Stereotactic ablation or surgery known as the lesioning therapies (LT) is a method to treat nervous system diseases by destroying specific tissue structures in the brain through stereotactic minimally invasive technology, mainly consisting of magnetic resonance guided focused ultrasound surgery (MRgFUS), gamma knife stereotactic radiosurgery (GK) and radiofrequency thermal ablation (RF). For Parkinson's disease (PD) patients with poor drug response, LT can significantly improve the clinical symptoms (such as stiffness, tremor, dyskinesia, etc.), reduce drug dosage and improve the long-term quality of life,and is an important alternative to deep brain stimulation (DBS). Fully understanding the mechanism, characteristics, advantages and disadvantages and applicable population of the different methods of LT is of great guiding significance for formulating an individualized treatment plan. The research progress of MRgFUS, GK and RF in LT in the treatment of PD in recent years were reviewed, and the therapeutic effects and adverse reactions of different methods and targets have been summarized in present paper,so as to provide some reference for the selection of clinical operation scheme in the future.

Objective To explore the effect and potential mechanism of Guiqi Yiyuan ointment on rats injured by bystander effects of ¹²C⁶⁺ radiation. Methods A total of 70 Wistar male rats were randomized into the following groups (n=10):blank control group, radiation 24 h group, Guiqi Yiyuan ointment + radiation 24 h group, Guiqi Yiyuan ointment 24 h group,radiation 7 d group, Guiqi Yiyuan ointment + radiation 7 d group, and Guiqi Yiyuan ointment 7 d group. Fourteen days before irradiation, rats in the groups with Guiqi Yiyuan ointment treatment received the same volume and concentration of Guiqi Yiyuan ointment. Other rats received the same amount of normal saline. After 14 days, the right lungs of each radiation group and the Guiqi Yiyuan ointment + radiation group were irradiated with a single 4 Gy ¹²C⁶⁺ beam (exposing only the right lung). The blank control group and each Guiqi Yiyuan ointment group were not irradiated. Rats in each group were sacrificed at different time points such as 24 h and 7 d, and lung tissues were collected. The histology of the left and right lungs of each group was examined by HE staining.The mRNA and protein expression levels of TGF-β₁ and p-Smad3 in the left and right lung tissues were quantified by Q-PCR and Western blotting, respectively. Results HE staining results showed the normal structure of the right lung alveoli of blank control group and each Guiqi Yiyuan ointment group. In radiation 24 h group, the alveolar septum of both lungs increased with inflammatory cells infiltrated. In Guiqi Yiyuan ointment + radiation 24 h group, both lungs showed some broken alveolar septum and some infiltrated inflammatory cells. In radiation 7 d group, the alveolar septal fissure was obvious, the alveolar cavity expanded irregularly,the inflammatory cells infiltrated, and the degree of infiltration in the left lung was lighter than that in the right lung. In Guiqi Yiyuan ointment + radiation 7 d group, there was no fibrous hyperplasia, no congestion in the alveolar cavity, and the degree of left lung injury was lighter than that of the right lung. Q-PCR and Western blotting results showed that compared with blank control group,the expression levels of TGF-β₁ mRNA and protein in the left and right lung tissues of rats in radiation 24 h group and radiation 7 d group increased (P<0.05), the expression level of p-Smad3 protein increased (P<0.05), the expression level of Smad6 mRNA in the right lung decreased (P<0.05), and the expression level of Smad6 mRNA in the left lung increased (P<0.05), the expression of Smad6 protein decreased in the left and right lung tissues (P<0.05), and the expressions of TGF-β₁ mRNA and protein in radiation 7 d group were higher than those in radiation 24 h group (P<0.05), and there was a time effect. The expressions of TGF-β₁ mRNA and protein and p-Smad3 protein in the left and right lungs of rats in Guiqi Yiyuan ointment + radiation group decreased, while the expression of Smad6 mRNA and protein increased (P<0.05). Conclusion Guiqi Yiyuan ointment has a protective effect on rats with bystander effects of radiation. The mechanism may be related to the downregulation of TGF-β₁ and p-Smad3, but increased Smad6 in the left and right lung tissues.

Objective To analysis the risk factors for the progression of white matter hyperintensities (WMHs) in the non-demented elderly. Methods A total of 263 non-demented elderly who completed baseline and 3-year follow-up T₂ FLAIR scans were screened from the Alzheimer's Disease Neuroimaging Initiative (ADNI)-1 cohort. They were divided into the progressive group(n=66) and non-progressive group (n=197) according to the progression of WMHs. The baseline demographic data, cardiovascular disease history, apolipoprotein E (apoE) genotype, cognitive function and WMHs volumes at baseline and three-year follow-up were compared between the two groups. The risk factors for the progression of WMHs in the non-demented elderly were evaluated by logistic regression analysis. Results The age, the proportion of coronary heart disease, the WMHs volume at baseline and three-year follow-up in WMHs progressive group were higher than those in non-progressive group, and the scores of immediate memory of auditory verbal learning test and trail making test-B were significantly lower than those in non-progressive group, and the differences were statistically significant (P<0.05). Age correlated positively with baseline WMHs volume and WMHs volume at three-year follow-up (r_s=0.273, P<0.001; r_s=0.306, P<0.001). Multivariate logistic regression analysis showed that age ≥80 years and a history of coronary heart disease were independent risk factors for the progression of WMHs (OR=2.257, 95%CI 1.219-4.178, P=0.010;OR=2.556, 95%CI 1.048-6.234, P=0.039). Conclusion Age ≥80 years and a history of coronary heart disease are independent risk factors for the progression of WMHs in the non-demented elderly.

Objective To explore the high-risk factors associated with relapse of chronic drug-induced liver injury(DILI) to provide a basis for accurate prediction and treatment. Methods The clinical data of 1660 patients with chronic DILI patients, who were hospitalized from January 2012 to June 2017, were retrospectively collected. The average age of the patients was(43.9±12.3) years old and 970 were females. And they were divided into relapse group (n=196) and non-relapse group (n=1464).Spearman rank correlation was used to analyze the association of inflammation degree and fibrosis stage with relapse, while the high-risk factors associated with relapse were analyzed by univariable and multivariable logistic regression. Results With the increase in the degree of inflammation and fibrosis, the proportion of patients with relapse increased [inflammation grade (G₀: 0%, G₁: 0.9%, G₂:5.8%, G₃: 50.7%, G₄: 72.7%), fibrosis stage (S₀: 2.8%, S₁: 5.0%, S₂: 17.1%, S₃: 22.4%, S₄: 42.7%), P<0.001]. Spearman rank correlation analysis showed inflammation grade (r=0.463) and fibrosis stage (r=0.275) had a positive correlation with relapse. Especially,inflammation grade ≥G₃ (OR=5.75, 95%CI 3.83-8.64, P<0.001) is a high-risk factor associated with relapse in chronic DILI patients. Biochemically, multivariable logistic regression analysis showed that age >60 years (OR=2.14, 95%CI 1.17-3.90, P=0.014),AST >2×ULN (OR=3.62, 95%CI 1.64-7.79, P=0.001), TBIL >2×ULN (OR=2.19, 95%CI 1.39-3.44, P=0.001), CHE <1×ULN(OR=3.42, 95%CI 2.34-5.01, P<00.01), PLT <100×10⁹/L (OR=2.09, 95%CI 1.24-3.54, P=0.006) were independent high-risk predictors associated with relapse. Conclusion Older age, high AST and TBIL, low CHE and PLT, inflammation grade ≥G₃ are high risk factors for relapse, which are of great clinical significance for early prediction and effective improvement of chronic DILI outcome.

Objective To investigate the effects of sevoflurane inhalation anesthesia and propofol-remifentanil combined maintenance anesthesia on the incidence of postoperative residual curarisation (PORC) in minor surgery. Methods A total of 104 patients who underwent elective surgery under general anesthesia in the Second Affiliated Hospital of Chongqing Medical University from May 2020 to January 2021 were selected for this study. Patients were divided into Sevo group (maintenance by inspirating sevoflurance) and PR group (maintenance by intravenous injecting propofol and remifentanil). The train-of-four ratio (TOFr) during extubation and the existence of adverse respiratory events after extubation were recorded. The incidence of residual muscle relaxation during extubation and the incidence of adverse respiratory events after extubation were compared under different anesthesia maintenance conditions. Results There were no significant differences in age, gender, American Society of Anesthesiologists (ASA) classification, body mass index (BMI), operation time, time from muscle relaxant administration to extubation, and bispect ralindex (BIS) at extubation between two groups (P>0.05). There was no significant difference in the incidence rate of PORC and adverse respiratory events between Sevo group and PR group [69.4%(34/49) vs. 53.8%(28/52),P>0.05; 2.0%(1/49) vs. 9.6%(5/52), P>0.05]. TOFr in Sevo group was slightly lower than that in PR group, and the difference was statistically significant [85%(78%, 90%) vs. 89%(84%, 93%), P<0.05]. The overall incidence of PORC was high, which was correlated with age, BMI, operative time, time from muscle relaxant administration to extubation, and BIS at extubation (P<0.05). Conclusion Sevoflurane anesthesia maintenance does not increase the incidence of muscle relaxation residual during extubation.The incidence of PORC can be high during extubation under general anesthesia in minor surgery. Muscle relaxation monitoring should be performed routinely during general anesthesia to improve safety.

Objective To analyze the correlation of plasma fibrinogen (Fib) and blood lipid composition to the progression of non-culprit coronary lesions (NCCLs) in CHD patients after percutaneous coronary intervention (PCI). Methods The clinical data were collected and retrospectively analyzed of 210 patients admitted from January 2017 to December 2017 in the Department of Cardiovascular Medicine of the First Hospital of Lanzhou University, received the first PCI treatment, and repeated the coronary angiography (CAG) before December 31, 2020 (the interval between two operations should be at least 6 months). According to whether the NCCLs progressed, 210 patients were divided into progressive group (n=99) and non-progressive group (n=111), and then, according to the degree of NCCLs progression, patients in progressive group were further divided into three subgroups: mild(n=42), moderate (n=35) and severe (n=22) progressive subgroup. The baseline clinical data were compared between the patients in progressive group and in non-progressive group, and among the patients in mild, moderate and severe progression subgroups. The correlation of the plasma Fib and blood lipid composition to the progression of NCCLs, and the risk factors affecting the progression of NCCLs were analyzed. Results There were no statistical difference between progressive group and non-progressive group in gender, smoking history, drinking history, hypertension history, hyperlipidemia history, heart failure, and admission blood pressure(P>0.05), but the mean age was higher in progressive group than that in non-progressive group, and more patients with diabetes in progressive group than those in non-progressive group, and there existed statistically significant differences (P<0.05). The plasma levels of Fib, cholesterol (TC), low density lipoprotein cholesterol (LDL-C), and non-high density lipoprotein cholesterol (non-HDL-C) were higher in progressive group than those in non-progressive group with statistically significant differences (P<0.05).There existed no significant difference (P>0.05) between the two groups in the levels of triglyceride (TG) and HDL-C; with the increasing in the severity of NCCLs, plasma Fib, TG, LDL-C, and non-HDL-C increased gradually in the mildly, moderately, and severely advanced subgroups, while the plasma level of HDL-C decreased gradually, but no statistical difference existed among the subgroups (P>0.05); Fib, TC, LDL-C, non-HDL-C, and D-dimer were positively correlated with the NCCLs progression. And also,Fib was positively correlated with TC, LDL-C, and non-HDL-C. Gender, age, and diabetes history can be used as risk factors for the progression of NCCLs with OR values of 2.284, 1.052, and 0.293, respectively. Conclusion The plasma Fib and blood lipid composition are correlated with the progression of NCCLs, and Fib is also correlated with some lipid components, but is not a risk factor for NCCLs progression.

Objective To investigate the effect of hnRNPAB overexpression on epithelial-mesenchymal transformation(EMT) and its molecular mechanism using human colorectal cancer line SW480 and HT29. Methods SW480 and HT29 cells were infected with lentivirus overexpressing hnRNPAB and negative control virus to generate the corresponding cell lines in experimental group (SW480-hnRNPAB, HT29-hnRNPAB) and control group (SW480-NC, HT29-NC). To quantify the levels of hnRNPAB and EMT-related indicators (E-cadherin, N-cadherin and vimentin), RT-qPCR and Western blotting were used. Cell migration was measured using the scratch assay. Cell invasion was evaluated using the Transwell assay. Western blotting was used to detect the expression levels of Wnt/β-catenin signaling key indicators WNT3A, WNT5A and β-catenin. Results Compared with control group, the expression levels of hnRNPAB mRNA and protein in experimental group significantly increased, and the differences were statistically significant (P<0.01). The scratch healing rates in experimental group were significantly higher than that in control group (SW480: 19.6%±0.90% vs. 2.23%±0.80%, P<0.01; HT29: 40.30%±0.70% vs. 6.40%±0.06%, P<0.01). The number of Transwell cells was significantly higher than that in control group [SW480: (315.0±6.7) cells vs. (62.0±4.3) cells, P<0.01; HT29:(289.0±7.2) cells vs. (54.0±5.2) cells, P<0.01]. Compared with control group, the epithelial cell marker E-cadherin mRNA and protein expression levels in experimental group significantly decreased. As expected, the mesenchymal cell markers N-cadherin and vimentin mRNA and protein levels significantly increased, and the differences were statistically significant (P<0.01). Compared with control group, the expressions of WNT3A, WNT5A and β-catenin protein in experimental group significantly increased (P<0.01). Conclusions The overexpression of hnRNPAB could induce EMT of human colorectal cancer SW480 and HT29, demonstrated by enhanced cell migration and invasion ability. The mechanism may be related to the activation of the Wnt/β-catenin signaling pathway.

Objective To investigate the effect and mechanism of transplanting Leydig-like cells from BMSCs to repair the testicular function of diethylhexyl phthalate (DEHP) infected mice. Methods Six C57 mice were randomly divided into two groups (3 each): control group (corn oil) and DEHP group [900 mg/(kg.d) DEHP mixed with corn oil]. Venous blood was taken from the eyeball 28 days after treatment to determine the serum testosterone level. One testis was stored in paraformaldehyde for HE and TUNEL staining, the other side of testis, after homogenization, was used to determine the changes of apoptotic proteins of caspase-3, caspase-8, caspase-9, Bcl-2 and Bax with Western blotting, the contents of MDA and GSH and the activities of SOD and GSH-Px were determined. Twenty-seven C57 mice were poisoned with DEHP for 28 days, and then randomly divided into Leydig-like cell transplant group, BMSCs transplant group and control group (9 each). BMSCs and Leydig-like cells from BMSCs were transplanted into the testis of mice in corresponding groups. Venous blood was taken from 3 mice of each group at 7th, 14th and 21st day after transplantation for determining the serum testosterone, and bilateral testis were obtained simultaneously to determine the contents of MDA and GSH and the activities of SOD and GSH-Px. The testis of mice was got 7th day after transplantation for HE and TUNEL staining, and the changes of apoptotic proteins of caspase-3, caspase-8, caspase-9, Bcl-2 and Bax were detected simultaneously. Results Compared with control group, the serum testosterone level decreased significantly, testicular spermatogenic cell disorder, tissue cells showed apoptosis, the serum levels of apoptotic protein caspase-3, caspase-8, caspase-9 and Bax increased obviously, while of Bcl-2 decreased markedly in testis of DEHP group, the content of MDA increased, and of GSH decreased, the activities of GSH-Px and SOD were inhibited with statistically significant difference (P<0.05 or P<0.01). Compared with control group, the serum testosterone level in Leydig-like cell transplantation group increased significantly at 7th, 14th and 21st day after testicular cell transplantation. The serum level of testosterone in BMSC transplantation group was higher than in control group at 14th and 21st day after transplantation. The content of MDA in testicular tissue decreased and of GSH increased,and the activities of GSH-Px and SOD recovered at 7th, 14th and 21st day after testicular cell transplantation (P<0.05 or P<0.01).The 7th day after transplantation, the apoptosis of testicular tissue was alleviated obviously in Leydig-like cell transplantation group and BMSC transplantation group than that in control group, the morphology of spermatogenic cells recovered, and the expression levels of apoptotic protein caspase-3, caspase-8, caspase-9 and Bax decreased significantly, while of Bcl-2 protein increased obviously(P<0.05 or P<0.01). Conclusion Transplantation of Leydig-like cells derived from BMSCs may repair the DEHP induced testicular damage by alleviating testicular oxidative stress and inhibiting testicular apoptosis, increase the teatosterone secretion, so as to promote the recovery of damaged testicular function.

Objective To evaluate the safety and effectiveness of ultrasound-guided percutaneous thermal ablation in the treatment of low-risk unifocal papillary thyroid microcarcinoma (PTMC). Methods Patients with single-focal PTMC admitted to the 928th Hospital of the PLA Joint Logistic Support Force from June 2017 to June 2019 were selected, and ultrasound-guided percutaneous thermal ablation therapy was performed. The extent of ablation was assessed with contrast-enhanced ultrasound immediately after thermal ablation, and the ablation area, and thyroid function were measured for clinical evaluation at 1, 3, 6, 12,and 18 months, respectively. Clinical evaluation was performed at 1, 3, 6 and 12 months after thermal ablation. Results A total of 214 patients with PTMC were included, including 62 males (29.0%) and 152 females (71.0%), aged 17-77 (44.1±13.1) years old.The maximum diameter of the tumor was 0.2-1.0 (0.59±0.18) cm. The patients were followed up at 1, 3, 6, 12 and 18 months after thermal ablation, the follow-up time was 12-18 (15.14±3.01) months. After the initial thermal ablation, the maximum diameter of the ablated area was (1.372±0.440) cm, and gradually decreased to (1.108±0.438) cm, (0.753±0.440) cm, (0.483±0.324) cm,(0.162±0.205) cm, and (0.047±0.140) cm. After initial thermal ablation, the volume of ablated lesion was (1.083±1.819) cm³, and gradually decreased to (0.606±1.259) cm³, (0.273±0.784) cm³, (0.069±0.154) cm³, (0.006±0.156) cm³, and (0.001±0.004) cm³.The volume reduction ratio (VRR) at 1, 3, 6, 12 and 18 months after thermal ablation was 0.457±0.218, 0.837±0.150,0.943±0.090, 0.994±0.012, 0.999±0.002. There was a significant difference in VRR between every two follow-up visits (P<0.001).The thyroid function test results of patients before and 1 month after thermal ablation were normal, and there were no statistically significant differences (P>0.05). During the follow-up period, no tumor regrowth, local recurrence or distant metastasis was found.The most common complication was mild pain (31.8%, 68/214). Some patients developed toothache, sub-mandibular radiation pain and unilateral headache during ablation, and the pain symptoms were relieved immediately after ablation. All local pain symptoms were relieved 24-48 h after thermal ablation without treatment. Conclusions Ultrasound-guided percutaneous thermal ablation for the treatment of low-risk PTMC is safe and effective. It has less trauma and fewer complications, and can preserve the patient's thyroid function. This is a safe and effective alternative strategy for the treatment of low-risk PTMC, especially for patients who are not suitable for surgical treatment.

The patients after cardiac surgery often suffer from malnutrition due to insufficient energy intake, which increases the incidence of complications and mortality. Thus, energy and protein intake can accelerate patients' recovery. Previously, enteral nutrition has been widely considered to be the major nutritional way, however, an increasing studies suggest a combination of enteral and parenteral way can provide nutrition to patients maximally. Albeit the timing of the inception of parenteral way of nutrition remains controversial, it is confirmed that early start of the enteral way is salubrious to patients, and the duration of nutritional support should be determined according to the specific situation of patients. Additionally, nutritional scoring system plays a crucial role. Various nutritional risk scores can predict the clinical outcome of patients, thus, the most adaptable nutritional score for patients after receiving cardiac surgery needs further study. This article reviews the importance of nutritional support for the patients after cardiac surgery, selection, timing, and duration of post-operative nutritional support, and the advances in nutritional risk assessment etc.