carried out to investigate whether the alterations of N-methyl-d-aspartate (NMDA) receptor-independent LTP following lead exposure involve internal calcium stores in hippocampus CA1 synapses. Monosynaptic field excitatory postsynaptic potentials in hippocampal slice area CA1 were recorded using the whole-cell patch-clamp upon acute lead treatment, and these studies were coupled with calcium imaging experiments to observe internal calcium changes in cultured hippocampal neurons. Inhibiting calcium release by ryanodine significantly reduced NMDA receptor-independent LTP, and depletion of internal calcium stores with thapsigargin blocked this form of LTP. Caffeine, an agonist of ryanodine receptors, enhanced this form of LTP. However, caffeine-enhanced NMDA receptor-independent LTP was depressed after bath application of lead. Moreover, lead further decreased ryanodine- and thapsigargin-reduced NMDA receptor-independent LTP. Calcium imaging also confirmed that lead had an effect on internal calcium release and uptake. Taken together, these results demonstrated that lead inhibited NMDA receptor-independent LTP by action on calcium release and uptake by ryanodine-sensitive stores in rat hippocampal area CA1.

Effect of snake venom of Agkistrodon halys on atherosclerosis and blood characteristics in Japanese quail

Extracts of snake venom have been widely used for the treatment of vascular thrombotic diseases, yet the therapeutic mechanism is not clear. The effect of snake venom fractions on atherosclerosis in Japanese quail was studied. The venom of Agkistrodon halys was fractionated by DEAE-cellulose chromatography and the pooled protein fractions that resulted were injected intravenously into the quail with aortic atherosclerosis induced by dietary cholesterol. After 7 weeks of injections on every other day, the quail were killed, blood clotting times and serum cholesterol levels were determined, and aortic atherosclerosis and fatty liver were scored. The results showed that while no regression of atherosclerosis was observed, the lowering of serum cholesterol, prolonged blood clotting time and reduced fatty liver were significantly affected by the injection of one of the pooled protein fractions. This venom fraction contained two major protein components, one of which had arginine esterase activity. From this study we conclude that snake venom has little effect on the regression of atherosclerosis, but it prolongs blood clotting and lowers serum cholesterol.