Specific inhibition of NLRP3 expression in GABAergic neurons in CA1 area of the hippocampus improves cognitive dysfunction in mice after traumatic brain injury / 中华神经医学杂志

Objective:To explore the effect of NOD-like receptor thermal protein 3 ( NLRP3) knockout in γ-aminobutyric acid (GABA)-ergic neurons in the hippocampal CA1 area on improving cognitive dysfunction in mice after traumatic brain injury (TBI). Methods:Forty-eight healthy male NLRP3 flox/flox mice weighing 25-28 g were randomly divided into 4 groups ( n=12): sham-operated+control virus group (SV group), sham-operated+ NLRP3 specific knockout group (SG group), TBI+control virus group (TV group), TBI+ NLRP3 specific knockout group (TG group). TBI in the TV and TG groups was established by free-fall method, while surgical procedures such as scalp incision and cranial window opening without impact were given to the SV and SG groups. Adenovirus was injected into the hippocampal CA1 area of SG and TG groups 21 d before TBI to induce NLRP3 specific knockout in GABA-ergic neurons in the hippocampal CA1 area; empty virus was injected into the CA1 area of SV and TV groups. Cognitive function was evaluated using novel object recognition test 30 and 31 d after TBI, and learning and memory functions were assessed using Morris water maze test 32-36 d after TBI. Field potentials in the hippocampal CA1 area were recorded during novel object recognition 31 d after TBI. After behavioral tests, these mice were sacrificed. Immunofluorescent staining was used to detect the fluorescent intensity of microtubule-associated protein2 (MAP2), glutamic acid decarboxylase 67 (GAD67), and postsynaptic density protein 95 (PSD95) in the hippocampal CA1 area, as well as percentage of pyroptosis-associated inflammatory factor interleukin-18 (IL-18)/GAD67 double-positive neurons in total GAD67 positive neurons. Results:Compared with the SV and SG groups, the TV and TG groups had decreased novel object recognition index, decreased number of platform crossings during the experimental period, increased escape latency on day 3 and day 4 of the training period in Morris water maze test, decreased θ and γ oscillation power in the hippocampal CA1 area during novel object recognition, decreased fluorescent intensity of MAP2, GAD67, and PSD95 in the hippocampal CA1 area, increased percentage of IL-18/GAD67 double-positive neurons, with significant differences ( P<0.05). Compared with the TV group, the TG group had increased novel object recognition index, increased number of platform crossings in Morris water maze test, decreased escape latency during the training period, increased θ and γ oscillation power in the hippocampal CA1 area during novel object recognition, increased fluorescence intensity of MAP2, GAD67, and PSD95 in the hippocampal CA1 area, decreased percentage of IL-18/GAD67 double-positive neurons, with significant differences ( P<0.05). Conclusion:Specific inhibition of NLRP3 expression in GABA-ergic neurons in the hippocampal CA1 area can improve cognitive dysfunction in mice after TBI, whose mechanism may be related to inhibited GABA-ergic neuronal pyroptosis in the hippocampal CA1 area.

Screening and genotyping of Mur blood group among voluntary blood donors in the population of Hezhou, Guangxi / 中国输血杂志

【Objective】 To screen the distribution frequency of Mur blood group among voluntary blood donors in Hezhou, Guangxi, and further analyze the molecular basis of of Mur antigen positive samples. 【Methods】 The Mur phenotype of voluntary blood donors in Hezhou was serologically screened using microplate method, and the distribution frequency of Mur antigens in different ethnic groups was analyzed. Genetic typing was performed on these positive samples with PCR-SSP method to verify the accuracy of the serological method, and the genetic background was sequenced and analyzed. 【Results】 Among 3 298 samples from voluntary blood donors in Hezhou, 432(13.10%, 432/3 298) were screened positive for Mur antigen, and PCR-SSP genotyping validation showed that all 432 samples were electrophoretic positive. Among them, the proportion of Han blood donors with positive Mur antigen was 12.79%(331/2 587), Yao ethnic group was 13.25%(64/483), Zhuang ethnic group was 16.51%(36/218), and no statistically significant difference was found in the three groups(P>0.05). Further sequencing results showed that 428 samples were GYP(B-A-B) Mur, also known as GYP. Mur type(12.98%, 428/3 298), the other 4 samples were GYP(B-A-B) Bun, also known as GYP. Bun type(0.12%, 4/3 298). 【Conclusion】 The Mur blood type frequency is high in the voluntary blood donors in Hezhou, Guangxi, and is predominant characterized by GYP. Mur genotype. Due to ethnic integration, no significant difference was noticed in the frequency of Mur blood type distribution between Han, Zhuang and Yao population. Therefore, conducting extensive Mur blood group antigen and antibody testing in Hezhou is of great significance for ensuring clinical blood transfusion safety.

Protective effect and mechanism of Longshengzhi capsules on cerebral ischemia-reperfusion injury in rats / 中国药房

OBJECTIVE To explore the protective effect and mechanism of Longshengzhi capsules on cerebral ischemia- reperfusion injury in rats. METHODS The model of middle cerebral artery occlusion （MCAO） was established by using the improved thread occlusion method. The experiment was divided into six groups： sham surgery group （only separating blood vessels without inserting thread plugs， given the same volume of normal saline）， model group （modeling， given the same volume of normal saline）， nimodipine group （positive control， modeling， dose of 20 mg/kg）， and low-dose， medium-dose， and high-dose groups of Longshengzhi capsules （modeling， doses of 0.72， 1.44 and 2.88 g/kg， respectively）， with 10 mice in each group. Each group was given corresponding medication solution/normal saline by gavage， once a day， for 7 consecutive days. One hour after the last administration， the Zea Longa scoring method was used to score the neurological deficits in each group of rats， and the ABC enzyme-linked immunosorbent assay was used to detect the serum levels of tumor necrosis factor-α （TNF-α） and interleukin-6 （IL-6） in rats； TTC staining was used to observe the volume of cerebral infarction in rats and calculate the cerebral infarction volume ratio. Hematoxylin eosin staining was used to observe the pathological changes in the brain tissue of rats. Immunohistochemical staining was used to detect the positive expression of NLRP3 protein in the brain tissue of rats. Real-time fluorescence quantitative PCR was used to detect mRNA relative expressions of Toll-like receptor 4 （TLR4） and nuclear factor-κB （NF-κB） in the brain tissue of rats. Western blot assay was adopted to detect the relative expressions of TLR4， NLRP3 and phosphorylated NF-κB （p-NF-κB） protein in the brain tissue of rats and its intracellular NF-κB protein. RESULTS Compared with the sham surgery group， the neural dysfunction score， serum levels of TNF-α and IL-6， cerebral infarction volume ratio， relative expression levels of NF-κB and TLR4 mRNA， as well as protein relative expressions of TLR4， NLRP3 and p-NF-κB in the brain tissue， and relative protein expression of intracellular NF-κB were increased significantly in the model group （P＜0.01）； the enlarged gap and significant edema were observed in cortical nerve cells of brain tissue in rats， with a large amount of inflammatory cell infiltration； the positive expression of NLRP3 protein in brain tissue of rats obviously increased. Compared with the model group， the levels of the above indicators in the medium-dose and high-dose groups of Longshengzhi capsules， as well as the Nimodipine group， were reversed to varying degrees， and most differences were statistically significant （P＜0.05 or P＜0.01）； the pathological morphology observation showed a significant improvement， and the positive expression of NLRP3 protein in the brain tissue of rats was obviously reduced. CONCLUSIONS Longshengzhi capsules may inhibit TLR4/NF-κB/NLRP3 signaling pathway and neuroinflammatory response， thereby achieving a protective effect against cerebral ischemia-reperfusion injury in rats.

Clinical value of abdominal adipose volume in predicting early tumor recurrence after resec-tion of hepatocellular carcinoma / 中华消化外科杂志

Objective:To investigate the clinical value of abdominal adipose volume in predicting early tumor recurrence after resection of hepatocellular carcinoma (HCC).Methods:The retrospective case-control study was conducted. The clinicopathological data of 132 HCC patients with tumor diameter ≤5 cm who were admitted to The First Affiliated Hospital of Army Medical University from December 2017 to October 2019 were collected. There were 110 males and 22 females, aged (51±4)years. All patients underwent resection of HCC. Preoperative computer tomography scanning was performed and the visceral and subcutaneous fats of patients were quantified using the Mimics Research 21.0 software. Based on time to postoperative tumor recurrence patients were divided to two categories: early recurrence and non-early recurrence. Observation indicators: (1) consistency analy-sis; (2) analysis of factors influencing early tumor recurrence after resection of HCC and construction of prediction model. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribu-tion were represented as M( Q1,Q3) or M(range), and comparison between groups was conducted using the Mann-Whitney U test. Count data were expressed as absolute numbers, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Consistency analysis was conducted using the intragroup correlation coefficient (ICC) test. Multivariate analysis was performed using the binary Logistic regression model forward method. Independent risk factors influencing early tumor recurrence after resection of HCC were screened. The area under curve (AUC) of receiver operating characteristic (ROC) curve was applied to select the optimal cut-off value to classify high and low risks of recurrence. The Kaplan-Meier method was used to draw survival curve and calculate survival time. The Log-Rank test was used for survival analysis. Results:(1) Consistency analysis. The consistency ICC of abdominal fat parameters of visceral fat volume (VFV), subcutaneous fat volume, visceral fat area, and subcutaneous fat area measured by 2 radiologists were 0.84, 1.00, 0.86, and 0.94, respectively. (2) Analysis of factors influencing early tumor recurr-ence after resection of HCC and construction of prediction model. All 132 patients were followed up after surgery for 662(range, 292-1 111)days. During the follow-up, there were 52 patients with non-early recurrence and 80 patients with early recurrence. Results of multivariate analysis showed that VFV was an independent factor influencing early tumor recurrence after resection of HCC ( odds ratio=4.07, 95% confidence interval as 2.27-7.27, P<0.05). The AUC of ROC curve based on VFV was 0.78 (95% confidence interval as 0.70-0.85), and the sensitivity and specificity were 72.2 % and 77.4 %, respectively. The optimal cut-off value of VFV was 1.255 dm 3, and all 132 patients were divided into the high-risk early postoperative recurrence group of 69 cases with VFV >1.255 dm 3, and the low-risk early postoperative recurrence group of 63 cases with VFV ≤1.255 dm 3. The disease-free survival time of the high-risk early postoperative recurrence group and the low-risk early post-operative recurrence group were 414(193,702)days and 1 047(620,1 219)days, showing a significant difference between them ( χ2=31.17, P<0.05). Conclusions:VFV is an independent factor influen-cing early tumor recurrence of HCC after resection. As a quantitative indicator of abdominal fat, it can predict the prognosis of HCC patients.

The modified Valsalva maneuver in hypopharynx CT scan / 临床耳鼻咽喉头颈外科杂志

Objective:To analyze the significance and factors influencing of CT scan under the modified Valsalva maneuver. Methods:Clinical data of 52 patients with hypopharyngeal carcinoma diagnosed from August 2021 to December 2022 were collected, all patients had calm breathing CT scan and modified Valsalva maneuver CT scan. Compare the exposure effect of the aryepiglottic fold, interarytenoid fold, postcricoid area, piriform fossa apex, posterior hypopharyngeal wall, and glottis with each CT scanning method. The effects of age, neck circumference, neck length, BMI, tumor site, and T stage on the exposure effect were analyzed. Results:In 52 patients, 50 patients（96.15%） completed CT scan at once time. The exposure effect of the CT scan under modified Valsalva maneuver in the aryepiglottic fold, interarytenoid fold, postcricoid area, piriform fossa apex, posterior hypopharyngeal wall was significantly better than CT scan under calm breathing（Z=-4.002, -8.026, -8.349, -7.781, -8.608, all P<0.01）, while CT scan under modified Valsalva maneuver was significantly worse in glottis than CT scan under calm breathing（Z=-3.625, P<0.01）. In the modified Valsalva CT scan, age had no obvious effect on the exposure effect. The exposure effect was better with long neck length, smaller neck circumference, smaller BMI and smaller T stage. The exposure of postcricoid carcinoma was better than pyriform sinus carcinoma and posterior hypopharyngeal wall carcinoma. But differences were not all statistically significant. Conclusion:The anatomical structure of the hypopharynx was clearly under CT scan with modified Valsalva maneuver, which clinical application is simple, but the effect of glottis was worse. The influence of age, neck circumference, neck length, BMI, and tumor T stage on the exposure effect still needs further investigation.

Bibliometric analysis of research on aneurysmal subarachnoid hemorrhage / 国际脑血管病杂志

Objective:To conduct a bibliometric analysis of scientific publications on aneurysmal subarachnoid hemorrhage (aSAH) worldwide from 2012 to 2022 and to investigate the current research status and hotspots in this field.Methods:The Web of Science Core Collection was used as the data source. According to the set retrieval strategy, the CiteSpace bibliometric tools were used to analyze the published literature and explore the research hotspots and cutting-edge directions.Results:A total of 4 937 articles were included, and the number of publications increased year by year from 2012 to 2022. The United States is a leading country in this field, Harvard University is a leading institution in this field, and Rinkel Gabriel JE is the researcher with the most published articles in this field. The analysis of the keywords provided by the author showed that delayed cerebral ischemia, vasospasm, risk, intracranial aneurysms, endovascular treatment, risk factors, embolization, complications, Pipeline embolization device, coil embolization, hemodynamics, and wall shear stress were the main hotspots and cutting-edge directions of aSAH research.Conclusion:The results of bibliometric analysis help to grasp the current research status of aSAH and determine new directions for future research.

Roles of intestinal microecological preparations in intra-abdominal infection / 中华消化外科杂志

Intra-abdominal infection is the second common infectious disease in intensive care unit and inhospital patients, with the mortality rate of 20%-30%. Advances in medicine have not improved the outcomes of patients with intra-abdominal infection, and the increasing multi-drug resistance organism may lead to a deterioration in the prognosis of patients with intra-abdominal infection. Gut microbiota dysbiosis and abdominal cavity infections show an interdependent and mutually aggravating relationship. Intestinal microecological preparations regulate gut flora and are potential therapeutic measures for intra-abdominal infections. The authors review the changes in gut flora during intra-abdominal infection, the effect of gut flora on the prognosis of intra-abdominal infections and the role of intestinal microecological preparations in intra-abdominal infections.

Application value of domestic robotic surgical system in radical resection of hilar cholangio-carcinoma / 中华消化外科杂志

Objective:To investigate the application value of domestic robotic surgical system in radical resection of hilar cholangiocarcinoma (hCCA).Methods:The retrospective and descriptive study was constructed. The clinicopathological data of a 66-year-old male patient with hCCA who was admitted to the Second Hospital of Shandong University in November 2022 were collected. Radical resection of hCCA was performed using the Toumai? laparoscopic surgical robot system. Observation indicators: (1) intraoperative conditions; (2) postoperative conditions; (3) follow-up. Count data were represented as absolute numbers and (or) percentages.Results:(1) Intraoperative conditions. The patient underwent radical resection of hCCA successfully using robotic surgical system, including tumor resection, lymph node dissection, and gastrointestinal reconstruc-tion. The operation time and volume of intraoperative blood loss were 400 minutes and 100 mL, respectively, and no intraoperative blood transfusion was required. (2) Postoperative conditions. The patient began ambulation on postoperative day 1 and began taking liquid food on postoperative day 4. Liver function examination and abdominal computed tomograph (CT) on postoperative day 5 showed a decrease in serum bilirubin, no biliary or intestinal leakage, and no edema or necrosis at the anastomotic site. The abdominal pre-anastomotic and post-anastomotic drainage tubes were removed on the 7th and 9th day after the surgery respectively, and the patient was discharged on the 10th day after surgery. Results of postoperative pathological examination showed moderately to poorly differentiated adenocarcinoma of the bile duct. Immunostaining was positive for CK7 and CK19. The Ki-67 proliferation index was 35%. The proximal and distal resection margin of bile duct were negative. The tumor diameter was 30 mm. Perineural invasion was positive. The surgical specimen margin was negative. Two lymph nodes were identified containing tumor cells positive for malignancy. No tumor cell metastasis was detected in the No.8, No.12 or gastric lesser curvature lymph nodes submitted for pathological examination. (3) Follow-up. The patient was followed up at postoperative 1-, 3-, 5-month after discharge. During follow-up period, results of liver function examination and abdominal CT showed liver function restore to normal levels, no complication such as biliary fistula, intestinal fistula, gastroparesis or tumor metastasis.Conclusion:The Domestic Toumai ? laparoscopic surgical robot system can be applied to radical resection of hCCA.

Short term efficacy of SuperCAP approach artificial femoral head replacement and PFNA internal fixation in the treatment of intertrochanteric fractures in patients with osteoporosis / 中国医师杂志

Objective:To investigate the short-term clinical efficacy of SuperCAP artificial femoral head replacement and proximal femoral anti rotation intramedullary nail (PFNA) internal fixation in the treatment of intertrochanteric fractures in patients with osteoporosis.Methods:A retrospective analysis was conducted on the clinical data of patients with osteoporosis and intertrochanteric fractures admitted to the Orthopedic Department of Changsha First Hospital from January 2017 to January 2020. The patients underwent SuperCAP artificial femoral head replacement or PFNA internal fixation surgery. According to the inclusion and exclusion criteria, a total of 32 cases were included in the SuperCAP group and 46 cases in the PFNA group. We compared the age, gender, fracture classification, bone density, American Society of Anesthesiologists (ASA) score, surgical time, postoperative weight bearing time, intraoperative bleeding volume, incidence of perioperative complications, and Oxford Hip Score (OHS) between two groups of patients.Results:There was no statistically significant difference in age, gender, fracture classification, bone density, ASA score, surgical time, intraoperative bleeding, and the OHS at 6 months and 1 year after surgery between the two groups of patients (all P>0.05). The SuperCAP group had better postoperative weight bearing time, incidence of perioperative complications, and OHS at 1 week, 1 month, and 3 months compared to the PFNA group (all P<0.05). Conclusions:SuperCAP minimally invasive approach for the treatment of osteoporotic femoral intertrochanteric fractures can achieve the same effect as PFNA internal fixation, and the short-term effect of SuperCAP artificial femoral head replacement is better than PFNA internal fixation.

Summary of 4 cases of minimally invasive tracheotomy for severe pneumonia under extracorporeal membrane oxygenation / 中国中西医结合急救杂志

Objective To summarize the experience of minimally invasive tracheotomy under veno-venous extracorporeal membrane oxygenation(VV-ECMO)in 4 cases of severe pneumonia,and to provide examples for airway management of severe pneumonia patients.Methods A retrospective study method was conducted.Four cases of severe pneumonia patients who underwent extracorporeal membrane oxygenation(ECMO)at the intensive care unit(ICU)of Shandong Provincial Hospital Affiliated to Shandong First Medical University from November 2022 to March 2023 were selected as the study subjects,clinical data on the general conditions,imaging examinations before and after admission to ICU,changes in biochemical indexes before and after ECMO technique,and the performance of bedside minimally invasive tracheotomy were collected.Bedside tracheotomy was performed to assist ventilation for patients according to the change of condition.The changes and prognosis of the patients were observed.Results Four patients with severe pneumonia were treated with bedside tracheotomy-assisted ventilation in the state of continuous VV-ECMO,the oxygen saturation was maintained between 0.98-1.00,the airway was cleared and sputum evacuation was smooth,the vital signs were stable after the operation,and the machine was gradually withdrawn.Conclusion During the treatment of severe pneumonia,the safe and rapid completion of bedside minimally invasive tracheotomy in patients with severe pneumonia under continuous VV-ECMO is a new challenge shared by doctors and nurses of otorhinolaryngology,head and neck surgery,and critical care emergency care unit.The four successful cases of bedside tracheotomy after VV-ECMO treatment we report suggest that bedside minimally invasive tracheotomy can safely and rapidly assist airway management,and may provide more useful experiences for the treatment of severe pneumonia and possible new acute respiratory infectious diseases in the future.

Values of mammography, ultrasound and magnetic resonance imaging in diagnosing breast cancer with silicone implants / 中华医学美学美容杂志

Objective:To investigate the diagnostic value of X-ray mammography, ultrasound and MRI in breast cancer with silicone implants.Methods:The clinical and imaging data of 20 patients with breast cancer in women with silicone implants in the First Affiliated Hospital of Zhengzhou University from March 2014 to October 2021 were analyzed retrospectively. The mammography, ultrasound and MRI findings were analyzed, and the differences in detection rate, diagnostic accuracy and omission diagnostic rate of breast cancer in women with implants were compared among the three imaging methods.Results:Compared with mammography, both ultrasound and MRI were able to display the prosthesis and breast lesions completely. There were significant differences in detection rate, diagnostic accuracy and omission diagnostic rate among mammography, ultrasound and MRI. And the detection rate and diagnostic accuracy of MRI in breast cancer in women with implants were higher than those of mammography, and the omission diagnostic rate was lower.Conclusions:Ultrasound and MRI are superior to mammography in evaluating breast cancer after silicone prosthesis implantation, and MRI has more advantages in guiding clinical diagnosis and treatment.

Selective Attentional Networks Deficits in Parents of Children With Autism Spectrum Disorder: Evidence From Attention Network Test

Objective@#We primarily aimed to investigate the attention network function among parents of children with autism spectrum disorder (ASD) using the Attention Network Test (ANT). The secondary objective was to observe whether the three attention networks of all participants were related to each other. @*Methods@#We included 28 parents of children with ASD and 28 well-matched parents of typically developing children. All participants underwent the neuropsychological assessment and ANT test. The three distinct attention networks, including alerting, orienting, and executive control, were also measured. @*Results@#Compared with controls, parents of children with ASD showed less-efficient alerting and executive control network (all p<0.05), but not orienting network (p=0.74). No significant correlation was found between the alerting, orienting, and executive control network for either group. @*Conclusion@#Our findings showed that parents of children with ASD had deficits in alerting and executive control attention functions. The deficits are indications of a broad autism phenotype.

Application of thrombelastogram in blood transfusion for patients in early stage of severe trauma / 中国输血杂志

【Objective】 To explore the value of thrombelastogram(TEG) on monitoring the coagulation function and guiding blood transfusion in admitted patients in early stage of severe trauma. 【Methods】 A total of 96 patients in early stage of severe trauma were selected from Ezhou Central Hospital, and were divided into two groups using a random number table method, with 48 patients in each group. The control group was guided by four routine coagulation tests for blood transfusion, while the observation group was guided by TEG.The detection rate of trauma-induced coagulopathy, detection duration, blood infusion volume within 24 hours of admission, coagulation index levels at different time points after blood transfusion, length of hospital stay, ICU stay, and mortality rate between the two groups were compared. 【Results】 The detection rate of trauma-induced coagulopathy was 72.9% in the control group and 93.8% in the observation group(P<0.05). The transfusion volume of fresh frozen plasma (U) and red blood cell (U) in the observation group within 24 hours of admission were significantly lower than those in the control group, which were (35.13±4.75) vs (45.17±6.54), (5.19±1.41) vs (7.08±1.32) (P<0.05); the tranfusion volume of cryoprecipitate (U) and the rate of platelet transfusion in the observation group were significantly higher than those in the control group, which were (36.78±2.49) vs (24.84±3.92), 79.2% vs 22.9%(P<0.05). The APTT(s), PT(s), TT(s), R(min), and K(min) in the observation group 8 hours after blood transfusion were significantly lower than those in the control group, which were (58.16±10.39) vs (70.83±14.99), (15.44±3.22) vs (17.32±2.89), (21.39±4.51) vs (25.18±4.73), (13.03±3.29) vs (14.95±4.57), and (8.07±3.65) vs (10.54±5.14) (P<0.05), while FIB(g/L), MA(mm), α(°), and Plt (×109/L) were higher than those in the control group, which were (2.02±0.46) vs (1.09±0.27), (35.56±11.88) vs (29.57±9.25), (40.07±13.34) vs (27.23±10.87), and (135.87±59.13) vs (108.17±52.08) (P<0.05). 【Conclusion】 TEG can help monitoring the coagulation function in patients in early stage of severe trauma and guide the blood transfusion.

Role of galectin-3 in the early brain injury of mice with subarachnoid hemorrhage is associated with the regulation of microglia polarization / 国际脑血管病杂志

Objective:To investigate the effect of galectin-3 (gal-3) on microglia polarization after subarachnoid hemorrhage (SAH).Methods:C57BL/6 male adult mice were used to induce SAH or sham operation models. Gal-3 siRNA or negative control siRNA was injected into the lateral ventricle 48 h before the model was induced. After 24 h of model preparation, the SAH score, neurological function score, brain water content, and Evans blue exudate were measured. Western blot analysis was used to detect the expressions of M1 phenotypic markers (inducible nitric oxide synthase [iNOS], CD11b, tumor necrosis factor [TNF]-α) and M2 phenotype markers (CD206, YM1/2, arginase-1 [Arg1]).Results:After using Gal-3 siRNA to inhibit Gal-3, the neurological function score significantly increased, while the SAH score, brain water content, and Evans blue exudate significantly decreased ( P<0.001). Western blot analysis showed that the expressions of M1 phenotypic markers (iNOS, CD11b and TNF-α) in microglia were significantly decreased after Gal-3 inhibition, while the expressions of M2 phenotypic markers (CD206, YM1/2 and Arg1) were significantly increased ( P<0.001). Conclusion:Inhibition of Gal-3 expression can alleviate the early brain injury after SAH, and its mechanism may be associated with regulating the polarization of microglia from M1 to M2 phenotype.

Role of SIRT1 in regulating endoplasmic reticulum stress in early brain injury after subarachnoid hemorrhage / 国际生物医学工程杂志

Objective:To investigate the effect of Sirtuin 1 (SIRT1) on subarachnoid hemorrhage (SAH) and its possible mechanism.Methods:A mouse model of SAH was constructed by internal carotid artery puncture. The protein and mRNA expression levels of SIRT1 at 0, 3, 6, 12, 24, 48, and 72 h were detected by Western Blot and qRT-PCR. A Western Blot assay was used to examine SIRT1 and the expression levels of endoplasmic reticulum stress-related markers GRP78, p-PERK/PERK, p-eIF2α/eIF2α, and CHOP after administration of a SIRT1 inhibitor or SIRT1 si-RNA. At 24 h after SAH, subarachnoid hemorrhage volume, neurological function score, brain water content, and blood-brain barrier integrity were measured.Results:The highest expression of SIRT1 protein and mRNA was observed at 24 h compared with other time points, and the differences were statistically significant (all P < 0.001). Inhibition of SIRT1 expression leads to increased expression of endoplasmic reticulum stress-related proteins GRP78, p-PERK/PERK, p-eIF2α/eIF2α, and CHOP, exacerbating hemorrhage and brain water content, disrupting blood-brain barrier integrity, and significantly reducing neurological function scores. Conclusions:Inhibition of SIRT1 expression significantly increased the endoplasmic reticulum response to excitation and exacerbated early brain injury after SAH.

Predictive value of preoperative abdominal adipose tissue measurement for early recurrence after resection of hepatocellular carcinoma / 中华消化外科杂志

Objective:To investigate the predictive value of preoperative abdominal adipose tissue measurement for early recurrence after resection of hepatocellular carcinoma (HCC).Methods:The retrospective case-control study was conducted. The clinicopathological data of 238 patients with HCC who underwent surgical resection from January 2018 to January 2020 in 2 medical centers in China were collected, including 46 cases in the First Affiliated Hospital of Chongqing Medical University and 192 cases in the First Affiliated Hospital of Army Medical University. There were 207 males and 31 females, aged 51(48,65)years. All patients underwent abdominal computed tomography (CT) and/or magnetic resonance imaging (MRI) before surgery. Observation indicators: (1) measure-ment of abdominal adipose tissue; (2) follow-up; (3) analysis of influencing factors for early recurrence after resection of HCC; (4) prediction of early recurrence after resection of HCC. Follow-up was conducted by outpatient examinations and telephone interview to detect the postoperative survival of patients up to February 2022. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was performed by the t test. Measurement data with skewed distribution was represented by M(range) or M( Q1, Q3), and comparison between groups was performed by the Mann-Whitney U test. Count data were expressed as absolute numbers or percen-tages, and the chi-square test was used for comparison between groups. Univariate analysis was conducted using the corresponding statistical methods based on data type. Multivariate analysis was performed using the Logistic regression model advance method. The receiver operating characteristic curve was drawn, and the area under curve was used to evaluate the efficacy. Results:(1) Measure-ment of abdominal adipose tissue. Of the 238 patients, the total abdominal adipose tissue, visceral adipose tissue, subcutaneous adipose tissue, total adipose tissue index, visceral adipose tissue index, subcutaneous adipose tissue index were 292(198,355)cm 2, 153(99,194)cm 2, 128(95,154)cm 2, 106(76,130)cm 2/m 2, (57±27)cm 2/m 2, 46(34,58)cm 2/m 2 for 139 patients with early postoperative recur-rence, versus 174(114,251)cm 2, 78(50,110)cm 2, 88(55,127)cm 2, 64(42,91)cm 2/m 2, (30±16)cm 2/m 2, 31(19,46) cm 2/m 2 for 99 patients without early recurrence, respectively, showing significant diffe-rences between them ( Z=?7.39, ?7.87, ?5.03, ?7.25, t=?9.46, Z=?5.00, P<0.05). (2) Follow-up. All the 238 patients were followed up according to the plan. The survival time of 238 patients was 26(8,44)months. The survival time was 11(5,18)months for patients with postoperative early recur-rence, versus 36(32,43)months for patients without early recurrence, respectively. (3) Analysis of influencing factors for early recurrence after resection of HCC. Results of univariate analysis showed that body mass index, total adipose tissue, visceral adipose tissue, subcutaneous adipose tissue, total adipose tissue index, visceral adipose tissue index and subcutaneous adipose tissue index were related factors for early recurrence after resection of HCC ( t=?5.88, Z=?7.39, ?7.87, ?5.03, ?7.25, t=?9.46, Z=?5.00, P<0.05). Results of multivariate analysis showed that visceral adipose tissue index was an independent influencing factor for early recurrence after resection of HCC ( odds ratio=1.06, 95% confidence interval as 1.04?1.08, P<0.05). (4) Prediction of early recurrence after resection of HCC. According to the results of multivariate analysis, the receiver operating characteris-tic curve showed that the area under curve of visceral adipose tissue index was 0.80 (95% confidence interval as 0.75?0.86, P<0.05), with the sensitivity and specificity as 75.5% and 71.7%. Conclusions:Visceral adipose tissue index is an independent influencing factor for early recurrence after resection of HCC. The risk of early recurrence increases with the increase of visceral adipose tissue index.

Clinical value of CT-based three-section formula in identification of Siewert types of adeno-carcinoma of esophagogastric junction / 中华消化外科杂志

Objective:To investigate the clinical value of computer tomography (CT)-based three-section formula in identification of Siewert types of adenocarcinoma of esophagogastric junction (AEG).Methods:The retrospective and descriptive study was conducted. The clinicopatho-logical data of 62 AEG patients who were admitted to two medical centers, including 33 patients from Peking University Cancer Hospital and 29 patients from the First Affiliated Hospital of Amy Medical University, between January 2019 and January 2021 were collected. There were 53 males and 9 females, aged (66±9)years. All patients underwent CT examination to obtain the coronal and axial images and determine the upper and lower edges of the tumor and the esophagogastric junction, which were imported into the formula for Siewert classification. Observation indicators: (1) results of CT examination and pathological examination; (2) consistence of judgements for CT examination between doctors; (3) consistence of judgements between CT examination and patholo-gical examination. Results of pathological examination came from intraoperative surgical observa-tion and postoperative histopathological examination. Measurement data with normal distribution were represented as Mean± SD, and count data were described as absolute numbers or percentages. The consistency coefficient Kappa ( κ) was used to evaluate the consistency of diagnosis between resear-chers. The κ≥0.75 was regarded as excellent consistency, 0.40< κ<0.75 as good consistency, κ ≤0.40 as poor consistency. Wilcoxon rank sum test was used to evaluate the statistical difference between results of the CT-based three-section formula method and the pathological examination. Taking the results of histopathological examination as standard, the sensitivity, specifi-city, accuracy and 95% confidence interval of the CT-based three-section formula method were calculated. Results:(1) Results of CT examination and pathological examination: all the 62 patients underwent CT examination successfully to obtain the coronal and axial images and determine the upper and lower edges of the tumor and the esophagogastric junction, which were used for Siewert classifica-tion. There were 3 cases with AEG of Siewert type Ⅰ, 47 cases with AEG of Siewert type Ⅱ and 12 cases with AEG of Siewert type Ⅲ according to doctor's judgement from the Peking University Cancer Hospital, and there were 3 cases with AEG of Siewert type Ⅰ, 49 cases with AEG of Siewert type Ⅱ and 10 cases with AEG of Siewert type Ⅲ according to doctor's judgement from the First Affiliated Hospital of Amy Medical University, respectively. After arbitration, there were 2 cases with AEG of Siewert type Ⅰ, 48 cases with AEG of Siewert type Ⅱ and 12 cases with AEG of Siewert type Ⅲ determined by the CT based three-section formula. There were 7 cases of stage T1, 10 cases of stage T2, 24 cases of stage T3, 14 of stage T4a and 7 cases of stage T4b of pathological T staging. There were 2 cases with AEG of Siewert type Ⅰ, 48 cases with AEG of Siewert type Ⅱ and 12 cases with AEG of Siewert type Ⅲ determined by pathological examination. (2) Consistence of judgements for CT examination between doctors: the consistency of Siewert classification determined by CT-based three-section formula between 2 doctors was good ( κ=0.74, P<0.001). (3) Consistence of judgements between pathological examination and CT examination: with Siewert classification determined by pathological examination as reference, the accuracy of Siewert classification determined by CT based three-section formula was 90.3%( κ=0.73, P<0.001). The sensitivity and specificity of CT-based three-section formula were 66.7%(95% confidence interval as 20.8%-93.9%) and 100.0%(95% confidence interval as 93.9%-100.0%) for AEG of Siewert type Ⅰ, 97.7%(95% confidence interval as 88.2%-99.6%) and 72.2%(95% confidence interval as 49.1%-87.5%) for AEG of Siewert type Ⅱ, 73.3%(95% confidence interval as 48.0%-89.1%) and 97.9%(95% confidence interval as 88.9%-99.9%) for AEG of Siewert type Ⅲ, respectively. Conclusion:The CT-based three-section formula can be used for identification of Siewert types of AEG, with a high accuracy.

Prevalence of learning disabilities among middle school students in Beijing / 中国学校卫生

Objective@#To understand the prevalence and distribution of learning disabilities among middle school students in Beijing.@*Methods@#By using stratified random cluster sampling, 6 365 students in grade one and grade two of 12 public middle schools in urban and rural in Beijing were selected. Criteria for learning disabilities included the following: on campus healthy students without serious physical and mental diseases and normal IQ assessed by combined Raven intelligence test; positive in the teacher rated Screening Scale for Middle School Students with Learning Disabilities; percentile ranking (below the bottom 10% percentile of grade) of the academic performance in the Chinese, mathematics and English tests.@*Results@#The learning disabilities of the subjects were determined by the teachers and it was found that the score of words reading, reading understanding, words spell, written expression, number calculation, mathematical reasoning and the total score of the scale were respectively (20.78±4.00, 18.16 ±4.35, 21.50±3.89, 20.06±3.92, 21.12±5.23. 18.67±5.35, 120.28±19.99) points. There were differences in the total score of learning ability between urban and rural areas, gender and grade. Urban area was better than rural area, girls were better than boys, and junior two students were better than junior one students( t=12.94, 9.94, 3.07, P <0.05). A total of 445(7%) students with learning disabilities were detected. Reading disabilities accounted for 5.0%, dysgraphia 2.7% and math disabilities 4.6%. Prevalence of learning ability differed by urban rural regions, gender and grade, with girls and students from urban areas and grade two being significantly lower( t =12.94, 9.94, 3.07, P <0.05).@*Conclusion@#The prevalence of learning disabilities in middle school students is high, which needs more attention.

Application of 3D printed model assisted network teaching in clinical probation of neurosurgery / 中华医学教育探索杂志

Objective:To explore the effect of the 3D printed model assisted network teaching of neurosurgery.Methods:Seventy-six probation students were divided into: 3D printed model assisted online course teaching group (test group) and traditional teaching group (control group). After 1-month online teaching, quantitative assessment and satisfaction survey were carried out. SPSS 17.0 was used for statistical analysis of variance.Results:The department graduation test (theory and operation) scores of students in the test group were (86.7±7.4) points, which was significantly higher than those in the control group (78.2±8.2) points ( t=5.56, P<0.01). The teaching satisfaction survey showed that the test group had significantly higher scores in self-evaluation of spatial imagination ( t=3.81, P<0.01), deepening understanding of neuroanatomy ( t=5.29, P<0.01), and increasing interest in clinical learning ( t=5.12, P<0.01) than those of the control group. Conclusion:Compared with the conventional online teaching methods, 3D printed model assisted online teaching helps to improve teaching quality and students' satisfaction.

The value of three-dimensional amide proton transfer-weighted imaging and its combination with diffusion weighted imaging in diagnosing breast benign and malignant lesions / 中华放射学杂志

Objective:To investigate the diagnostic value of three-dimensional amide proton transfer-weighted imaging (APTWI) and its combination with diffusion weighted imaging (DWI) for differentiating breast benign from malignant lesions.Methods:This was a prospective study. From July to December 2020, 226 patients with breast lesions confirmed by surgery or puncture pathology in the First Affiliated Hospital of Zhengzhou University were collected. All patients underwent MR T 1-weighted imaging, T 2-weighted imaging, DWI, APTWI, and dynamic contrast-enhanced MRI, and the apparent diffusion coefficient (ADC) value and the magnetization transfer ratio asymmetry at an offset of 3.5 ppm [MTRasym(3.5 ppm)] were obtained from DWI and APTWI respectively. Mann-Whitney U test was used for the comparison of DWI and APTWI parameters between breast benign and malignant lesions. Receiver operating characteristic (ROC) curve was used to evaluate the differences of diagnostic efficacy between DWI, APTWI, and their combination. Results:There were 226 patients with 226 breast lesions, including 124 malignant and 102 benign lesions. The ADC values of patients with malignant breast lesions [1.03 (0.93, 1.13)×10 -3 mm 2/s] and MTRasym (3.5 ppm) [1.95% (1.10%, 2.88%)] were lower than those of benign breast lesions [1.38 (1.11, 1.55)×10 -3 mm 2/s, 3.30% (2.20%, 4.20%), respectively], and the differences were statistically significant ( Z=-8.19, -6.51, P<0.05). The area under the ROC curves (AUC) of DWI, APTWI, and its combination in the differential diagnosis of benign and malignant breast lesions were 0.817, 0.752, and 0.868, respectively. The AUC of the combination of DWI and APTWI was higher than that of DWI and APTWI ( Z=4.00, 2.93, P<0.05), and there was no significant difference in the AUC between DWI and APTWI diagnoses ( Z=1.58, P>0.05). Taking 1.25×10 -3 mm 2/s as the optimal cut-off value for ADC values, the sensitivity, specificity, and accuracy in differentiating benign from malignant breast lesions were 94.4% (117/124), 62.7% (64/102), and 80.1% (181/226), respectively; Taking 2.70% as the optimal cut-off value for MTRasym (3.5 ppm), the sensitivity, specificity, and accuracy in differentiating benign from malignant breast lesions were 73.4% (91/124), 64.7% (66/102), and 69.5% (157/226), respectively, and the sensitivity, specificity, and accuracy of DWI combined with APTWI in differentiating benign from malignant breast lesions were 82.3% (102/124), 79.4% (81/102), and 81.0% (183/226), respectively. Conclusion:APTWI can be used for the differential diagnosis of benign and malignant breast lesions, and the combination of APTWI and DWI can obtain the better diagnostic performance than the single method.