Objective To investigate the expression of dipeptidyl peptidase 4 (DPP4) and angiotensin-converting enzyme 2 (ACE2) in lung tissues of patients with four different diseases including coronavirus disease 2019 (COVID-19), chronic obstructive pulmonary disease (COPD), pulmonary sarcoidosis and pulmonary bullae, and to find out the potential risk factors affecting COVID-19. Methods This study retrospectively analyzed the clinical data of 40 patients admitted to Renmin Hospital of Wuhan University with COVID-19 (COVID-19 group), COPD (COPD group), pulmonary sarcoidosis (pulmonary sarcoidosis group) and pulmonary bullae (pulmonary bullae group) and surgically resected paraffin-embedded pathological lung tissues were obtained from their lung tissue pathological specimens after surgery and paraffin embedding. The GEO database (https://www.ncbi.nlm.nih.gov/geo/) was used for bioinformatics analysis to explore the expression difference of DPP4 and ACE2 mRNA in COVID-19, COPD, pulmonary sarcoidosis and normal lung tissues. Immunohistochemistry method was used to detect the expression of DPP4 and ACE2 protein in lung tissues of each group and the average optical density was measured by image analysis software. Results The results of GEO database analysis showed that compared with pulmonary bullae group, the expression level of DPP4 mRNA had no significant difference in the COPD group and pulmonary sarcoidosis group (both P>0.05), but it was increased in the COVID-19 group (P<0.05); There was no significant difference in the expression level of ACE mRNA in the pulmonary sarcoidosis group (P>0.05), but it was increased in the lung tissue of COVID-19 group and COPD group (both P<0.05). The results of immunohistochemistry showed that DPP4 and ACE2 proteins were lowly expressed in the pulmonary sarcoidosis group and pulmonary bullae group, while their expression level was high in COVID-19 and COPD groups without significant difference (P>0.05). The expression of DPP4 and ACE2 proteins in COVID-19 group was not related to the patient’s gender and age (P>0.05), but was related to smoking and long smoking duration (P<0.05), and there was a positive correlation between DPP4 and ACE2 expression (P<0.05). Conclusions DPP4 and ACE2 proteins are lowly expressed in the pulmonary sarcoidosis group and pulmonary bullae group, while their expression level is high in COVID-19 and COPD groups. There is no significant difference in the expression level of DPP4 and ACE2 protein in the COVID-19 and COPD lung tissues. There may be a positive correlation between DPP4 and ACE2 proteins expression in lung tissue, and smoking may be a potential risk factor for COVID-19.
Atrial fibrillation is the most common arrhythmia and is known to be in connection with stroke, dementia, heart failure and increased risk of death. For drug-refractory atrial fibrillation, surgical or catheter ablation is recommended. Early attempts to design procedures to ablate atrial fibrillation and restore sinus rhythm culminated in the Cox-Maze Ⅲ procedure, which was the first truly successful procedure. However, Cox-Maze Ⅲ procedure is complex and technically demanding, so it has been extensively modified with new techniques to create new types of surgical ablation procedures: Cox-Maze Ⅳ procedure, minimally invasive Cox-Maze Ⅳ procedure, and the latest “hybrid approach”. This review mainly discusses these surgical treatment strategies and the latest research progress.
Objective To employ spinal virtual surgery system (SVSS) for preoperative planning of thoracolumbar pedicle screw fixation, and to establ ish the measurement method for pedicle screw-related parameters. Methods Eight thoracicand lumbar spine specimens (T11-L3) were selected. First of all, SVSS was used for the preoperative planning of pedicle screw and the parameters of both sides of pedicle were measured in every vertebral segment, including angle of axial view (Aa), angle of sagittal view (As), x-direction entrance (XE), total pedicle length of axial view (TLa), total pedicle length of sagittal view (TLs), pedicle height (PH), pedicle width (PW), and pedicle spongy width (PSW). Then the corresponding parameters of the right and left pedicle screws of the specimens were measured actually. Finally, its accuracy was verified by comparing the data by virtual measurement and actual measurement. Results There was no significant difference in the parameters of virtual measurement (Aa, As, TLa, TLs, XE, PW, PSW, and PH) and actual measurement (Aa, As, TLa, XE, PW, PSW, and PH) between the right and left sides (P gt; 0.05). Except XE of the L3 vertebral segment and PSW of T11 and T12 vertebral segments (P lt; 0.05), the differences in other parameters of other segments were not significant (P gt; 0.05). Conclusion After statistical analysis and comparison, the feasibil ity of preoperative planning of thoracolumbar pedicle screw fixation and the accuracy of the measurement of the SVSS is verified.
Objective To explore the diameter change of the extrahepatic bile duct before and after laparoscopic cholecystectomy (LC). Methods From Jan. 2006 to Dec. 2007， 113 patients including chronic gallstone cholecystitis （n=55）, inactive cholecystolithiasis （n=46） and gallbladder polyps （n=12） were collected and treated by LC. The diameters of their extrahepatic bile ducts were measured by B ultrasonography before operation， 3 months and 6 months after operation. These data were collected and analyzed retrospectively. Results The diameters of the extrahepatic bile ducts of all patients before LC， 3 months and 6 months after LC were (5±2) mm, (8±2) mm and (6±2) mm respectively. And in chronic gallstone cholecystitis patients they were (5±2) mm, (9±2) mm and (6±2) mm respectively， in inactive gallstone cholelithiasis patients they were (5±2) mm, (8±2) mm and (6±2) mm respectively， and in gallbladder polyps ones they were (5±2) mm, (7±2) mm and (5±2) mm respectively. Conclusion The change of the extrahepatic bile duct diameter after LC is a dynamic process. It is enlarged on the third month after operation than before operation. In the sixth month after operation marked retraction occurs, and compared with before operation, it shows no obvious statistic significance.
Objective To investigate the effectiveness of posterior short-segmental fixation with bone cement augmentation in treatment of stage Ⅲ Kümmell’s disease with spinal canal stenosis. Methods Between June 2012 and January 2017, 36 patients with stage Ⅲ Kümmell’s disease and spinal canal stenosis were treated by posterior short-segmental fixation and bone cement augmentation. There were 12 males and 24 females, aged 55-83 years (mean, 73.5 years). The disease duration ranged from 2 to 8 months, with an average of 4.6 months. Preoperative bone mineral density examination showed that all patients had different degrees of osteoporosis in the spines. The lesion segments included T10 in 4 cases, T11 in 7 cases, T12 in 8 cases, L1 in 9 cases, and L2 in 8 cases. The preoperative neural function was classified as grade B in 4 cases, grade C in 12 cases, grade D in 13 cases, and grade E in 7 cases according to Frankle classification. The operation time, intraoperative blood loss, and the volume of injected bone cement, and hospital stay were recorded. The visual analogue scale (VAS) score, Oswestry Disability Index (ODI), kyphotic Cobb angle, and the height of anterior edge of injured vertebra were recorded before operation, at 1 week after operation, and at last follow-up; and the leakage of bone cement was observed. Results All operations were completed successfully. The operation time was 90-145 minutes (mean, 110.6 minutes); the intraoperative blood loss was 198-302 mL (mean, 242.5 mL); the volume of injected bone cement was 8.3-10.5 mL (mean, 9.2 mL); the hospital stays were 7-12 days (mean, 8.3 days). All patients were followed up 12-26 months (mean, 24.5 months). At 1 week after operation, the neural function was classified as grade B in 2 cases, grade C in 8 cases, grade D in 12 cases, and grade E in 14 cases, which was significantly improved when compared with that before operation (Z=2.000, P=0.047). The VAS score, ODI, the height of anterior edge of injured vertebra, and Cobb angle were significantly improved at 1 week and last follow-up when compared with preoperative values (P<0.05); but there was no significant difference between 1 week and last follow-up (P>0.05). Two cases had asymptomatic cement leakage to the intervertebral disc at 1 week after operation; and 1 case had adjacent vertebral fracture at 8 months after operation. No complication such as loosening or breaking of internal fixator occurred during the follow-up. Conclusion Posterior short-segmental fixation with bone cement augmentation is a safe and effective surgical scheme for stage Ⅲ Kümmell’s disease combined with spinal canal stenosis, which can avoid the aggravation of nerve injury and complications related to staying in bed.
Objective To summarize the research progress on rodent models of cervical spinal cord injury (SCI). Methods The relevant domestic and foreign literature in recent years was reviewed, the methods of establishing the rodent models of cervical SCI and the evaluation methods of behavior, imaging, neuroelectrophysiology, and histology were summarized. Results Cervical SCI involves primary and secondary injuries. Primary cervical SCI can be simulated with contusion, contusion compression, fracture dislocation, spinal cord traction, and spinal cord transection; scondary cervical SCI can be simulated with photochemical model and excitotoxicity model. Certain evaluation methods such as behavior, imaging, neuroelectrophysiology, and histology are used to evaluation during model building and research. Conclusion Different rodent models of cervical SCI have different advantages and application directions, and it is critical importance for the study of cervical SCI to establish effective animal models.
[Abstract]Extracellular matrix (ECM) provides a unique tissue-specific microenvironment for resident cells with the structure and biochemical signaling required for their functioning. Decellularized extracellular matrix (dECM) is designed to remove cells that mediate immune rejection and retain the original tissue structure and matrix function. dECM has attracted extensive attention in tissue engineering and has become a new full-fledged tissue engineering material. This article summarizes representative methods for decellularization, and discusses the emerging frontiers of decellularized tissue-derived materials and bioinks in the field of thoracic and cardiovascular surgery. Finally, we analyze the current problems and challenges faced by decellularized matrices, and anticipate future development trends.
ObjectiveTo investigate the effect of continuous occupational therapy (OT) on the life satisfaction of patients with spinal cord injury (SCI). MethodsFifty-two SCI patients treated in Department of Rehabilitation at People’s Hospital of Mianzhu City between 2008 and 2010 were randomly assigned into two groups with 26 patients in each. Patients in the trial group received OT and rehabilitation nursing both in hospital and after being discharged from hospital, whereas patients in the control group only received treatment in hospital. Life satisfaction was assessed when patients were discharged from hospital and 21 months later. ResultsThe patients were treated for an average of 12 weeks in hospital before being discharged. Twenty-six questionnaires were given out to the patients when they were discharged from hospital, and another 26 were given 21 months later. All the questionnaires were retrieved, with a retrieval rate of 100%. The life satisfaction scores between the trial and control groups were not different from each other when the patients were discharged from hospital (P>0.05). The trial group was more satisfied with their life 21 months after being discharged from hospital (P<0.05). The life satisfaction scores of the control group were not changed (P>0.05). The trial group had higher life satisfaction than the control group 21 months after being discharged (P<0.05). ConclusionContinuous OT instruction on patients can increase their life satisfaction, and the rehabilitation effect of patients is better than rehabilitation intervention at a certain stage.
Guideline Development Tool (GRADE pro GDT) is an online tool that addresses the integration of the important data and process of the clinical practice guidelines and diagnostic guidelines. GRADE pro GDT has been updated several times, including the whole style of the web page, details of the information recording, management of the conflict of interests, and the presentation and dissemination of the results. The new version of the tool is much more intellectualized and transparent, which makes the guideline development and rating quality of evidence more standardized and scientific. This paper introduces new aspects of this tool with examples.