Effect of midazolam on postoperative delirium in elderly patients with preoperative moderate-severe anxiety undergoing radical resection of colorectal cancer / 临床麻醉学杂志

Objective To investigate the effect of preoperative oral midazolam on postoperative de-lirium in elderly patients with preoperative moderate-severe anxiety undergoing radical resection of colorectal cancer.Methods Eighty elderly patients undergoing laparoscopic surgery for radical resection of colorectal cancer,32 males and 48 females,aged 65-79 years,BMI 21-27 kg/m2,ASA physical status Ⅱ or Ⅲ,the state-trait anxiety inventory(STAI-S)≥38 scores at admission were selected.Patients were divided into two groups using random number method:control group and midazolam group,40 patients in each group.The midazolam group were administrated midazolam 7.5 mg per night till one day before surgery,while the placebo was administrated in the control group.The incidence of delirium 3 days after surgery and the STAI-S scores of one day before surgery were evaluated.The HR and MAP at entry,30 minutes after an-esthesia induction,1 hour,2 hours after anesthesia induction,and 30 minutes after extubation were recor-ded.The total dose of propofol,remifentanil and dexmedetomidine and the using rate of metaraminol were recorded.The visual analog scale scores 30 minutes after extubation,24 and 72 hours after surgery,the u-sing rate of tramadol,and the extubation time were recorded.Results Compared with the control group,the STAI-S scores of one day before surgery,and the incidence of postoperative delirium,the rate of using metaraminol,the VAS scores 30 minutes after extubation and 24 hours after surgery,the rate using of tram-adol were significantly decreased in the midazolam group(P＜0.05).There were no significant differences in total dose of propofol,remifentanil,and dexmedetomidine,extubation time between the two groups.Conclusion Preoperative oral midazolam can effectively reduce the incidence of postoperative delirium in elderly patients with preoperative moderate-severe anxiety undergoing radical resection of colorectal cancer.

Research progress on risk factors and identification tools for child abuse / 中国学校卫生

Abstract@#Child abuse is a global public health problem, which has emerged as a neglected yet pressing issue in global development. Early and accurate identification of abuse at a lower-age group is of great significance for treatment, which might reduce the risk of re-maltreatment and promote children s physical and mental health development. Therefore, by reviewing the clinical characteristics, risk factors and existing abuse identification and screening tools of child abuse, the study aims at providing basic evidence for the development of child abuse risk identification tools and the establishment of child maltreatment system in China, so as to take timely intervention measures to prevent adverse outcomes or reduce their severity.

Effect of neutrophils on cell pyroptosis in early brain injury following subarachnoid hemorrhage and its mechanism in mice / 中华神经医学杂志

Objective:To investigate the effect of neutrophils on cell pyroptosis and its mechanisms in mice with early brain injury (EBI) following subarachnoid hemorrhage (SAH).Methods:Seventy six male C57BL/6J mice were randomly divided into sham-operated group, SAH group, SAH+vehicle group, and SAH+anti-ly6G group ( n=19). SAH models in the latter 3 groups were established by modified endovascular perforation. Mice in the SAH+vehicle group and SAH+anti-ly6G group received intravenous injection of equal normal saline or anti-ly6G antibody (4 mg/kg) 24 h before SAH. At 24 h after SAH, immunofluorescent staining was used to detect the locations/expressions of neutrophils, S100 calcium binding protein A8 (S100A8) and gasdermin D (GSDMD); FJC staining was performed to assess the neuronal injury; modified Garcia test and rotarod test were used to evaluate the neurological functions, and brain water content test was applied to evaluate the brain edema; Western blotting was used to detect the expressions of S100A8, Toll-like receptor 4 (TLR4), NOD-like receptor thermal protein domain associated protein 3 (NLRP3), cleaved cysteinyl aspartate specific proteinase-1 (cleaved-caspase1), and cleaved N-terminal gasdermin D (GSDMD-N). Results:(1) Compared with those in the sham-operated group, neutrophil infiltration at the damaged cortex with highly expressed S100A8 in neutrophils was observed in the SAH group, and increased GSDMD expression at the damaged cortex and GSDMD co-localization in astrocytes, microglia and neurons were observed in the SAH group. (2) Compared with the sham-operated group, the SAH group and SAH+vehicle group had significantly increased numbers of infiltrated neutrophils and FJC-positive neurons, significantly decreased falling latency in the modified Garcia score and rotarod test, significantly increased brain water content, and significantly elevated expressions of S100A8, TLR4, NLRP3, cleaved-caspase1 and GSDMD-N ( P<0.05); the SAH+anti-ly6G group had statistically decreased numbers of infiltrated neutrophils and FJC-positive neurons, statistically increased falling latency in the modified Garcia score and rotarod test, statistically decreased brain water content, and statistically decreased expressions of S100A8, TLR4, NLRP3, cleaved-caspase1 and GSDMD-N compared with the SAH group and SAH+vehicle group ( P<0.05). Conclusion:Inhibition of neutrophils can down-regulate the S100A8 expression after SAH and attenuate TLR4/NLRP3 activation-mediated cell pyroptosis, thereby improving EBI.

K antigen serological screening results in 20 354 population from Qingdao area / 中国输血杂志

【Objective】 To perform serological screening of K antigen in Qingdao area and analyze the results. 【Methods】 From March to June 2023, 16 201 samples of patients treated in our hospital and applied for blood grouping, and 4 153 samples of blood donors sent to the clinic by Blood Transfusion Department during the same period were detected for Rh and K antigen by Ortho BioVue System Rh/K Cassette. 【Results】 A total of 18 out of 16 201 patient samples and 8 out of 4 153 blood donor samples were positive for K antigen, with the positive rate at 0.127 7%. 【Conclusion】 There was K antigen in Qingdao population, and the positive frequency of K antigen was different from previous reports. It is of great significance to construct rare blood group bank in this area and formulate reasonable blood donation and transfusion strategy for population with K antigen, so as to avoid unexpected antibody production of Kell blood group system, prevent hemolytic disease of newborn and ensure the safety of blood use.

Correlation between frailty status and white matter hyperintensity in elderly patients with leukoaraiosis / 中华行为医学与脑科学杂志

Objective:To investigate frailty status of the elderly patients with leukoaraiosis (LA) and to analyze the correlation between white matter hyperintensities and their frailty status.Methods:From June 2019 to September 2020, a total of 162 patients with leukoaraiosis over 65 years old were screened by cranial MRI.The Fried frailty phenotype was used to evaluate their frailty status.The Fazekas scale scoring method was used to independently assess the periventricular white matter hyperintense (PVH) and deep white matter hyperintense (DWMH) by the cranial MRI images.SPSS 22.0 software was used for statistical analysis.ANOVA test was used to compare normal distribution data between groups, and Kruskal-Wallis H test was used to compare non-normal distribution data between groups.Spearman rank correlation analysis was used to analyze the correlation between PVH and DWMH scores and Fried frailty phenotype score. Results:Among 162 elderly patients with leukoaraiosis, 46 patients (28.40%) were non-frailty, 76 patients (46.91%)were pre-frailty and 40 patients (24.69%) were frailty.There were statistically significant differences in age( F=9.382, P<0.01), number of chronic diseases( H=10.736, P<0.01), number of medication ( H=15.927, P<0.01) and mini-nutritional assessment short form (MNA-SF) scores( F=5.263, P<0.01) among older LA patients with different frailty phenotype.There was statistical difference in PVH scores in elderly LA patients with different frailty phenotype (χ 2=108.537, P<0.01), but no significant difference in DWMH scores (χ 2=4.239, P>0.05). Spearman correlation analysis showed significant positive correlation between PVH score and frailty phenotype score in elderly LA patients ( r=0.718, P<0.001). Conclusion:Elderly LA patients have a high incidence of frailty, which may be related to aging, multi-disease coexistence, multiple medication, nutritional risk and other factors.The occurrence of weakness in elderly LA patients is related to periventricular white matter lesions, and the more serious the white matter damage, the more obvious the degree of frailty.

Analysis of gait and balance disorder in patients with leukoaraiosis / 中华行为医学与脑科学杂志

Objective:To analyze the gait and balance disorder and fall risk in patients with leukoaraiosis (LA) in different degrees and locations.Methods:Seventy-eight patients with LA (LA group) and thirty healthy controls (NC group) were selected.According to Fazekas grading scale, the LA group were subgroups of different degrees(LA1, LA2, LA3)and evaluated independent scores for periventricular white matter hypersignal (PVH) and deep white matter hypersignal (DWMH). All subjects were tested by Tinetti scale, and the gait test, balance test and fall risk assessment were carried out, and the correlation between gait test results and balance test results and PVH and DWMH scores were analyzed.Results:There were significant differences in gait test((11.47±0.51), (10.18±1.29)), balance test((15.63±0.49), (13.96±1.58)) and fall risk((27.10±0.76), (24.15±2.73)) between LA group and NC group ( t=5.310, 5.667, 5.799, all P< 0.01). There were no significant differences in gait test, balance test and fall risk between NC group and LA1 group (all P>0.05). There were significant differences in gait test, balance test and fall risk between NC group and LA2 group and LA3 group ( t=1.110, 1.562, 1.336; 2.592, 3.342, 2.985; all P<0.01). There were significant differences in gait test, balance test and fall risk between LA1 group((11.19±0.85), (15.38±0.75), (26.58±1.47)) and LA2 group((10.36±0.82), (14.07±1.09), (24.43±1.64)) and LA3 group((8.88±0.99), (12.23±1.08), (21.21±1.93)) ( t=0.835, 1.313, 1.039; 2.317, 3.093, 2.756; all P<0.01). There were significant differences in gait test, balance test and fall risk between LA2 group and LA3 group ( t=1.482, 1.780, 1.639, all P<0.01). The analysis showed that the gait test was negatively correlated with the PVH and DWMH scores ( r=-0.810, P<0.01; r=-0.452, P<0.01). The balance test was negatively correlated with the PVH and DWMH scores ( r=-0.502, P<0.01; r=-0.836, P<0.01). Conclusions:There are gait disorder and balance disorder in patients with moderate and severe LA.With the increase of the degree of LA , the damage of gait and balance function is significantly increased, and the risk of fall is also significantly increased.The gait disorder and the balance disorder of LA patients has different correlation with the high-signal score of the white matter in different parts.The correlation between gait disorder and PVH score is more obvious, and the correlation between balance disorder and DWMH score is more obvious.

Phytochemical profiling and biological activity of Plectranthus amboinicus (Lour.) mediated by various solvent extracts against Aedes aegypti larvae and toxicity evaluation

Objective: To analyze the phytochemical compounds and to investigate the bio-toxic efficacy of various solvent extracts of Plectranthus amboinicus against mosquito larvae activity and lethality on non-targeting organisms. Methods: The methanol, ethyl acetate, hexane, and aqueous extracts of Plectranthus amboinicus were subjected to analyze the mosquitocidal activity against the dengue vector, Aedes aegypti and toxicity assays on zebra fish and brine shrimp. Three replications were performed, and negative control was also maintained. Amongst, ethyl acetate extract of Plectranthus amboinicus was chosen for the determination of bio-active compounds. Results: The mosquitocidal assays of methanol and ethyl acetate extracts of Plectranthus amboinicus showed the maximal activity with minimal concentration against the 4th instar mosquito-larvae of Aedes aegypti through the following lethal concentration (LC50 and LC90) values: 53.36 & 92.51 μg/mL and 13.64 & 86.09 μg/mL, respectively. In addition, the plant extracts showed no toxicity on zebra fish embryo and brine shrimp assays. The gas-chromatography analysis of the ethyl acetate extract of Plectranthus amboinicus revealed the presence of seven different compounds. Among them, PAEA-fraction 60 contained a major active bioactive compound, hexadecanoic acid, methyl ester (270.0). Conclusions: Plectranthus amboinicus possesses mosquitocidal properties and could be used as a potential alternative source for preparing the mosquitocidal agents.

Role of hesperitin in regulating inflammatory response in early brain injury after subarachnoid hemorrhage / 中华神经医学杂志

Objective To investigate the role of hesperitin in regulating inflammatory response in early brain injury after subarachnoid hemorrhage (SAH). Methods A total of 96 adult male SD rats were divided into sham-operated group, SAH group, solvent group and intervention group (n=24) by random number table method. The SAH rat models in the latter three groups were prepared by carotid artery puncture method; the rats in the intervention group were given oral administration of hesperidin solution, which was dissolved in 5％ dimethyl sulfolide (DMSO), with a concentration of 1 mg/100 μL and a dosage of 40 mg/kg within 30 min after operation; rats in the solvent group were given oral administration of an equal volume of 5％ DMSO solution. Modified Garcia behavioral scale was used to evaluate the neurobehavior of rats, and the wet/dry weight method was used to measure the water content in the brain tissues of the left and right hemispheres of the rats 24 h after SAH. Immunofluorescence staining was used to detect the microglia activation, Fluoro-dyed Jade C staining was used to assess the brain neuron degeneration, enzyme-linked immunosorbent assay (ELISA) was employed to detect the inflammatory factors interleukin (IL)-1β, IL-6 and tumor necrosis factor-α (TNF-α) content in the brain tissues, and Western blotting was used to detect the nuclear factor-κB (NF-κB) and phosphorylated (p) -NF-κB protein expressions. Results As compared with the solvent group, intervention group had significantly increased improved modified Garcia behavioral scale scores (10.08±1.73 vs. 13.83±1.70), and significantly decreased water content of brain tissues in the left and right hemispheres ([81.44 ± 1.05]％ vs. ([79.14±0.82]％; [80.55±1.55]％ vs. [78.79±1.02]％), significantly smaller number of CD68+ and Iba1+ microglias (30.17±1.04 vs. 10.67±0.75; 29.33±1.16 vs. 12.00±0.41), significantly smaller number of degenerate neurons (53.21±0.94 vs. 31.33±0.28), significantly reduced levels of inflammatory cytokines IL-1β, IL-6 and TNF-α ([429.88±106.32] pg/mL vs. [221.50±48.80] pg/mL; [1015.50±221.80] pg/mL vs. [448.11±93.40] pg/mL; [1021.75±149.17] pg/mL vs. [595.71±190.81] pg/mL), and significantly lower p-NF-κB/NF-κB ratio (1.13±0.07 vs. 0.71±0.02, P<0.05). Conclusion Hesperitin may reduce the inflammatory response mediated by microglia after subarachnoid hemorrhage by inhibiting NF-κB pathway, thereby improving the neurological dysfunction of rats.

Correlation of cerebral microbleeds with intracranial aneurysm rupture and hemorrhage / 中华神经医学杂志

Objective To evaluate the effect of cerebral microbleeds (CMBs) on intracranial aneurysm rupture and hemorrhage. Methods A total of 2023 patients with intracranial single aneurysms (944 un-ruptured aneurysms and 1029 ruptured aneurysms) were enrolled in our study. The 3D-DSA was applied to all patients to evaluate the aneurysm sizes, locations, and morphous features, and to confirm the presence of A1 dominance and variations of Circle of Willis; moreover, aspect ratio (AR), size ratio (SR) and aneurismal inclination angle were measured. The presence of CMBs identified by T2-weighted gradient-recalled-echo sequence on magnetic resonance imaging (MRI) was evaluated; the clinical data of combined with/without CMBs patients were compared. Ninety-two untreated intracranial aneurysms patients combined with CMBs were followed up to evaluate the incubation periods of CMBs-related intracranial aneurysm rupture and hemorrhage; the clinical data of patients with un-ruptured aneurysms and ruptured aneurysms were compared; the risk factors of intracranial aneurysm rupture and hemorrhage were analyzed by univariate and multivariate Logistic regression analyses. Results CMBs confirmed by MR imaging were presented in 158 patients, with 7.81％ incidence rate (158/2023). Age, proportion of smokers, aneurysm inclination Angle, SR, narrow neck, irregular aneurysm shape, proportion of rupture and hemorrhage, aneurysm sites, and hypertension showed significant differences between patients without CMBs and patients with CMBs (P<0.05). In the untreated intracranial aneurysms patients combined with CMBs, 27 had intracranial aneurysm rupture and 65 did not appear intracranial aneurysm rupture; the rupture time was 3-46 months, with an average of (15.07± 10.76) months. As compared with the un-ruptured group, the ruptured group had a statistically higher proportion of patients with irregular aneurysm morphology (P<0.05). Univariate analysis showed that CMBs, female, age, aneurysm size, aneurysm morphology, ICA and ACA aneurysms, AR, variations of Circle of Willis, hypertension grading II and III, diabetes mellitus with fasting blood glucose≤6.0 mmol/L, hyperlipidemia, coronary heart disease, and drinking alcohol were important factors affecting intracranial aneurysm rupture, and the differences were statistically significant (P<0.05). Multivariate Logistic regression analysis showed that CMB was an independent risk factor for intracranial aneurysm rupture and hemorrhage; as compared with patients without CMBs, patients with CMBs had a 1.75 fold increased risk of aneurysm rupture. Conclusions Patients with intracranial aneurysms with older age, smaller aneurysm inclination Angle and larger SR are more likely to be associated with CMBs. Intracranial aneurysms with CMBs patients with irregular morphology are prone to have rupture and hemorrhage. CMBs is an independent risk factor for intracranial aneurysm rupture and hemorrhage.

Study on a high-throughput method with LC-MS/MS technique for detecting aflatoxins in ginger / 国际中医中药杂志

Objective@#To optimize the method of simultaneous determination of four aflatoxins (B1, B2, G1 and G2) of ginger by the ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method and high-throughput method.@*Methods@#The aflatoxins were extracted from ginger by methanol-water (80:20, V/V) solution, concentrated and dried with nitrogen. The aflatoxins were detected by UPLC-MS/MS by using Waters Acquity UPLC BEH C18 chromatographic column. The mobile phase was 0.1% formic acid water (A phase) -0.1% formic acid methanol (B phase), gradient elution, flow rate 0.35 ml/min, mass spectrometry was electrospray ion source, positive ion scanning mode, multi reaction ion monitoring were using.@*Results@#Quantification of four aflatoxins by matrix matching standard curve. The linear was good in the range of 0.125-20.000 ng/ml, and the correlation coefficients were all greater than 0.999 0. The ginger sample detection was 0.125-0.300 μg/kg and 0.125-1.000 μg/kg, respectively. The average recoveries were 81.7%-96.0%, and the relative standard deviation (RSD) was lower than 7.53%.@*Conclusions@#This method is simple, rapid, sensitive and low limit of detection, which can meet the requirements for the detection of trace aflatoxins residues in ginger.

Effect of bone marrow mesenchymal stem cells transplantation on recovery of neurological functions and Nogo-A expression in cerebral ishchemia rats at recovery stage / 中华神经医学杂志

Objective To investigate the effect of bone marrow mesenchymal stem cells (BMSCs) transplantation on recovery of neurological functions and Nogo-A expression in cerebral ischemia rats at recovery stage.Methods BMSCs were isolated and cultured by whole bone marrow adherence method.Thirty-six SD rats were randomized into sham-operated group,ischemia group and BMSCs transplantation group (n=12).The middle cerebral artery occlusion (MCAO) models in the ischemia group and BMSCs transplantation group were established with Zea Longa line embolism.After 21 d of MCAO,one mL ofBMSCs (3×106) were transplanted into rats of the BMSCs transplantation group,and same amount of phosphate buffer was given to the rats of the sham-operated group and ischemia group.After 14 and 28 d of treatment,neurological functions of the rats were evaluated by modified neurological severity scale (mNSS);the brain infarct sizes were tested by TTC staining;the pathological alterations were tested by HE staining,and the Nogo-A expression was determined by immunofluorescence.Results After 14 and 28 d of treatment,as compared with the ischemia group,BMSCs group had significantly lower mNSS scores (14 d∶ 7.50±0.55 vs.6.17±0.75;28 d∶ 7.33±0.52 vs.5.67±0.82),statistically smaller brain infarct sizes (14 d∶ 31.38％±1.02％ vs.26.32％±1.19％;28 d∶27.71％±0.55％ vs.21.68％±1.09％),and significantly lower Nogo-A expression (14 d∶ 39.33％±2.08％ vs.33.67％±2.52％;28 d∶ 30.33％±0.58％ vs.25.67％±4.39％,P＜0.05).What's more,rats in the BMSCs group had milder cell damage and decreased scar tissues as compared with those in the ischemia group.Conclusion BMSCs transplantation can improve the neurological function of cerebral ischemia rats at recovery stage,and it may work via regulation of Nogo-A expression.

Multivariate predictors of intracranial aneurysm rupture by regression analysis of Willis circle variation and hemodynamic forces alteration arised from vascular structural abnormity / 中华神经医学杂志

Objective To explore the effect of Willis circle variation and hemodynamic forces alteration arised from vascular structural abnormity on intracranial aneurysm (IA) rupture using 3D-digital subtraction angiography (DSA) and transcranial color Doppler (TCCD) detection.Methods Two hundred and twenty-three patients with IA,admitted to and conformed by DSA in our hospital from November 2010 to November 2011,were divided into ruptured IA group (n=182) and un-ruptured IA group (n=41).The 3D-DSA was applied in all patients to carefully evaluate the aneurysm sizes,locations,and morphous features,and to confirm the presence of A1 dominance and Willis circle variation.Moreover,aneurysmal neck area,diameter of parent artery,angle between A2 segments of bilateral anterior cerebral artery,angle between aneurysmal longitudinal axis and parent artery,aortic diameter (AD) and aspect ratio (AR) were measured with assistance of 3D-DSA images.Besides,TCCD was applied to all patients,and the hemodynamic parameters were recorded to calculate wall shear stress (WSS) and mechanical stretch.The risk factors of IA rupture were analyzed by receiver operating characteristic (ROC) curve and multivariate Logistic regression with emphasis on Willis circle variation and hemodynamic forces alteration.Results Whether it was in ruptured IA group or in un-ruptured IA group,the incidence rate of variation of anterior Willis circle was higher than that of variation of posterior Willis circle.A1 dominance on the left side was the most common asymmetry.As compared with those in un-ruptured IA group,statistically elder age,smaller AD,larger angle between aneurysmal longitudinal axis and parent artery,decreased WSS and increased mechanical stretch in the ruptured IA group were noted (P＜0.05).ROC curve indicated that angle between aneurysmal longitudinal axis and parent artery,AD,WSS and mechanical stretch could be used to evaluate IA rupture (area under the curve:0.606、0.618、0.396、0.637).Age (OR=8.618,95％CI:2.866-25.917,P=0.000),hypertension (grade Ⅲ OR=16.320,95％CI:1.628-163.556,P=0.018),angle between aneurysmal longitudinal axis and parent artery (OR=3.053,95％CI:1.131-8.242,P=0.028),AD (OR=5.638,95％CI:1.507-20.251,P=0.008) and mechanical stretch (OR=4.230,95％CI:1.554-11.516,P=0.000) were risk factors of IA rupture.A1 dominance (OR=0.242,95％CI:0.074-0.785,P=0.018),small aneurysms (2-5 mm,OR=0.207,95％CI:0.054-0.788,P=0.002) and WSS (OR=0.021,95％CI:0.060-0.672,P=0.009) were identified as protective factors.Conclusions Willis circle variation exists in IA patients.Age,hypertension (grade ⅢD,angle between aneurysmal longitudinal axis and parent artery,AD and mechanical stretch are risk factors of IA rupture,while A1 dominance,small aneurysm (2-5 mm) and WSS are identified as protective factors.Accurate assessment of these factors is of great clinical significance for the prevention and treatment of IA in the future.

Neuroprotective effect of erythropoiet in treatment of traumatic brain injury in rats / 中华创伤杂志

Objective To evaluate the neuroprotective effects of erythropoiet (EPO) for traumatic brain injury (TBI) in rats and investigate the possible role of endoplasmic reticullum stress response and Caspase-12-induced apoptosis.Methods According to the random number table,140 male Sprague-Dawley rats were divided into sham injury group,sham injury plus EPO group,TBI group and TBI plus EPO group,with 35 rats per group.TBI was induced by a fluid percussion device.EPO (5 000 U/kg in saline) was administered intraperitoneally at 6 hours after injury.The rate of TUNEL positive cells in injured cortex were measured to evaluate cell apoptosis status.Neurological function was assessed at days 1,4,7,21,28 and 35 after intervention using a modified neurological severity score (mNSS).At 24 hours after injury,the expressions of Caspase-12 in injured cortex and C/EBP-homologous protein (CHOP) which was the symbol of ERS response were measured by Western blot and immunofluorescent staining to assess the changes of ERS response after TBI and EPO treatment.Results TUNEL-positive staining cell density was significantly increased by (30.3 ± 2.3) ％ in the injured cortex 24 hours after injury (P ＜ 0.01).Compared with TBI group,TBI plus EPO group had a significant decrease of the positive rate of TUNEL cells [(14.6 ± 1.5) ％] (P ＜ 0.01).Compared with TBI group,mNSS score significantly was decreased in TBI plus EPO group at 7-35 days after injury (P ＜ 0.05).At 24 hours after injury,the results of Western blot showed that the expression levels of Caspase-12 and CHOP in the injured cortex in TBI group were higher than those in sham group,but that in TBI plus EPO group was lower than those in TBI group (P ＜ 0.01).At 24 hours after injury,the results of immunofluorescent staining showed the rates of Caspase-12 and CHOP positive cells in the injured cortex in TBI group were higher than sham group (P ＜ 0.01).But the rates of Caspase-12 and CHOP positive cells in TBI plus EPO group was lower than that in TBI Group (P ＜ 0.01).Conclusion Exogenous EPO has significant neuroprotective effects on TBI rats.EPO may exert its neuroproective effects through suppression of ERS response and inhibition of Caspase-12-induced apoptosis.

Short-term outcome following treatment of intracranial aneurysms with pipeline embolization device / 中华神经医学杂志

Objective To present our preliminary experience and short-term safety and efficacy of pipeline embolization device (PED) for endovascular of intracranial aneurysms.Methods Six patients treated with PED in our hospital from February 2016 to June 2016 were chosen.Their clinical data and short-term safety and efficacy were retrospectively analyzed.Results Six patients with 6 intracranial aneurysms were treated during the study period.Mean aneurysm size was 18.3±9.2 mm.PED was technically successful in all aneurysms (100％).A total of 8 PEDs were used,and the mean number of devices per aneurysm was 1.3.Treatment was achieved with one single PED in 5 aneurysms,with 3 overlapping PEDs in one aneurysm.Adjunctive coiling was performed in 3 aneurysms.Retention of contrast agent in the tumor cavity was detected by immediate radiography:Kamran grade Ⅰ was noted in 4 patients and grade Ⅱ in 2 patients.No procedure-related complications occurred.Five patients achieved good clinical outcome (mRS score 0 in 2 patients,one in 3 patients and 3 in one patient).MRA was performed in 5 patients 3 months after surgery,indicating no arterial aneurysm residual and far-endvascular patency;and one of these 5 patients was performed DSA showing no arterial aneurysm relapse.Conclusions In our series,early results of the PED are encouraging.However,larger studies with longer follow-up duration are warranted to assess the safety and efficacy of PED for treating intracranial aneurysms.

Stent-assisted coil embolization versus simple coil embolization for large and giant intracranial aneurysms: comparison of postoperative recurrence rate / 介入放射学杂志

Objective To compare the recurrence rate and long-term follow-up angiographic findings between stent-assisted coil embolization and simple coil embolization in treating large and giant intracranial aneurysms.Methods The clinical data and imaging materials of a total of 90 patients with large and giant intracranial aneurysms (＞10 mm,91 aneurysms in total),who were admitted to authors' hospital during the period from January 2004 to January 2016 to receive interventional embolization therapy,were retrospectively analyzed.Of the 90 patients,52 patients (52 lesions in total) received simple coil embolization (SCE group)and 38 patients (39 lesions in total) received stent-assisted coil embolization (SACE group).Postoperative recurrence rates of aneurysm were compared between the two groups,and recurrence risk factors were analyzed.Results The whole postoperative recurrence rate of aneurysm and re-treatment rate were 38.5％(35/91) and 20.9％(19/91) respectively;the recurrence rate and re-treatment rate of SACE group were 35.9％ (14/39) and 17.9％ (7/39) respectively,while those of SCE group were 40.4％ (21/52) and 23.1％ (12/52) respectively;the differences between the two groups were not statistically significant (P＞0.05).Multivariate logistic regression indicated that the recurrence risk factors of large or giant intracranial aneurysms included rupture of aneurysm (OR=0.284,95％CI=0.083-0.978,P=0.046),simple coil embolization (OR=5.03,95％ CI=1.04-24.44,P=0.045),concurrent hypertension (OR =0.13,95％ CI=0.036-0.51,P=0.003)and long time after operation (OR=1.002,95％CI=1.001-1.003,P=0.002).Conclusion Compared with simple coil embolization,stent-assisted coil embolization can reduce the recurrence rate of aneurysm.Rupture of aneurysm,simple coil embolization,long time after operation and concurrent hypertension are independent risk factors for recurrence of aneurysm after transcatheter arterial embolization.

The surgical outcomes of acute type A aortic intramural hematoma: a curative effect analysis of 40 cases / 中华胸心血管外科杂志

Objective The aim of this study is to evaluate clinical outcomes of patients with acute type A intranural hematoma of the aorta(IMH) received surgical treatment.Methods We analyzed 40 consecutive patients with acute type A aortic IMH in Fuwai hospital.The patients are from 2012.1.1 to 2015.12.31.The average age of patients is(56 ± 11) years.Clinical outcomes and morphological evolution by CT were analyzed for 2 years.Results Most of the patients were treated medically during their initial hospitalization.There were 2 patients died in in-hospital and no 2-year mortality.16 patients (40％) were received acute surgery,24 patients(60％)were received normal surgery.Conclusion Surgical treatment would be a favorable treatment option in type A acute IMH.

Effect and safety of celiac continued circulatory hyperthermia perfusion with chemotherapy in the treat-ment of cancer with ascites Meta-analysis / 实用肿瘤学杂志

Objective To evaluate the clinical efficacy and safety of celiac continued circulatory hyper -thermia perfusion with chemotherapy in the treatment of cancer with ascites .Methods Databases including the Cochrane Library MEDLINE,PubMed,Embase,CBM,VIP,CNKI and WanFang Data,and the other sources as supplying .The literatures were screened according to the inclusion criteria ,extracted data and assessed the meth-odological quality ,and then meta -analysis was performed using RevMan 5.0.2 software.Results Totally 14 RCTs with 867 patients were included .Meta-analysis showed that compared intraperitoneal chemotherapy ,with celiac continued circulatory hyperthermia perfusion had a significant difference in CR ( OR=3.18,95%CI:2.18~4.64,P<0.00001),PR(OR=2.05,95%CI:1.51~2.77,P<0.00001),overall effective rate(OR=4.88, 95%CI:3.59~6.46,P<0.00001).The incidence of adverse reactions was no statistically significant in the two groups.Conclusion Celiac continued circulatory hyperthermia perfusion with chemotherapy in the treatment of cancer with ascites demonstrates better efficacy and safety ,but it still needs to verify the above conclusion .

The episodic memory monitoring in patients with white matter lesions / 中华神经科杂志

Objective To investigate the episodic memory monitoring in patients with white matter lesions (WML) and explore the relevance of episodic memory disorder and memory monitoring and the possible mechanism.Methods The feeling of knowing-episodic memory (FOK-EM) paradigm was adopted and subsequently administered in 30 WML patients and 30 control participants who were matched in age and educational level.Results Compared with control group (cued recall 4.37 ± 1.59;recognition 8.73 ± 1.05),the episodic memories of WML patients were significantly impaired on the cued recall performance (3.30 ± 1.51,t =2.666,P ＜ 0.05) and recognition performance (7.23 ± 0.77,t =6.306,P ＜ 0.01).Furthermore,the accuracy of FOK judgment (-0.13 ± 0.31),the correct judgment and correct recognition of FOK-EM (23.16％ ±5.96％) and the correct judgment and false recognition of FOK-EM (34.26％ ± 7.65％) in the WML patients group were significantly different compared with the control group (the accuracy of FOK judgment:0.34 ± 0.27,t =6.280,P ＜ 0.01;the correct judgment and correct recognition:35.12％ ± 6.82％,t =7.234,P ＜ 0.01;the correct judgment and false recognition:19.27％ ±6.50％,t =-8.174,P ＜ 0.01).In addition,the correct judgment and false recognition performance were positively correlated with the severity of periventricular lesions and deep white matter lesions in the WMLpatients group (r=0.716,P＜0.01;r=0.598,P＜0.01).Conclusions The WML patients demonstrated an overestimation of their recognition ability of episodic memory.Moreover,this impairment of memory monitoring was correlated with the deficit of executive function caused by the damage of the prefrontal-subcortical circuit,indicating that this mechanism could be an influential factor of episodic memory disorder in WML.

Role of RhoA in hypoxia-induced breast cancer cell VEGF secretion and proliferation, migration and tube formation of HUVECs / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the role of RhoA in regulating vascular endothelial growth factor (VEGF) secretion level in breast cancer cells and in the proliferation, migration and tube formation of human umbilical vascular endothelial cells (HUVECs) under hypoxia.</p><p><b>METHODS</b>Enzyme-linked immunosorbent assay was used to examine the effect of V14RhoA plasmid transfection-induced RhoA activation and RhoA knockdown on VEGF secretion level in breast cancer MCF-7 cells under hypoxic condition. A MCF-7/HUVEC co-culture model was established to assess the effect of the changes in RhoA expressions in MCF-7 cells on HUVEC proliferation, migration, and tube formation under hypoxia.</p><p><b>RESULTS</b>Under hypoxic condition, RhoA activation promoted VEGF secretion in MCF-7 cells, and RhoA knockdown inhibited VEGF secretion. In the co-culture model, RhoA activation in the MCF-7 cells enhanced HUVEC proliferation, migration, and tube formation, and RhoA knockdown inhibited these changes.</p><p><b>CONCLUSION</b>Under hypoxic condition, RhoA indirectly influences HUVECs to affect tumor angiogenesis by regulating VEGF level in breast cancer cells.</p>

Electron microscopic observation on neurodegeneration induced by brain injury newborn rats / 中国组织工程研究

BACKGROUND: As a result of immature brain of children and their imperfect blood brain barrier, improper clinical treatment would affect growth and development of children. It is fully important to perform further investigation on immature brain injury induced neurodegeneration.OBJECTIVE: To observe the ultramicrostructure of neurons in homolateral parietal cortex and hippocampus in newborn 7-day SD rat with contusion of parietal cortex.DESIGN: Completely randomized controlled trial.SETTING: Laboratories of Nerve Morphology and Cytobiology, Medical College of Shanghai Jiaotong University; Electron Microscope Room of Institute for Physiology, Chinese Academy of Science.MATERIALS: The experiment was performed in Teaching and Research Section of Anatomy, Laboratories of Nerve Morphology and Cytobiology ofShanghai Second Medical University (Medical College of Shanghai Jiaotong University; Electron Microscope Room of Institute for Physiology of Chinese Academy of Science from October 2002 to June 2003. A total of 19newborn 7-day SD rats were randomly divided into experimental group, operation control group and normal control group with 15, 2 and 2 in each group respectively.METHODS: In experimental group, free-fall device for brain injury was used for establishing model of contusion of parietal cortex in newborn 7-day SD rat. Anesthesia and scalp incision were conducted, without using free-fall device in operation control group. But above procedures were not carried out in normal control group. The changes of ultramicrostructure were observed under transmission electron microscope after routine treatment of electron microscopic samples.MAIN OUTCOME MEASURES: Ultramicrostructure of neurons in homolateral parietal cortex and hippocampus.RESULTS: All the 19 rats entered results analysis. ① There were two sorts of morphological changes in neurons in experimental group. One was evident swelling of dendrites and bodies of neurons, accompanied with the changes of organelles. In the early stage, expansion of endoplasmic reticulum cisterna could be observed and mitochondria became compact and concentrated. Then, vacuolization of endoplasmic reticulum, progressive swelling and vacuolization of mitochondria, dissociation of polysomes from rough endoplasmic reticulum and scattering of them in cytoplasm could be seen. Changes of nucleolus presented after significant changes of cytoplasm. Nuclear chromatin clustered together under karyotheca and arranged as clockface, which were some masses with irregular contours gathering to the center. Axons were almost normal. The other was concentration of cytoplasm and nucleolus with vacuolizations of unequal size in cytoplasm. ②There was no abnormal change in neurons in homolateral parietal cortex and hippocampus both in operation control group and normal control group.CONCLUSION: Swelling of brain cell and concentration of cytoplasm and nucleolus after brain injury play important roles in brain injury-induced neurodegeneration of immature rats.