Research progress of autophagy in retinal and eye diseases / 国际眼科杂志(Guoji Yanke Zazhi)

Maintaining the homeostasis of intracellular components degradation and recycling, autophagy is a critical control mechanism of cellular quality. It promotes the degradation of cell components to provide nutrients and energy for cellular metabolism in stress response. The retina is a light-sensitive tissue that transduces and processes visual images in the eye, and it has a high demand for substances and energy. Basal autophagy is essential for holding retinal homeostasis and the normal function of the visual system. Therefore, the latest studies that investigating the participation of autophagy in eye diseases such as glaucoma, age-related macular degeneration, diabetic retinopathy, retinal dystrophies, and retinal detachment were summarized, providing a theoretical basis for the future treatment of eye diseases by regulating autophagy.

Safety and efficacy of hemoperfusion in cardiopulmonary bypass for postoperative inflammatory response in patients with acute Stanford type A aortic dissection: A randomized controlled trial / 中国胸心血管外科临床杂志

@#Objective     To explore the clinical effect of hemoperfusion (HP) in cardiopulmonary bypass (CPB) on postoperative inflammation in patients with acute type A aortic dissection (AAD). Methods    Adult patients with AAD who planned to undergo total aortic arch replacement from July 2020 to November 2021 were continuously enrolled in our heart center. Patients were randomly divided into a HP group and a control (C) group. The HP group was treated with disposable HP device (Model: HA380, Zhuhai Jafron Biomedical, China) in CPB during the operation. Results    Finally,  70 patients were included with 59 males and 11 females at an age range of 21-67 years. There were 35 patients in both groups. In this study, 3 patients died within 3 days after surgery, 2 in the HP group and 1 in the C group, and the remaining 67 patients survived to the follow-up end point (30 days after surgery). There was no statistical difference in preoperative baseline data, operative method, CPB time, block time, or other intraoperative data between the two groups. Blood product dosage, intubation time, hospital stays, and hospitalization expenses were similar between the two groups. Intraoperative hemoglobin (82.70±2.31 g/L vs. 82.50±1.75 g/L, P=0.954] and platelet concentration [(77.87±7.99)×109/L vs.(89.17±9.99)×109/L, P=0.384] were not statistically different between the HP group and C group. In the HP group, postoperative (ICU-12 h) interleukin-6 (IL-6) [338.14 (128.00, 450.70) pg/mL vs. 435.75 (180.50, 537.00) pg/mL, P=0.373], IL-8 [35.04 (18.02, 40.35) pg/mL vs. 43.50 (17.70, 59.95) pg/mL, P=0.383], and IL-10 [21.19 (6.46, 23.50) pg/mL vs. 43.41 (6.34, 50.80) pg/mL, P=0.537] were slightly lower than those in the C group, and the difference was not statistically different. The incidences of pulmonary infection (0.00% vs. 11.76%, P=0.042) and liver injury (2.94% vs. 20.58%, P=0.027) in the HP group were significantly lower than those in the C group, and the incidence of other postoperative complications, such as arrhythmia, nervous system complications and urinary system complications, showed no statistical difference between the two groups. Conclusion     HP therapy in CPB is safe, but its effect on reducing postoperative inflammatory factors, postoperative inflammatory reactions and postoperative complications in the patients with AAD is limited, and it may be of application value to some high-risk patients with lung and liver injury.

Ghrelin and appetite regulation: Mechanism and clinical application / 中华内分泌代谢杂志

The development of obesity is closely related to the disruption of central appetite regulation. Gastric growth hormone-releasing peptide is the only appetite-promoting peptide known to be present in the circulatory system. Ghrelin may act on the central homeostatic and hedonic feeding neural pathways to promote appetite and feeding behavior, and may be a new target for appetite regulation. In addition, Ghrelin is also involved in the regulation of energy homeostasis via promoting growth, regulating gastrointestinal function, and suppressing inflammatory response. Therefore, the research on the mechanism of ghrelin and its receptors will help understand the pathophysiological changes in the central appetite regulation process of obese patients, and to find potential targets for the treatment of obesity. In this paper, we focus on the molecular mechanism of appetite regulation by Ghrelin and its clinical application.

Platelet-rich fibrin membrane packing and air filling in the treatment of refractory macular holes / 中华眼底病杂志

Objective:To observe and explore the feasibility and effectiveness of platelet-rich fibrin (PRF) membrane packing and air filling in the treatment of refractory macular holes.Methods:A retrospective clinical study. From January 2019 to January 2020, 17 patients with refractory macular hole (17 eyes) who diagnosed in Renmin Hospital of Wuhan University were included in the study. Among them, there were 7 males (7 eyes) and 10 females (10 eyes), with the age of 55.18±7.91 years. All eyes underwent 23G minimally invasive vitrectomy combined with internal limiting membrane stripping and PRF packing, and air filling was performed at the end of the operation. The best corrected visual acuity (BCVA) and optical coherence tomography angiography were performed in all eyes before surgery and at 1 week and 1, 3 months after surgery. The BCVA examination was performed using a international standard logarithmic visual acuity chart, which was converted into logarithm of the minimum angle of resolution visual acuity during statistics. Taking 3 months after surgery was as the time point to judge the efficacy, the changes of BCVA, superficial retinal vascular density (SVD), foveal avascular zone (FAZ) area and central foveal thickness (CFT) before and after surgery were compared. Paired t-test was used to compare the indicators before and after surgery. Results:Among the 17 eyes, there were 6, 7, and 4 eyes with giant macular hole, high myopia macular hole, and recurrent macular hole, respectively; the hole diameter was 723.94±38.30 μm. Three months after surgery, all holes were closed. Compared with before surgery, the BCVA ( t=4.458) and SVD ( t=2.675) increased, and the CFT ( t=6.329) and FAZ area ( t=4.258) decreased at 3 months after surgery, and the differences were statistically significant ( P<0.05). At the last follow-up, there was no complications such as intraocular hypertension and retinal detachment in all eyes. Conclusion:Minimally invasive vitrectomy combined with internal limiting membrane stripping and PRF tamponade in the treatment of refractory macular holes can increase the closure rate, improve visual acuity and retinal blood perfusion.

The efficacy of platelet-rich fibrin membrane insertion combined with air filling for giant macular hole / 中华眼底病杂志

Objective:To observe the efficacy of platelet-rich fibrin (PRF) membrane tamponade combined with air filling for giant macular hole (MH).Methods:A prospective case-control study. From January 2019 to February 2021, 56 patients (56 eyes) diagnosed with giant MH from Eye Center of Renmin Hospital of Wuhan University were enrolled. Among them, there were 17 males with 17 eyes and 39 females with 39 eyes. The average age of the patients was 64.23±9.30 years old. The average MH minimum diameter was 827.36±83.16 μm. The best corrected visual acuity (BCVA) and optical coherence tomography angiography (OCTA) examination were performed before surgery. The Chinese version of 25-item National Eye Institute visual functioning questionnaire (NEI VFQ-25) was used to investigate patient's visual-related quality of life. There were 28 eyes of 28 cases receiving PRF membrane covering, as PRF group, another 28 eyes of 28 cases receiving inverted internal limiting membrane (ILM) insertion into giant MH, as ILM group. The differences of the age ( t=-1.588), sex ratio ( χ2=0.760), BCVA ( Z=-0.400), macular hole minimum diameter ( t=-0.604), choriocapillary blood flow area (CBFA) ( t=1.331) and NEI VFQ-25 score ( t=0.921) were not statistically significant ( P>0.05). All eyes underwent 23G minimally invasive vitrectomy. In the PRF group, PRF membrane was used to fill the hole, and in the ILM group, the hole was filled with ILM inversion, and filled with sterile air after full gas-liquid exchange. The follow-up time after surgery was ≥6 months. The same equipment and methods as before surgery were used to conduct related examinations, and the changes of BCVA, the shape of hole closure, CBFA and the improvement of vision-related quality of life were compared between the two groups. For comparison between groups, independent samples t-test was used for data with normal distribution, and Mann-Whitney U test was used for data with non-normal distribution. For intra-group comparisons, paired-samples t-test was used for data with normal distribution, and Wilcoxon rank-sum test was used for non-normally distributed data. Results:Six months after surgery, in the eyes of PRF group and ILM group, the hole of 27 (96.4%, 27/28) and 26 (92.6%, 26/28) eyes were closed; the median BCVA was 0.70 and 0.70, respectively; CBFA were 1.99±0.20 and 1.91±0.18 mm 2; NEI VFQ-25 scores were 81.36±12.39 and 78.39±10.12, respectively. Compared with before surgery, the BCVA ( Z=-4.636,-4.550) and CBFA ( t=-27.115,-31.135) of the affected eyes in the PRF group and ILM group were significantly improved after surgery, and the NEI VFQ-25 scores ( t=-15.557, -10.675) was significantly increased, and the difference was statistically significant ( P<0.05). There was no significant difference in BCVA ( Z=-0.167), CBFA ( t=1.554), and NEI VFQ-25 scores ( t=0.980) between the two groups after interocular surgery ( P=0.726, 0.126, 0.331). Conclusion:PRF membrane insertion with air filling has the same efficacy as ILM insertion in the treatment of giant MH, which can improve the closure rate of MH, patients' vision and vision-related quality of life, and increase choroidal blood perfusion.

Cytochrome P450s in algae: Bioactive natural product biosynthesis and light-driven bioproduction

Algae are a large group of photosynthetic organisms responsible for approximately half of the earth's total photosynthesis. In addition to their fundamental ecological roles as oxygen producers and as the food base for almost all aquatic life, algae are also a rich source of bioactive natural products, including several clinical drugs. Cytochrome P450 enzymes (P450s) are a superfamily of biocatalysts that are extensively involved in natural product biosynthesis by mediating various types of reactions. In the post-genome era, a growing number of P450 genes have been discovered from algae, indicating their important roles in algal life-cycle. However, the functional studies of algal P450s remain limited. Benefitting from the recent technical advances in algae cultivation and genetic manipulation, the researches on P450s in algal natural product biosynthesis have been approaching to a new stage. Moreover, some photoautotrophic algae have been developed into "photo-bioreactors" for heterologous P450s to produce high-value added pharmaceuticals and chemicals in a carbon-neutral or carbon-negative manner. Here, we comprehensively review these advances of P450 studies in algae from 2000 to 2021.

Value of 18F-FDG PET/MR in evaluating the effect of neoadjuvant chemoradiotherapy in locally advanced rectal cancer / 中华核医学与分子影像杂志

Objective:To assess the value of 18F-fluorodeoxyglucose (FDG) PET/MR parameters and their changes in predicting and evaluating the curative effect in patients with locally advanced rectal cancer before and after neoadjuvant chemoradiotherapy (NCRT). Methods:From June 2017 to June 2020, 13 patients (9 males, 4 females; age (52.2±13.2) years) with locally advanced rectal cancer confirmed pathologically and underwent NCRT in Chinese PLA General Hospital were retrospectively enrolled. All patients performed the first PET/MR within one month before NCRT and the second PET/MR within one month before operation. PET/MR parameters including maximum standardized uptake value (SUV max), mean standardized uptake value (SUV mean), metabolic tumor volume (MTV) 2.5, total lesion glycolysis (TLG), minimum apparent diffusion coefficient (ADC min), and their changing percentage (Δ) before and after NCRT were collected. Patients were divided into pathologically complete remission (pCR) group and non-pCR group or response group and non-response group according to the postoperative pathological results as the gold standard. Mann-Whitney U test and logistic regression analysis were used for data analysis. The cut-off values of related parameters and their diagnostic efficiencies were determined by receiver operating characteristic (ROC) curve analysis. Results:Of 13 patients, 5 reached pCR and 8 had histological reaction (response). There were no significant differences in parameters (SUV max, SUV mean, MTV 2.5, TLG, ADC min) between different groups before treatment ( U values: 8.00-19.00, all P>0.05). There were significant differences in SUV max, SUV mean, MTV 2.5, TLG and ΔADC min between pCR group and non-pCR group after treatment ( U values: 0.00-6.00, all P<0.05), but only SUV max was correlated with pCR after treatment (odds ratio ( OR)=0.335, 95% CI: 0.123-0.917, P=0.033). The area under curve (AUC) was 0.95 and the cut-off value of SUV max was 3.055, with the sensitivity of 100%, the specificity of 80.0% and the accuracy of 92.3%. There were significant differences in SUV max, SUV mean, TLG, ADC min, ΔSUV max and ΔADC min between the response group and non-response group after treatment ( U values: 0.00-6.00, all P<0.05), but only ΔSUV max was correlated with the response results ( OR=2.022, 95% CI: 1.100-4.130, P=0.048). The AUC was 0.90 and the cut-off value of ΔSUV max was 69.0%, with the sensitivity of 87.5%, the specificity of 80.0% and the accuracy of 84.6%. Conclusions:PET/MR has high accuracy in evaluating NCRT for locally advanced rectal cancer. SUV max is an independent predictor of pCR after treatment, while ΔSUV max is an independent predictor of histological reaction (response).

Evaluation of the effect of traditional Chinese medicine comprehensive nursing in patients with rectal cancer chemotherapy / 中国实用护理杂志

Objective:To explore the effect of traditional Chinese medicine comprehensive nursing on psychological state, skin degree and quality of life in patients with rectal cancer.Methods:A total of 88 cases with rectal cancer chemotherapy in Nanyang Nanshi Hospital from August 2017 to August 2020 were as the research object, all patients were divided into two groups with 44 cases in each group by random number table method. The control group received routine nursing, the observation group was given traditional Chinese medicine comprehensive nursing based on the control group. The more satisfaction with the two groups, psychological state before and after nursing, cancer fatigue degree, the quality of life, adverse reaction after chemotherapy were compared between the two groups.Results:The satisfaction score of the observation group was (80.24±9.02) points, which was higher than that of the control group (74.64±9.02) points, there was statistically significant ( t value was 2.912, P<0.05). The probability of adverse reactions was 4.55%(2/44), which was lower than that of the control group (20.45%, 9/44), there was statistically significant ( χ2 value was 5.090, P<0.05). There were no differences in psychological state, cancer fatigue degree and quality of life between the two groups before intervention ( P>0.05). The scores of anxiety, depression, cognitive fatigue, body fatigue, emotional fatigue and behavioral fatigue after intervention were (58.24±3.56), (57.82±3.36), (5.64±1.32), (6.56±0.88), (6.04±0.64), (5.98±1.52) points in the observation group, and (60.12±3.72), (59.27±3.12), (6.28±1.48), (7.24±0.90), (6.48±0.72), (6.78±1.56) points in the control group, there were statistically significant( t values were 2.141-3.583, P<0.05).The quality of life score of the observation group after intervention was (211.68±17.12) points, which was higher than that of the control group (199.08±17.36) points, there was statistically significant( t value was 3.428, P<0.05). Conclusions:Comprehensive nursing of traditional Chinese medicine for patients with rectal cancer chemotherapy can make patients more satisfied with nursing service, relieve negative emotions and cancer fatigue, reduce the occurrence of adverse reactions to chemotherapy, and promote the improvement of patients' quality of life. It is worth popularizing.

Application of clinical flow examination scale in standardized residency training of anesthesiology / 中华医学教育探索杂志

Objective:The clinical flow examination (CFE) scale was used to evaluate the effect of standardized residency training in the department of anesthesiology in West China Hospital of Sichuan University.Methods:Using the CFE scale, 98 students were tested three times consecutively, and then satisfaction surveys were conducted on the assessment tutors and students respectively. IBM SPSS software was used to test the reliability and validity of the CFE scale, and then the scores and satisfaction were statistically analyzed. SPSS 23.0 was used for t test and chi-square test. Results:The CFE scale had high reliability and validity, and the results of 95 students were included for analysis. The 95 students had a very high rate of excellence in basic, professional and final grades. Except that the basic, professional and final overall scores of the female group were higher than those of the male group ( P < 0.05), the differences between the other groups were not statistically significant ( P > 0.05). Results of the CFE satisfaction survey showed that the satisfaction of students and instructors was 98.9% and 100%, respectively. Conclusion:CFE scale can be well used to evaluate the effect of standardized residency training, and the training effect of anesthesiology department in our hospital is good and basically homogeneous, while there is still room for further improvement.

Assessment of Prognostic Factors of Racial Disparities in Testicular Germ Cell Tumor Survival in the United States (1992-2015) / 生物医学与环境科学（英文）

Objective@#Testicular germ cell tumors (TGCT) are the most common cancer among men aged 15 to 39 years. Previous studies have considered factors related to TGCT survival rate and race/ethnicity, but histological type of the diagnosed cancer has not yet been thoroughly assessed.@*Methods@#The data came from 42,854 eligible patients from 1992 to 2015 in the Surveillance Epidemiology and End Results 18. Frequencies and column percent by seminoma and nonseminoma subtypes were determined for each covariates. We used Cox proportional hazard regression to assess the impact of multiple factors on post-diagnostic mortality of TGCT.@*Results@#Black males were diagnosed at a later stage, more commonly with local or distant metastases. The incidence of TGCT in black non-seminoma tumors increased most significantly. The difference in survival rates between different ethnic and histological subtypes, overall survival (OS) in patients with non-seminoma was significantly worse than in patients with seminoma. The most important quantitative predictor of death was the stage at the time of diagnosis, and older diagnostic age is also important factor affecting mortality.@*Conclusion@#Histological type of testicular germ cell tumor is an important factor in determining the prognosis of testicular cancer in males of different ethnic groups.

Analysis of Predictive Value of Laboratory Indexes for Malignant Lymphoma Patients with Bone Marrow Involvement / 中国实验血液学杂志

OBJECTIVE@#To analyze the influence of bone marrow involvement (BMI) in patients with malignant lymphoma (ML) on laboratory indexes, and evaluate the laboratory markers that can be used to predict/diagnose BMI.@*METHODS@#The clinical characteristics and laboratory indexes of 137 ML patients were analyzed retrospectively, from which the indexes of BMI in ML patients was studied. The logistic regression analysis and receiver operating curve (ROC) were used to evaluate independent risk factors and predictors of BMI diagnosis in ML patients.@*RESULTS@#Compared with non-BMI group, the red blood cell distribution width, C-reactive protein, erythrocyte sedimentation rate, D-dimer, lactate dehydrogenase, alkaline phosphatase, β@*CONCLUSION@#PLT and sIL2R show good diagnostic value for ML patients with BMI.

Sex Comb on Midleg Like-2 Accelerates Hepatocellular Carcinoma Cell Proliferation and Metastasis by Activating Wnt/β-Catenin/EMT Signaling

Purpose@#The purpose of this study was to investigate the influences of sex comb on midleg like-2 (SCML2) on hepatocellular carcinoma (HCC) and potentially related mechanisms. @*Materials and Methods@#SCML2 expression in tumor tissues and cells was analyzed using the TCGA database and/or qRT-PCR. The proliferation of HCC cells was detected by CCK-8, colony formation, and EdU assays. The migration and invasion of HCC cells were detected by transwell and wound healing assays. Apoptosis of HCC cells was determined by flow cytometry. Additionally, qRT-PCR and Western blot were used to detect the expression of SCML2 and Wnt/β-catenin/epithelial–mesenchymal transition (EMT) signaling. A xenograft model in mice was established to verify the in vitro findings. @*Results@#We found that SCML2 was highly expressed in HCC tissues and cells and that high expression of SCML2 was correlated with poor prognosis in HCC patients. SCML2 overexpression promoted proliferation, invasion, and migration and repressed apoptosis of HCC cells. The reverse results were obtained in SCML2-silenced cells. Further, we found that SCML2 activated the Wnt/β-catenin/EMT pathway. SCML2 silencing reduced the protein levels of Wnt3a, β-catenin, N-cadherin, Vimentin, and Snail and enhanced E-cadherin protein expression both in vivo and in vitro. @*Conclusion@#SCML2 silencing inhibits the proliferation, migration, and invasion of HCC cells by regulating the Wnt/β-catenin/ EMT pathway.

Changes of plasma high density lipoprotein cholesterol and metabolic indicators in obese patients after laparoscopic sleeve gastrectomy / 中华消化外科杂志

Objective:To investigate the changes of plasma high density lipoprotein cholesterol (HDL-C) and metabolic indicators in obese patients after laparoscopic sleeve gastrectomy (LSG).Methods:The retrospective cohort study was conducted. The clinical data of 69 obese patients who were admitted to the Tenth People′s Hospital of Tongji University from August 2013 to March 2017 were collected. There were 32 males and 37 females, aged (33±12)years, with a range from 18 to 65 years. Of 69 patients, 44 patients with preoperative HDL-C concentration <1.04 mmoL/L were allocated as low HDL-C group, and 25 patients with preoperative HDL-C concentration ≥1.04 mmoL/L were allocated as normal HDL-C group. Sixty-nine patients underwent LSG. Observation indicators: (1) analysis between preoperative HDL-C and clinical indicators; (2) follow-up; (3) stratified analysis of plasma HDL-C. Follow-up was conducted using outpatient examination and hospitalization review to detect changes of plasma HDL-C, insulin resistance index, uric acid, free fatty acids and body mass every 3 months after operation up to September 2017. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test. Measurement data with skewed distribution were represented as M ( P25, P75), and comparison between groups was analyzed using the Mann-Whitney U test. Count data were expressed as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test. Pearson correlation coefficient was used to analyze measurement data with normal distribution, and Spearman correlation was used to analyze measurement data with skewed distribution. Repeated measurement data were analyzed by ANOVA. Results:(1) Analysis between preoperative HDL-C and clinical indicators: results of correlation analysis showed that the preoperative plasma HDL-C concentration was negative correlated with the body mass, height, abdominal circumference, insulin resistance index and triglyceride in 69 patients ( r=-0.246, -0.307, -0.262, -0.253, -0.301, P<0.05), and the preoperative plasma HDL-C concentration was not correlated with the age, body mass index (BMI), fasting blood glucose, glycosylated hemoglobin, alanine aminotransferase, aspartate aminotransferase, gamma glutamyltransferase, uric acid, creatinine, free fatty acid, fasting serum insulin, total cholesterol and low density lipoprotein cholesterol ( P>0.05). The preoperative plasma HDL-C concentration was still negative correlated with the body mass in 69 patients after adjusting for age, BMI, fasting blood glucose, glycosylated hemoglobin, fasting serum insulin and insulin resistance index ( r=-0.277, P<0.05). (2) Follow-up: 69 patients were followed up postoperatively for 6 months (6 months, 12 months). The plasma HDL-C concentration, insulin resistance index, uric acid, free fatty acids, body mass of low HDL-C group at postoperative 3 and 6 months were (0.96±0.18)mmol/L, 2.20(0.51, 11.66), (411±93)μmol/L, 0.57 mmol/L (0.20 mmol/L, 1.00 mmol/L), (92±18)kg and (1.11±0.18)mmol/L, 2.19(0.71, 8.75), (389±100)μmol/L, 0.40 mmol/L(0.13 mmol/L, 1.10 mmol/L), (86±17)kg, respectively. The above indicators of normal HDL-C group at postoperative 3 and 6 months were (1.17±0.24)mmol/L, 2.22(0.24, 7.04), (379±105)μmol/L, 0.60 mmol/L(0.27 mmol/L, 1.10 mmol/L), (84±16)kg and (1.34±0.20)mmol/L, 1.60(0.36, 5.56), (359±92)μmol/L, 0.42 mmol/L (0.16 mmol/L, 2.90 mmol/L), (80±18)kg, respectively. There was significant difference in the changes of postoperative plasma HDL-C concentration between the two groups ( F=41.443, P<0.05), and there was interaction between groups and time points ( F=6.252, P<0.05). There was significant difference between different time points ( F=29.900, P<0.05). There was significant difference in the changes of postoperative insulin resistance index between the two groups ( F=4.313, P<0.05), and there was no interaction between groups and time points ( F=2.298, P>0.05). There was significant difference between different time points ( F=29.800, P<0.05). There was no significant difference in the changes of postoperative uric acid between the two groups ( F=1.669, P>0.05), and there was no interaction between groups and time points ( F=0.111, P>0.05). There was significant difference between different time points ( F=12.796, P<0.05). There was significant difference in the changes of postoperative free fatty acids between the two groups ( F=5.465, P<0.05), and there was no interaction between groups and time points ( F=0.504, P>0.05). There was no significant difference between different time points ( F=1.405, P>0.05). There was significant difference in the changes of postoperative body mass between the two groups ( F=5.614, P<0.05), and there was no interaction between groupsand time points ( F=2.174, P>0.05). There was significant difference between different time points ( F=497.496, P<0.05). (3) Stratified analysis of plasma HDL-C. ① Changes of postoperative plasma HDL-C in obese patients of different genders: of 69 patients, the plasma HDL-C concentration of the 32 male patients before operation and at postoperative 3 and 6 months were (0.91±0.19)mmol/L, (1.02±0.24)mmol/L, (1.18±0.23)mmol/L, respectively, and the percentage increase of plasma HDL-C concentration at postoperative 3 and 6 months were 12.00%(4.00%, 12.00%)and 20.00%(12.00%, 39.25%), respectively. The above indicators of the 37 female patients were (1.05±0.21)mmol/L, (1.06±0.22)mmol/L, (1.22±0.22)mmol/L and 0(-9.50%, 8.25%), 12.00%(2.00%, 23.00%), respectively. There was significant difference in the changes of percentage increase of plasma HDL-C concentration between the male and female patients ( F= 6.716, P<0.05), and there was interaction between groups and time points ( F=3.861, P<0.05). There was significant difference between different time points ( F=37.374, P<0.05). ② Changes of postoperative plasma HDL-C in obese patients of different genders in low HDL-C group and normal HDL-C group: of 44 patients in low HDL-C group, the plasma HDL-C concentration of the 24 male patients before operation and at postoperative 3 and 6 months were (0.82±0.12)mmol/L, (0.99±0.21)mmol/L, (1.12±0.22)mmol/L, respectively, and the percentage increase of plasma HDL-C concentration at postoperative 3 and 6 months were 16.00%(-1.75%, 28.75%) and 27.50%(15.75%, 43.50%), respectively. The above indicators of the 20 female patients in low HDL-C group were (0.89±0.08)mmol/L, (0.93±0.14)mmol/L, (1.10±0.14)mmol/L and 1.50%(-8.25%, 16.50%), 18.00%(9.00%, 23.00%), respectively. There was significant difference in the changes of percentage increase of plasma HDL-C concentration between the male and female patients ( F=4.503, P<0.05), and there was interaction between groups and time points ( F=3.594, P<0.05). There was significant difference between different time points ( F=37.096, P<0.05). Of 25 patients in normal HDL-C group, the plasma HDL-C concentration of the 8 male patients before operation and at postoperative 3 and 6 months were (1.15±0.12)mmol/L, (1.12±0.32)mmol/L, (1.32±0.21)mmol/L, respectively, and the percentage increase of plasma HDL-C concentration at postoperative 3 and 6 months were -1.00%(-14.00%, 12.00%), 13.50%(6.75%, 32.50%), respectively. The above indicators of the 17 female patients in normal HDL-C group were (1.23±0.16)mmol/L, (1.20±0.20)mmol/L, (1.36±0.20)mmol/L and 0(-13.75%, 4.25%), 5.50%(0, 28.50%), respectively. There was no significant difference in the changes of percentage increase of plasma HDL-C concentration between the male and female patients ( F=0.209, P>0.05), and there was no interaction between groups and time points ( F=0.176, P>0.05). There was significant difference between different time points ( F=6.481, P<0.05). Conclusions:For patients with low or normal plasma HDL-C concentration preoperative, there are significant differences in the changes of HDL-C, insulin resistance index, free fatty acids and body mass after LSG. There is significant difference in the changes of postoperative percentage increase of plasma HDL-C concentration between male and female patients who with low plasma HDL-C concentration preoperative.

In vivo MRI tracking after transplantation of PEG/PEI-SPIO labeled adipose derived stem cells in AD rats models / 中国介入影像与治疗学

Objective: To explore the feasibility of tracking the transplantation of adipose derived stem cells (ADSC) for Alzheimer disease (AD) with polyethylene glycol/polyethyleneimine modified superparamagnetic iron oxide (PEG/PEI-SPIO) with in vivo MRI. Methods: Totally 48 AD rat models were randomly divided into labeled group, unlabeled group and phosphate buffer saline (PBS) group (each n=16). PEG/PEI-SPIO labeled or unlabeled ADSC and PBS were injected into the ventricle of rats, respectively. Other 16 rats were taken as the sham operation group. On the 7th, 14th, 21st and 28th day after transplantation, T2 value of temporal parietal cortex, hippocampus and cerebellum were measured with cranial MRI, and the iron content of brain tissue were measured on the above-mentioned brain areas. Results: T2 values of the hippocampus and the cortex were shorter in labeled group than in other groups after transplantation (all P<0.05), and of the cortex were shorter than of the hippocampus and cerebella on the 7th and 14th day, of the hippocampus were shorter than of cortex and cerebella on the 21st and 28th day in the labeled group (all P<0.05). At the same time point, the iron content of the labeled group was higher than that of the other groups in each brain region (all P<0.05). The iron content of the cortex was higher than of other regions in the labeled group on the 7th and 14th day (all P<0.05), and the iron content of the hippocampus was higher than of other regions in the labeled group on the 21st and 28th day (all P<0.05). Conclusion: Being labeled with PEG/PEI-SPIO, the distribution and migration of ADSC in the brain of rat AD models could be tracked with in vivo MRI.

Perioperative protection for right heart in patients with apical displacement of tricuspid valve leaflets / 中国胸心血管外科临床杂志

@#The apical displacement of tricuspid valve leaflets complicated with significantly enlarged, thin and fibrotic wall of the right ventricle is prone to dysfunction of right heart. Therefore, the myocardial protection for the right ventricle is important. Based on the pathological changes, an algorithm of perioperative myocardial protection strategy is summarized. Firstly, we should clearly know that the right ventricular myocardium with severe lesions is much different from the unimpaired myocardium, because it is now on the margin of failure; secondly, right heart protection should be regarded as a systematic project, which runs through preoperative, intraoperative and postoperative periods, and requires close collaboration among surgeons, perfusionists, anesthesiologists and ICU physicians. In this article, we try to introduce the systematic project of the right heart protection, in order to improve the outcome of this population.

Molecular Mechanism of Tangshenping Capsule in Intervening Apoptosis of Podocytes Induced by High Glucose+LPS Through PI3K/Akt Signaling Pathway / 中国实验方剂学杂志

Objective: To observe effect of Tangshenping capsule on lipopolysaccharide (LPS)-stimulated podocytes apoptosis under high glucose conditions of podocyte in rats with diabetic nephropathy (DN), and discuss possible mechanism. Method: With cultured rat podocytes as object of study,the podocytes model was established with high glucose and LPS,and divided into 7 groups:control group,high glucose group,high glucose plus LPS group,irbesartan group,and low,moderate and high-dose Tangshenping capsule groups.Protein and mRNA expressions of CD2-associated protein (CD2AP), nephrin, phosphatidylinositol 3-kinase (PI3K), protein kinase B (Akt) and B-cell lymphoma-2 associated death protein (Bad protein) of podocyte in each group were detected by Western blot and reverse transcription polymerase chain reaction (RT-PCR). Result: Compared with control group,the protein and mRNA expressions of podocyte CD2AP, nephrin, PI3K, Akt decreased definitely (PPPPPPPPPPPPConclusion: Tangshenping capsule can maintain a stable protein expression of Slit diaphragm (SD) in podocyte, inhibit podocyte apoptosis by activating PI3K/Akt signaling pathway. This is one of mechanisms for preventing and treating diabetic nephropathy.

Comparison of three lung recruitment maneuvers in the treatment of severe extra-pulmonary acute respiratory distress syndrome / 中国综合临床

Objective To investigate the efficacy and side effects of three recruitment maneuvers (RM) for severe extra-pulmonary acute respiratory distress syndrome ( ARDS). Methods A total of sixty-three extra-pulmonary ARDS patients were enrolled and randomly divided into three groups, which were treated with sustained inflation (SI),increment of positive end-expiratory pressure (IP) and pressure control ventilation (PCV) respectively. The oxygenation index ( PaO2/FiO2) before and after lung recruitment was recorded in patients with complete lung recruitment,and the cause of discontinuation of lung recruitment was recorded in patients with incomplete lung recruitment. Positive end-expiratory pressure (PEEP) was recorded in patients who completed lung recruitment with the latter two methods when they reached the maximum degree of lung recruitment. The mortality rate of 14 d in 3 groups was recorded, and the clinical characteristics and prognosis differences were compared before and after each group. Results With PaO2/FiO2as the standard, all the three methods of pulmonary reexpansion could make the lungs obviously reexpanse. The PaO2/FiO2of each group before, 5 minutes after and 1 hour after reexpansion were respectively as below (SI group: 70. 4±14. 8 mmHg,306. 8±97. 5 mmHg,229. 6±116. 2 mmHg; IP group:74. 9±13. 6 mmHg,328. 0 ± 95. 5 mmHg,252. 8 ± 111. 0 mmHg; PCV group: 67. 8 ± 14. 9 mmHg, 304. 2 ±82. 2 mmHg,223. 7±83. 6 mmHg. P＜0. 01). There were no significant differences among the three methods in the effect of RM (P＞0. 05). PEEP of IP group is higher than that of PCV group at the time of maximum RM (20. 3±2. 5 cmH2O vs. 18. 5±1. 8 cmH2O,P＜0. 05). There were significant differences in the incidence of adverse reactions caused by the three methods (54. 5%(12/22) in SI group,35. 0%(7/20) in IP group and 9. 6%(2/21) in PCV group. The 14 d mortality of each group was 63. 6%(14/22) in SI group,70. 0%(14/20) in IP group and 61. 9%(13/21) in PCV group,with no significant difference (P＞0. 05) . Conclusion The effects of three methods of lung recruitment on severe pulmonary exogenous ARDS patients were similar, but there was no significant difference in prognosis. Adverse reactions of SI method leads to the greatest probability of discontinuation of lung recruitment,and that of the PCV method is the smallest. Under the same effect of lung recruitment, IP method needs higher PEEP than PCV method. In practice,PCV method should be preferred.

Advances in the roles and mechanisms of nonsense-mediated mRNA decay in embryonic development / 生理学报

Nonsense-mediated mRNA decay (NMD) is originally identified as a widespread mRNA surveillance machinery in degrading 'aberrant' mRNA species with premature termination codons (PTCs) rapidly, which protects the cells from the accumulation of truncated proteins. Recent studies show that NMD can also regulate the degradation of normal gene transcripts, which execute important cellular and physiological functions. Therefore, NMD is considered as a highly conserved post-transcriptional regulatory mechanism in eukaryotes. NMD modulates 3% to 20% of the transcriptome from yeast to human directly or indirectly, which is essential for various physiological processes, such as cell homeostasis, stress response, proliferation, and differentiation. NMD can regulate the level of transcripts that involves in development, and single knockout of most NMD factors has an embryonic lethal effect. NMD plays an important role in the self-renewal, differentiation of embryonic stem cells and is critical during embryonic development. In this review, we summarized the latest advances in the roles and mechanisms of NMD in embryonic development, in order to provide new ideas for the research on embryonic development and the treatment of embryonic development related diseases.

Impact of vacuum sealing drainage on outcomes of patients with post-sternotomy mediastinitis: a systematic review / 中国实用护理杂志

Objective To examine the impact of vacuum sealing drainage on clinical outcomes of patients with post-sternotomy mediastinitis after cardiac surgery. Methods A systematic search were performed in Cochrane Library, Pubmed, Embase, China Biology Medicine(CBM), WanFang, VIP database. The quality of articles was critically appraised and data were extracted by 2 reviewers independently. Meta-analysis were conducted for the eligible researches. Results Fourteen cohort studies were inclued finally. Patients treated with VSD had significantly lower in-hospital mortalityand lower re-infection compared to those treated without VSD. While there had no significant defferences in length of ICU stay(days) and in-hospital stay (days) between VSD group and control group. Conclusions VSD therapy was associated with lower re-infection and in-hospital mortality than other conventional methods in patients with post-sternotomy mediastinitis after cardiac surgery and those results should be further tested in future research and practice.

Role and mechanism of Epac protein in regulation of inflammatory pain in paraventricular nucleus of hypothalamus / 中国药理学通报

Aim To investigate the role and mecha-nism of exchange protein directly activated by cAMP (Epac) protein in the paraventricular nucleus(PVN) of the hypothalamus in the development of inflammatory pain in rats. Methods Adult SD male rats were cho-sen to establish the model of inflammatory pain through subcutaneous injection of complete Freund's adjuvant(CFA) on the center of left hind foot. Western blot was used to detect the changes of the expression of Ep-ac protein. Thermal withdrawal latency(TWL) was ob-served after the PVN injecting 8p-CPT-2′-O-Me-cAMP (8p-CPT),the agonist of Epac. Then activated down-stream MEK1/2 protein of Epac in PVN was detected using Western blot when the potency was the strongest.Results ① Compared with normal saline(control group),TWL decreased significantly on d 1, d 3, d 5, d 7,d 9 on the ipsilateral foot of CFA group rats(P<0.01),whereas it returned to normal level in d 13;the paw mechanical withdrawal threshold(PMWT) de-creased significantly on d 6,d 8,d 10,d 12 and d 14 (P<0.05);②Compared with the control,the Epac1 protein in CFA group rats began to decrease from d 3, and significantly decreased on d 3 and d 9(P<0.05), however the expression of Epac2 had no significant change, meanwhile p-MEK1/2 protein decreased sig-nificantly on d 3(P<0.05);③Compared with micro-injection of saline into the PVN(Saline group), the heat hyperalgesia of 20 min and 1h decreased signifi-cantly and TWL increased significantly after PVN ad-ministration of 8p-CPT(8p-CPT group)(P <0.05);paraventricular nucleus p-MEK1/2 protein expression increased significantly in 30 min(P <0.05) and re-covered to normal level 2 h after administration. Con-clusion The Epac1-MEK1/2 signaling pathway in the paraventricular nucleus of the hypothalamus may be in-volved in the development of chronic inflammatory pain induced by CFA.