Objective To observe the protective effect of ultrasound microbubble contrast agentmediated transfection of brain-derived neurotrophic factor(BDNF) into the retina and visual cortex on retinal ganglion cells (RGC) after optic nerve injury. Methods A total of 88 male Sprague-Dawley (SD) rats were randomly divided into normal group (group A, eight rats), sham operation group (group B, 16 rats), control group (group C, 16 rats), eyes transfection group (group D, 16 rats), brain transfection group (group E, 16 rats), combined transfection group (group F, 16 rats). The optic nerve crush injury was induced, and then the groups B to F were divided into one-week and two-week after optic nerve injury subgroup with eight rats each, respectively. The rats in group B and C underwent intravitreal and visual cortex injection with phosphate buffered solution respectively. The rats in group D and E underwent intravitreal and visual cortex injection with the mixture solution of microbubbles and BDNF plasmids respectively. The rats in group F underwent both intravitreal and visual cortex injection with the mixture solution of microbubbles and BDNF plasmids at the same time. The ultrasound exposure was performed on the rats in group D to F after injection with the mixture solution of microbubbles and BDNF plasmids. One and two weeks after optic nerve injury, RGC were retrogradely labeled with Fluorogold; active caspase-3 protein was observed by immunohistochemistry and the N95 amplitude was detected by pattern electroretinogram (PERG). Results Golden fluorescence can be observed exactly in labeled RGC in all groups，the difference of the number of RGC between the six groups and ten subgroups were significant（F=256.30，65.18；P＜0.01）. Active caspase-3 in ganglion cell layer was detected in group C to F, but not in group A and B. The difference of the N95 amplitude between the six groups and ten subgroups were significant（F=121.56，82.38；P＜0.01）.Conclusion Ultrasound microbubble contrast agent-mediated BDNF transfection to the rat retina and visual cortex can inhibit the RGC apoptosis after optic nerve injury and protect the visual function.
Objective To observe the protection effects of ultrasonic microbubbles combined with memantine on rat retinal ganglion cells (RGCs) after optic nerve injury. Methods Forty Sprague-Dawley adult male rats were randomly divided into normal control group (group A), sham operation group (group B), blank control group (group C), memantine group (group D) and memantine and ultrasonic microbubbles group (group E), 8 rats in each group. Then A - E groups were randomly divided into 1 week subgroup and 2 weeks subgroup after the optic nerve injury, 4 rats in each subgroup. Group A had no interference treatment. The optic nerves in group B eyes were exposed but not clamped. Normal saline was injected into the vitreous, and those eyes were immediately radiated with ultrasound. The optic nerves in Group C - E were exposed and clamped to establish the optic nerve clamped models. Normal saline was injected into the vitreous of group C eyes; memantine was injected into the vitreous of group D eyes; ultrasonic microbubble and memantine was orderly injected into the vitreous of group E eyes and those eyes were immediately radiated with ultrasound. One week and 2 weeks after the optic nerve injury, RGC was labeled by retrograde fluorogold to count the RGC number; flash visual evoked potential (F-VEP) was used to record the incubation period and amplitude of P100 wave; fluorescence microscopy was used to observe the pathological morphology change of retinal cell. Results There were goldlabeled RGCs on the retina of group A-E. The difference of RGC count was not statistically significant between group A and B (q=0.018, 0.011; P=0.986, 0.873). Compared to group A, the RGC count in group C-E were decreased significantly (F=85.944, P=0.012). The RGC count in group D was significantly higher than that in group C (q=1.721, 1.924; P=0.043, 0.037). The RGC count in group E was significantly higher than that in group C and D (q=1.128, 1.482, P=0.027, 0.008; q=1.453, 1.855, P=0.031, 0.010).F-VEP showed that there was no statistically significant difference of incubation period and amplitude of P100 wave between group A and B (q=0.008, 0.019,P= 0.981, 0.946; q=0.072, 0.052, P=0.737, 0.851). Compared to group A, the incubation period were lengthened and the amplitude were decreased in group C- E with statistically significant (F=134.312, 106.312; P=0.017, 0.009). Observed under the electron microscope, the retinal structure of group A, B eyes was normal, but there were varying degrees of edema and thickening, RGC loss in group C-E eyes. Conclusions Memantine and ultrasonic microbubble can inhibit the rat RGC loss after optic nerve injury, and improve the visual function.
ObjectiveTo investigate the impact of thoracic duct ligation (TDL) on metabolism and postoperative complications during esophagectomy in patients with type-2 diabetes mellitus (T2DM).MethodsWe conducted a retrospective clinical data analysis of 230 esophageal carcinoma patients with T2DM who underwent esophagectomy in our hospital from January 2003 to December 2018. Patients were divided into a TDL+ group (n=112), including 78 males and 34 females aged 63.47±7.23 years, and a TDL– group (n=118), including 84 males and 34 females aged 64.38±7.57 years. We compared the blood glucose, liver function parameters and lipid metabolic parameters at different time points before and after surgery. In addition, we compared the postoperative major complications between the two groups. Propensity score-matched (PSM) was used to control the observed confounders.ResultsCompared with the TDL– group, patients in TDL+ group had higher blood glucose level (P<0.05, except the fourth postoperative day). The total protein and albumin levels on the first and fourth postoperative days in the TDL+ group were lower than those in the TDL– group (P<0.05). The alanine transaminase (P=0.027) and aspartate transaminase (P=0.007) levels on the fourth postoperative day in the TDL+ group were higher than those in the TDL– group. More pulmonary complications (P=0.014) and anastomotic leaks (P=0.047) were found in the TDL+ group.ConclusionGiven that TDL may aggravate metabolic disorders, increase anastomotic leaks and the pulmonary complications, it is cautious to perform TDL, and prophylactic TDL should not be performed routinely for patients with T2DM.
ObjectiveTo investigate the risk factors for lymph node metastasis (LNM) and prognosis of T1-stage esophageal squamous carcinoma (ESC).MethodsClinical data of 387 patients with T1-stage ESC who underwent surgical treatment in our hospital from March 2013 to March 2018 were collected. There were 281 males and 106 females aged 60 (41-80) years. The patients were divided into a lymph node metastasis group (n=77) and a non-metastasis group (n=310). The risk factors for LNM and prognosis were analyzed.ResultsAmong 387 patients with T1-stage ESC, 77 (19.9%) patients had LNM. The incidence of LNM was 8.4% (8/95) in T1a-stage patients and 23.6% (69/292) in T1b-stage patients. Univariate analysis showed that tumor size, differentiation degree, depth of invasion and vascular tumor thrombus were associated with LNM (P<0.05). Multivariate logistic regression analysis showed that invasion depth of tumor [OR=2.456, 95%CI (1.104, 5.463), P<0.05] and vascular tumor thrombus [OR=15.766, 95%CI (4.880, 50.938), P<0.05] were independent risk factors for LNM. The follow-up time was 41 (12, 66) months. The 1-year, 3-year and 5-year survival rates were 98.71%, 89.67% and 86.82%, respectively. Univariate analysis showed statistically significant differences in tumor invasion depth, vascular tumor thrombus and LNM between the survival group and the death group. Cox analysis showed that LNM [OR=3.794, 95%CI (2.109, 6.824), P<0.05] was an independent risk factor for prognosis.ConclusionT1-stage ESC patients with deeper invasion or vascular tumor thrombus have a higher risk of LNM. The prognosis of T1-stage ESC with LNM is relatively poor.