Clinical characteristics of epileptic seizure in neurofibromatosis type 1 in 15 cases / 中华儿科杂志

Objective: To summarize the clinical characteristics of epileptic seizure associated with neurofibromatosis type 1 (NF1). Methods: From January 2017 to July 2023 at Children's Hospital Capital Institute of Pediatrics, medical records of patients with both NF1 and epileptic seizure were reviewed in this case series study. The clinical characteristics, treatment and prognosis were analyzed retrospectively. Results: A total of 15 patients(12 boys and 3 girls) were collected. Café-au-lait macules were observed in all 15 patients. There were 6 patients with neurodevelopmental disorders and the main manifestations were intellectual disability or developmental delay. The age at the first epileptic seizure was 2.5 (1.2, 5.5) years. There were various seizure types, including generalized tonic-clonic seizures in 8 patients, focal motor seizures in 6 patients, epileptic spasm in 4 patients, tonic seizures in 1 patient, absence in 1 patient, generalized myoclonic seizure in 1 patient and focal to bilateral tonic-clonic seizure in 1 patient. Among 14 patients whose brain magnetic resonance imaging results were available, there were abnormal signals in corpus callosum, basal ganglia, thalamus or cerebellum in 6 patients, dilated ventricles of different degrees in 3 patients, blurred gray and white matter boundary in 2 patients, agenesis of corpus callosum in 1 patient and no obvious abnormalities in the other patients. Among 13 epilepsy patients, 8 were seizure-free with 1 or 2 antiseizure medications(ASM), 1 with drug resistant epilepsy was seizure-free after left temporal lobectomy, and the other 4 patients who have received 2 to 9 ASM had persistent seizures. One patient with complex febrile convulsion achieved seizure freedom after oral administration of diazepam on demand. One patient had only 1 unprovoked epileptic seizure and did not have another seizure without taking any ASM. Conclusions: The first epileptic seizure in NF1 patients usually occurs in infancy and early childhood, with the main seizure type of generalized tonic-clonic seizure and focal motor seizure. Some patients have intellectual disability or developmental delay. Most epilepsy patients achieve seizure freedom with ASM.

A case of combined oxidative phosphorylation deficiency 32 caused by MRPS34 gene variation and literature review / 中华儿科杂志

Objective: To investigate the clinical features and genetic features of combined oxidative phosphorylation deficiency 32 (COXPD32) caused by MRPS34 gene variation. Methods: The clinical data and genetic test of a child with COXPD32 hospitalized in the Department of Neurology, Children's Hospital, Capital Institute of Pediatrics in March 2021 were extracted and analyzed. A literature search was implemented using Wanfang, China biology medicine disc, China national knowledge infrastructure, ClinVar, human gene mutation database (HGMD) and Pubmed databases with the key words "MRPS34" "MRPS34 gene" and "combined oxidative phosphorylation deficiency 32" (up to February 2023). Clinical and genetic features of COXPD32 were summarized. Results: A boy aged 1 year and 9 months was admitted due to developmental delay. He showed mental and motor retardation, and was below the 3rd percentile for height, weight, and head circumference of children of the same age and gender. He had poor eye contact, esotropia, flat nasal bridge, limbs hypotonia, holding instability and tremors. In addition, Grade Ⅲ/6 systolic murmur were heard at left sternal border. Arterial blood gases suggested that severe metabolic acidosis with lactic acidosis. Brain magnetic resonance imaging (MRI) showed multiple symmetrical abnormal signals in the bilateral thalamus, midbrain, pons and medulla oblongata. Echocardiography showed atrial septal defect. Genetic testing identified the patient as a compound heterozygous variation of MRPS34 gene, c.580C>T (p.Gln194Ter) and c.94C>T (p.Gln32Ter), with c.580C>T being the first report and a diagnosis of COXPD32. His parents carried a heterozygous variant, respectively. The child improved after treatment with energy support, acidosis correction, and "cocktail" therapy (vitaminB1, vitaminB2, vitaminB6, vitaminC and coenzyme Q10). A total of 8 cases with COXPD32 were collected through 2 English literature reviews and this study. Among the 8 patients, 7 cases had onset during infancy and 1 was unknown, all had developmental delay or regression, 7 cases had feeding difficulty or dysphagia, followed by dystonia, lactic acidosis, ocular symptoms, microcephaly, constipation and dysmorphic facies(mild coarsening of facial features, small forehead, anterior hairline extending onto forehead,high and narrow palate, thick gums, short columella, and synophrys), 2 cases died of respiratory and circulatory failure, and 6 were still alive at the time of reporting, with an age range of 2 to 34 years. Blood and (or) cerebrospinal fluid lactate were elevated in all 8 patients. MRI in 7 cases manifested symmetrical abnormal signals in the brainstem, thalamus, and (or) basal ganglia. Urine organic acid test were all normal but 1 patient had alanine elevation. Five patients underwent respiratory chain enzyme activity testing, and all had varying degrees of enzyme activity reduction. Six variants were identified, 6 patients were homozygous variants, with c.322-10G>A was present in 4 patients from 2 families and 2 compound heterozygous variants. Conclusions: The clinical phenotype of COXPD32 is highly heterogenous and the severity of the disease varies from development delay, feeding difficulty, dystonia, high lactic acid, ocular symptoms and reduced mitochondrial respiratory chain enzyme activity in mild cases, which may survive into adulthood, to rapid death due to respiratory and circulatory failure in severe cases. COXPD32 needs to be considered in cases of unexplained acidosis, hyperlactatemia, feeding difficulties, development delay or regression, ocular symptoms, respiratory and circulatory failure, and symmetrical abnormal signals in the brainstem, thalamus, and (or) basal ganglia, and genetic testing can clarify the diagnosis.

Effect of experiential health education on diet control of college students with type 2 pre diabetes mellitus / 中国学校卫生

Objective@#To understand the influence of experiential health education on diet control of college students with pre diabetes mellitus, and to provide reference for healthy eating habits promotion among college students.@*Methods@#According to the method of random number table, 78 pre diabetic college students screened from Changzhi Medical College from September 2020 to June 2021 were randomly assigned to observation group and control group (39 students in each group). The control group received routine health education for 10 months, once a week for 1 hour each time; On the basis of the above, the observation group received experiential health education once a week for 1 hour, including diet experience, exercise experience, blood sugar test experience and chronic complications experience. Blood glucose and lipids level, body mass index (BMI), dietary control as well as the stages of change for dietary control behavior were compared between the two groups.@*Results@#There was significant difference between the observation group and the control group in the stages of change for dietary control behavior 10 months after intervention ( χ 2=8.92, P <0.05). The compliance score of the observation group was significantly higher than that of the control group in the same period 10 months after the intervention ( t =3.74, P <0.01), the score of the knowledge of diet control in the observation group 10 months after intervention was significantly higher than that in the control group ( t =11.51, P <0.05). The levels of BMI, TG and TC in the observation group were significantly lower than those in the control group at 5 and 10 months after intervention, and the differences were statistically significant ( P <0.05).@*Conclusion@#Experiential health education helps to promote awareness of diabete related knowledge, enhance self management behavior and good diet control habits, and is effective for blood glucose control.

Voluntary wheel running exercise regulates microglia polarization in hippocampus through STAT3 signal pathway to inhibit depression-like behavior induced by chronic stress in rats / 生理学报

This paper was aimed to investigate the effect of voluntary wheel running exercise on depression-like behavior induced by chronic water immersion restraint stress (CWIRS) and the underlying mechanism. Sprague-Dawley (SD) rats received CWIRS to induce depression-like behavior and 4-week voluntary wheel running exercise. Meanwhile, the rats were treated with lipopolysaccharide (LPS) or STAT3 over-expression vector (pcDNA-STAT3) by intracerebroventricular injection. Behavioral tests were used to detect depression-like behavior. ELISA assay was used to detect levels of various inflammatory factors in the rat hippocampus. Western blot was used to detect protein expression levels of ionized calcium binding adaptor molecule 1 (Iba1), inducible nitric oxide synthase (iNOS), arginase 1 (Arg1), phosphorylated STAT3 (p-STAT3) and total STAT3 (t-STAT3). The results showed that, compared with stress group, stress + exercise group exhibited improved depression-like behavior, decreased interleukin-1β (IL-1β) and IL-6 levels, increased IL-4 and IL-10 levels, down-regulated Iba-1 and iNOS protein expression levels, up-regulated Arg1 protein expression level, and decreased p-STAT3/t-STAT3 ratio in hippocampal tissue. LPS reversed the improving effect of voluntary wheel running exercise on depression-like behavior in rats, and the over-expression of STAT3 reversed the promoting effects of voluntary wheel running on M2 polarization of microglial cells in rat hippocampus and depression-like behavior. These results suggest that voluntary wheel running ameliorates the depression-like behavior induced by CWIRS in rats, and the mechanism may be related to regulating hippocampal microglia polarization via STAT3 signaling pathway.

Repurposing econazole as a pharmacological autophagy inhibitor to treat pancreatic ductal adenocarcinoma

Pancreatic ductal adenocarcinoma (PDAC) is characterized by the highest mortality among carcinomas. The pathogenesis of PDAC requires elevated autophagy, inhibition of which using hydroxychloroquine has shown promise. However, current realization is impeded by its suboptimal use and unpredictable toxicity. Attempts to identify novel autophagy-modulating agents from already approved drugs offer a rapid and accessible approach. Here, using a patient-derived organoid model, we performed a comparative analysis of therapeutic responses among various antimalarial/fungal/parasitic/viral agents, through which econazole (ECON), an antifungal compound, emerged as the top candidate. Further testing in cell-line and xenograft models of PDAC validated this activity, which occurred as a direct consequence of dysfunctional autophagy. More specifically, ECON boosted autophagy initiation but blocked lysosome biogenesis. RNA sequencing analysis revealed that this autophagic induction was largely attributed to the altered expression of activation transcription factor 3 (ATF3). Increased nuclear import of ATF3 and its transcriptional repression of inhibitor of differentiation-1 (ID-1) led to inactivation of the AKT/mammalian target of rapamycin (mTOR) pathway, thus giving rise to autophagosome accumulation in PDAC cells. The magnitude of the increase in autophagosomes was sufficient to elicit ER stress-mediated apoptosis. Furthermore, ECON, as an autophagy inhibitor, exhibited synergistic effects with trametinib on PDAC. This study provides direct preclinical and experimental evidence for the therapeutic efficacy of ECON in PDAC treatment and reveals a mechanism whereby ECON inhibits PDAC growth.

Advance in Researches of Low Back Pain: A Bibliometrics and Visualization Study / 中国康复理论与实践

Objective:To explore the research focus, frontier and trend of global reseaches about low back pain using bibliometrics and visualization technology. Methods:The researchs in the Web of Science core database from 2016 to 2020 were retrieved with the subject terms of "low back pain" and categories of rehabilitation, and analyzed with Creating Citation Reports and Analyzing Retrieval Results of Web of Science, as well as the CiteSpace. Results:A total of 2026 papers were retrieved. The total frequency of citations in the last five years was 6793. The number of papers and citations increased year by year. Most of the papers came from the countries of America, Europe and Australia; the top five university institutions also with high centrality; and funded by US National Research Fund mostly. The top ten journals for number of papers and cited frequency were mainly rehabilitation journals, and the researches mainly focused on orthopedics, sports medicine and healthcare medicine. A total of 468 key words were obtained, including 33 key words with high centrality and 29 key words with Strongest Citation Bursts. Nine papers of highly cited were suggested by Web of Science. A total of 466 references were obtained through CiteSpace, including 35 references with high centrality and 53 references with Strongest Citation Bursts. The researches of key node literature were mainly randomized controlled trails and systematic review. Conclusion:The researches of low back pain mainly focus on the mechanism and management of pain, such as central sensitization, pressure pain threshold, pain pattern classification, pain directional preference and centralization, pain physiology/neuroscience education, and nonpharmacologic strategies for comprehensive pain care; as well as the psychological and social factors, such as behavioral cognitive therapy/psychologically informed physical therapy, self-efficacy, kinesiophobia, fear avoidance, and variables and interventions related to return-to-work. The trial studies of STarT Back tool, core instruments and standardization of core outcome reporting in clinical trials, and individualized and targeted treatment, would be the global trends in the research of low back pain.

Effect of electroacupuncture on lung dysplasia in rats with intrauterine growth restriction induced by maternal food restriction / 中国针灸

OBJECTIVE@#To investigate the protective effect of electroacupuncture (EA) at "Zusanli" (ST 36) in pregnant rats on lung dysplasia of newborn rats with intrauterine growth restriction (IUGR) induced by maternal food restriction.@*METHODS@#Twenty-four female SD rats were randomly divided into a control group, a control+EA group, a model group and a model+EA group, 6 rats in each group. From the 10th day into pregnancy to the time of delivery, the rats in the model group and the model+EA group were given with 50% dietary restriction to prepare IUGR model. From the 10th day into pregnancy to the time of delivery, the rats in the control+EA group and the model+EA group were treated with EA at bilateral "Zusanli" (ST 36), once a day. The body weight of offspring rats was measured at birth, and the body weight and lung weight of offspring rats were measured on the 21st day after birth. The lung function was measured by small animal lung function detection system; the lung tissue morphology was observed by HE staining; the content of peroxisome proliferator activated receptor γ (PPARγ) in lung tissue was detected by ELISA.@*RESULTS@#Compared with the control group, the body weight at birth as well as the body weight, lung weight, lung dynamic compliance (Cdyn) and PPARγ at 21 days after birth in the model group were significantly decreased (@*CONCLUSION@#EA at "Zusanli" (ST 36) may protect the lung function and lung histomorphology changes by regulating the level of PPARγ of lung in IUGR rats induced by maternal food restriction.

Sox9 Is Crucial for Mesenchymal Stem Cells to Enhance Cutaneous Wound Healing

Background and Objectives@#Human umbilical cord mesenchymal stem cells (HUC-MSCs) are promising candidates for cell-based therapy in regenerative medicine or other diseases due to their superior characteristics, including higher proliferation, faster self-renewal ability, lower immunogenicity, a noninvasive harvest procedure, easy expansion in vitro, and ethical access, compared with stem cells from other sources. @*Methods@#and Results: In the present study, we knocked down the expression of SOX9 in HUC-MSCs by lentivirus interference and found that knockdown of SOX9 inhibited the proliferation and migration of HUC-MSCs and influenced the expression of cytokines (IL-6 and IL-8), growth factors (GM-CSF and VEGF) and stemness-related genes (OCT4 and SALL4). In addition, the repair effect of skin with burn injury in rats treated with HUC-MSCs transfected with sh-control was better than that rats treated with HUC-MSCs transfected with shSOX9 or PBS, and the accessory structures of the skin, including hair follicles and glands, were greater than those in the other groups. We found that knockdown of the expression of SOX9 obviously inhibited the expression of Ki67, CK14 and CK18. @*Conclusions@#In conclusion, this study will provide a guide for modifying HUC-MSCs by bioengineering technology in the future.

Assurance of precision radiotherapy quality control: The advances in position/dose monitoring technologies / 西安交通大学学报(医学版)

How to realize the real-time monitoring of the position and dose of the superficial tumor target area in the process of radiotherapy and ensure the target area to receive sufficient radiation dose, so as to improve the local control rate of patients is both the key problem to be solved urgently in radiotherapy and an important way for the accurate and safe implementation of quality control and quality assurance. The ideal radiotherapy monitoring technology should have the advantages of being non-radiation and non-invasive, and three-dimensional dynamic real-time imaging. This paper will briefly review the existing location and dose monitoring technologies in the process of precise radiotherapy.

Value of anti-neutrophil cytoplasmic antibody in assessing the severity of bronchiolitis obliterans in children / 中国当代儿科杂志

OBJECTIVE@#To study the value of anti-neutrophil cytoplasmic antibody (ANCA) in assessing the severity of bronchiolitis obliterans (BO) in children.@*METHODS@#A prospective analysis was performed on 59 children who were diagnosed with BO from June 2009 to October 2014. ELISA was used to measure the concentrations of myeloperoxidase (MPO)-ANCA and proteinase 3 (PR3)-ANCA in serum. According to the results of ELISA, the children were divided into three groups: double-negative ANCA (n=22), single-positive ANCA (n=17), and double-positive ANCA (n=20). The three groups were compared in terms of the scores of BO risk factors, clinical symptoms, chest high-resolution computed tomography (HRCT), and lung pathology on admission, as well as the changes in the expression level of ANCA and the scores of clinical symptoms and chest HRCT over time.@*RESULTS@#Compared with the double-negative ANCA group, the double-positive ANCA group had a significantly higher score of BO risk factors (P0.05). The single-positive ANCA and double-positive ANCA groups still had a significantly higher score of clinical symptoms than the double-negative ANCA group (P<0.05).@*CONCLUSIONS@#The expression level of ANCA is correlated with the severity of BO in children and thus has certain clinical significance in disease evaluation.

Regulatory Effect of Liuwei Dihuangtang and Guifu Dihuangtang on Low-dose Hydrocortisone Reduction and Discontinuance in Mice with Drug-induced Deficiency Syndrome / 中国实验方剂学杂志

Objective:To study the effect of the kidney-tonifying recipes on mouse syndrome and adrenal function induced by low-dose hydrocortisone reduction and discontinuation. Method:The 48 male ICR mice were randomly divided into normal control group, hydrocortisone group, Liuwei Dihuangtang group and Guifu Dihuangtang group, with 12 rats in each group. Each group was given 1.32 mg·kg-1·d-1 hydrocortisone for 28 days, and half a dose for 7 days, and the administration was discontinued 14 days before modeling. In the reduction and discontinuation phase, 12.5 g·kg-1·d-1 Liuwei Dihuangtang and 13.5 g·kg-1·d-1 Guifu Dihuangtang were simultaneously administered to the corresponding group for 21 d. On the 28th and 49th day of the experiment, the characteristic information of mice was detected by the experimental methodology of syndrome differentiation and treatment in mice (holding power, body surface infrared temperature). The mice were sacrificed on the 50th day of the experiment, the spleen and thymus were separated, and the spleen and thymus index were calculated, serum corticosterone content is measured by enzyme-linked immunosorbent assay (ELISA), the total RNA of the adrenal gland was extracted, and the expressions of Star, cholesterol-side-chain cleavage enzyme (Cyp11a1), Cyp21a1, Cyp11b1, low-density lipoprotein receptor (Ldlr), scavenger receptor class B type I (Scarb1/SRB1), Hmgcr, acyl-CoA-cholesterol acyltransferase-1 (Acat1), hormone sensitive lipase (Lipe/HSL), insulin-inducible gene 1 (Insig1) and sterol regulatory element binding transcription factor 2 (Srebf2) were detected by Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR). Western blot was used to detect the expressions of LDLR, SRB1, CYP11A1 and cytochrome P450 family 21 subfamily A member 2 (CYP21A2) in adrenal gland. Result:Compared with the normal control group, the body weight and the body mean infrared temperature of the model group were significantly decreased after 28 days of continuous administration (P<0.01). After the administration of the drug, the mice in the model group showed a significant decrease in the grip strength (P<0.05), a significant increase in the thymus index (P<0.01), a significant decrease in the serum corticosterone content (P<0.05). Expressions of adrenal Cyp21a1 and Hmgcr genes decreased (P<0.05, P<0.01), Lipe and Acat1 gene expressions increased significantly (P<0.01), adrenal CYP11A1, SRBI protein expressions decreased significantly, and LDLR protein expression increased. Compared with the model group, the body weight of Guifu Dihuangtang group decreased significantly after 21 days of treatment with traditional Chinese medicine (P<0.01), the spleen index of Liuwei Dihuangtang group decreased significantly (P<0.01), expressions of Cyp11a1, Cyp21a1, Acat1 and Lipe genes in Guifu Dihuangtang group were significantly increased (P<0.05, P<0.01), expressions of Ldlr and Scarb1 genes were significantly decreased (P<0.05), and expressions of Ldlr, Acat1 and Lipe genes in Liuwei Dihuangtang group were significantly decreased (P<0.05, P<0.01), and expressions of CYP11A1 and SRBI proteins in Liuwei Dihuangtang and Guifu Dihuangtang increased. Conclusion:Guifu Dihuangtang can promote the recovery of adrenal function in mice with drug-induced deficiency syndrome by correcting expression of adrenal cortex synthase.

Effect of Modified Shaoyao Gancaotang， Electroacupuncture and Acupuncture Combined with Herb on γ-Aminobutyric Acid Related Receptor Proteins in Cortex in SCA Rats / 中国实验方剂学杂志

Object:To analyze the effect of muscular tension injury in spasticity of cerebral apoplexy(SCA) rats with spasticity and the expression of γ-aminobutyric acid receptor (GABAα), γ-aminobutyric acid transporter (GAT-1) protein and mRNA expression in cerebral cortex modified Shaoyao Gancaotang, electroacupuncture Quchi, Yanglingquan and acupuncture combined with herb therapies alleviate the effect of SCA. Method:Randomly divided into two groups, divided into blank group, sham operation group, model group, modified Shaoyao Gancaotang group, acupuncture combined with herb group, electroacupuncture group, selected qualified SD rats into the group, 9 rats in each group. The modified Zea-Longa thread embolism method+internal capsule injection of NMDA receptor method was used to prepare a rat model. After the behavioral score confirms the success of the model,dispose of each group separately,electroacupuncture group (electroacupuncture on both sides of Yangling Spring and Quchi,1 time/d for 5 days), modified Shaoyao Gancaotang group (with Shaoyao Gancaotang 1 time/d,10 mL·kg-1 for 5 days),acupuncture combined with herb (modified Shaoyao Gancaotang was given, then electroacupuncture treatment was continued for 5 days). After treatment, the muscle tension was detected by behavioral analysis. Real-time fluorescent quantitative PCR（Real-time PCR） and Western blot were used to detect the expression of GABAα and GAT-1 related mRNA and protein in the cortex. Result:Compared with normal group, the muscle tension of the model group increased (P<0.01), the expression of GABAα mRNA and protein decreased (P<0.01), and the expression of GAT-1 mRNA and protein increased (P<0.01), compared with model group, the muscle tone score of the each treatment group decreased (P<0.05), the expression of GABAα mRNA and protein increased (P<0.05，P<0.01), and the expression of GAT-1 mRNA and protein decreased (P<0.05，P<0.01), of which the corresponding expression in the acupuncture combined with herb group was the most significant. Conclusion:Electroacupuncture Quchi, Yanglingquan,modified Shaoyao Gancaotang and acupuncture combined with three therapies can alleviate the muscle tension of limbs spasm of stroke,and the combination of acupuncture and medicine treatment on the cortical γ-aminobutyric acid receptor the highest expression efficiency suggests that it has the best effect on improving the excitatory spasticity of stroke limbs.

Effect of ticagrelor on plasma P-selectin concentration during acute kidney injury in septic rats / 中华麻醉学杂志

Objective@#To evaluate the effect of ticagrelor on plasma P-selectin (CD62P) concentration during acute kidney injury in septic rats.@*Methods@#Thirty SPF healthy male Sprague-Dawley rats, aged 6-8 weeks, weighing 180-220 g, were divided into 3 groups(n=10 each)using a random number table method: sham operation group (group S), sepsis group (group Sep) and ticagrelor group (group T). Sepsis was induced by cecal ligation and puncture in anesthetized rats.The abdomen was opened after anesthesia induction and then closed after turning the intestines in group S. Ticagrelor 8.6 mg/kg was given through a gastric tube into stomach at 12 h after establishing the model in group T, while the equal volume of distilled water was given instead in S and Sep groups.Blood samples were collected from hearts at 24 h after establishing the model for determination of the concentrations of Scr and plasma CD62P.The rats were then sacrificed, and bilateral renal tissues were taken for examination of pathological changes and for determination of cell apoptosis by fluorescence microscopy after Annexin/V-FITC double staining was performed.@*Results@#Compared with group S, the concentrations of Scr and plasma CD62P, renal Paller score and apoptosis rate of renal cells were significantly increased in Sep and T groups (P<0.05). Compared with group Sep, the concentrations of Scr and plasma CD62P, renal Paller score and apoptosis rate of renal cells were significantly decreased in group T (P<0.05).@*Conclusion@#The mechanism by which ticagrelor reduces acute kidney injury is related to decreasing plasma CD62P concentrations and inhibiting cell apoptosis in septic rats.

Effect of ticagrelor on plasma P-selectin concentration during acute kidney injury in septic rats / 中华麻醉学杂志

Objective To evaluate the effect of ticagrelor on plasma P-selectin(CD62P)concentra-tion during acute kidney injury in septic rats.Methods Thirty SPF healthy male Sprague-Dawley rats,aged 6-8 weeks,weighing 180-220 g,were divided into 3 groups(n＝10 each)using a random number table method: sham operation group(group S),sepsis group(group Sep)and ticagrelor group(group T).Sepsis was induced by cecal ligation and puncture in anesthetized rats.The abdomen was opened after anesthesia in-duction and then closed after turning the intestines in group S.Ticagrelor 8.6 mg/kg was given through a gas-tric tube into stomach at 12 h after establishing the model in group T,while the equal volume of distilled wa-ter was given instead in S and Sep groups.Blood samples were collected from hearts at 24 h after establishing the model for determination of the concentrations of Scr and plasma CD62P.The rats were then sacrificed,and bilateral renal tissues were taken for examination of pathological changes and for determination of cell ap-optosis by fluorescence microscopy after Annexin/V-FITC double staining was performed.Results Compared with group S,the concentrations of Scr and plasma CD62P,renal Paller score and apoptosis rate of renal cells were significantly increased in Sep and T groups(P＜0.05).Compared with group Sep,the concentra-tions of Scr and plasma CD62P,renal Paller score and apoptosis rate of renal cells were significantly de-creased in group T(P＜0.05).Conclusion The mechanism by which ticagrelor reduces acute kidney injury is related to decreasing plasma CD62P concentrations and inhibiting cell apoptosis in septic rats.

Effect of Compressive Low Elastic Bandage on Upper Limb Lymphedema after Breast Cancer Surgery / 中国康复理论与实践

Objective:To observe the effect of compressive low elastic bandage on upper limb lymphedema after breast cancer surgery. Methods:From November, 2017 to December, 2018, 64 patients with upper limb lymphedema after breast cancer surgery were randomly divided into control group (n = 32) and observation group (n = 32). Both groups accepted manual lymphatic drainage and low elastic bandage, while the observation group increased the pressure with sponge pads on the fibrous swelling site as bandaging, five times a week for two weeks. They were measured L-Dex with bioelectrical spectroscopy before the first treatment (T1), before the second treatment (T2), before the third treatment (T3), before the sixth treatment (T4), and 24 hours after the tenth treatment (T5), respectively. The arm circumference of affected side and un-affected side was also measured at T1 and T5. Results:L-Dex decreased since T2 in both groups, but increased at T4 in the observation group and more than that of the control group (t = 2.13, P < 0.05), and less than that of the control group at T5 (t = -2.29, P < 0.05). The difference of arm circumference between affected side and un-affected side was less in the observation group than in the control group (t = -3.78, P < 0.001)。 Conclusion:Low elastic bandage combined with lymphatic drainage technique can alleviate the fibrous swelling. On the basis of low elastic bandage with local sponge pad compression is more effective than simple low elastic bandage on fibrous swelling after lymphedema of upper limbs after breast cancer surgery.

Expression of CBX8 in gastric adenocarcinoma and the relationship with clinicopathologic characters and survival prognosis / 临床与实验病理学杂志

Purpose To explore the expression of CBX8 in gastric adenocarcinoma tissue and its clinical significance.Methods 119 cases of primary gastric adenocarcinoma treated by surgery and corresponding adjacent normal tissues were collected. The protein expression levels of CBX8 in gastric adenocarcinoma and their corresponding adjacent normal tissue was determined using tissue microarray and immunohistochemistry PV 6000 method staining. The relationship between CBX8 expression and clinicopathologic characters and survival prognosis was analyzed. Results The positive expression rate of CBX8 in gastric cancer and their corresponding adjacent normal tissue was 46.2％ (55/119) and 13.4％ (16/119) respectively. There was statistically significant difference between two groups (χ2=30.53, P < 0.01). The expression of CBX8 in gastric adenocarcinoma tissue was obviously correlated with the differentiation, clinical staging, and lymph node metastasis (P < 0.05). The high expression rate of CBX8 in the poorly differentiated gastric adenocarcinoma was lower than moderately differentiated and well differentiated group. The high expression rate of CBX8 in stage Ⅰ + Ⅱ gastric adenocarcinoma was higher than that in stage Ⅲ + Ⅳ. The gastric adenocarcinoma patients with high expression of CBX8 had low metastasis rate. Cox multivariate analysis showed CBX8, clinical staging, and lymphatic metastasis were independent predictors of overall survival and disease-free survival (P < 0.05). Kaplan-Meier analysis showed that the patients with higher expression of CBX8 had both longer overall survival time (P = 0.004) and disease-free survival time (P =0.004). Conclusion The expression of CBX8 may be involved in the tumorigenesis and progression of gastric adenocarcinoma. CBX8 is one of the independent predictor of prognosis, and the detecting of CBX8 expression may have important clinical value for the evaluation of gastric adenocarcinoma. CBX8 may became a new target for target therapy of gastric adenocarcinoma.

Impact on platelet recovery of recombinant human thrombopoietin in severe aplastic anemia patients with allogeneic hematopoietic stem cell transplantation / 中华血液学杂志

Objective: To investigate and analyze the impact on PLT recovery of recombinant human thrombopoietin (rhTPO) in severe aplastic anemia (SAA) patients with allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods: A retrospective analysis of Hematology Division of General Hospital of Jinan Military Command was conducted in the 85 SAA cases who treated with allo-HSCT from January 2010 to March 2017. According to the administration of medicines for platelets, 85 patients were divided into rhTPO group (n=29), rhIL-11 group (n=27) and blank group (n=29), respectively. The median time of PLT ≥20×109/L, PLT ≥50×109/L, and PLT ≥100×109/L, the numbers of megakaryocytes in marrow smear (25±5) days after transplantation and the quantities of platelet transfusion were analyzed retrospectively. The adverse events of rhTPO and rhIL-11 groups were observed. Results: There were no significant differences in the recovery of granulocytes and PLT ≥20×109/L among the three groups (P>0.05). The time of PLT ≥50×109/L in rhTPO group was shorter than that in blank group [16.5 (11-39) d vs 22 (14-66) d, P<0.05], as well as the time of PLT ≥100×109/L [rhTPO: 23 (12-51) d; rhIL-11: 28 (12-80) d; blank group: 35 (18-86) d, P<0.05]. Platelet transfusions were also less in rhTPO group than in rhIL-11 and blank groups [20 (10-30) U, 30 (10-50) U, 35 (10-70) U, P<0.05]. The counts of megakaryocyte in rhTPO group, rhIL-11 group and blank group were 31.5 (0-200), 12 (0-142) and 11(0-187) (P<0.05), respectively. The difference between rhTPO group and rhIL-11 group was statistically significant (P<0.05), but no difference between rhIL-11 group and blank group (P>0.05). Multivariate analysis showed that rhTPO was an independent factor for platelet recovery [HR=4.01 (95%CI 1.81-9.97), P=0.010]. The rhTPO group had no obvious adverse events. Conclusion: rhTPO can promote platelet recovery of SAA patients after allo-HSCT, reduce platelet transfusion with safety.

Dynamic variation trend and prognostic value of bronchial wall thickness in severely burned patients combined with inhalation injury / 中华烧伤杂志

Objective@#To explore the dynamic variation trend of bronchial wall thickness (BWT) in severely burned patients combined with inhalation injury, and to determine the value of BWT to prognosis of patients.@*Methods@#Forty-three severely burned patients with inhalation injury hospitalized in Intensive Burn Department of the Affiliated Hospital of Nankai University (Tianjin No.4 Hospital) from July to November 2016, conforming to the study criteria, were divided into survival group (n=27) and death group (n=16) according to the prognosis of patients within 14 days after admission. All patients underwent fiberoptic bronchoscopy and inhalation injury rating based on abbreviated injury scale at admission. High resolution CT examination was performed in patients of two groups at admission and 24 h post admission, 3, 7, and 14 d post admission to measure the BWT of right superior lobar bronchus trunk opening. Receiver operating characteristic curves of rating of inhalation damage at admission and BWT at admission were drawn to evaluate the predictive value for death of 43 patients. Data were processed with chi-square test, independent sample t test, Wilcoxon rank sum test, analysis of variance for repeated measurement and least-significant difference-t test.@*Results@#(1) The numbers of patients rated as 0, 1, 2, 3, and 4 grade for inhalation injury in survival group and death group were 0, 19, 6, 2, and 0, and 0, 2, 7, 7, and 0, respectively. There were statistically significant differences between the two groups (Z=-3.79, P<0.01). (2) BWT of patients in death group at admission and 24 h post admission, 3, 7, and 14 d post admission was respectively (2.72±0.26), (3.18±0.22), (2.98±0.18), (2.29±0.17), and (1.45±0.21) mm, which was significantly larger than (2.24±0.15), (2.49±0.15), (1.51±0.17), (1.04±0.16), and (1.01±0.13) mm in survival group (t=7.55, 12.14, 27.11, 19.99, 7.11, P<0.01). BWT of patients in survival group and death group at 24 h post admission, 3, 7, and 14 d post admission showed statistically significant difference when compared with that at admission within the corresponding group (t=5.97, 16.63, 28.21, 38.57, 5.34, 3.31, 4.39, 6.48, P<0.01). BWT of patients in survival group and death group on 3, 7, and 14 d post admission was significantly smaller than that at 24 h post admission within the corresponding group (t=22.27, 34.02, 45.03, 2.77, 10.53, 10.59, P<0.01). BWT of patients in survival group and death group on 7 and 14 d post admission was significantly smaller than that on 3 d post admission within the corresponding group (t=10.49, 18.26, 9.57, 11.44, P<0.01). BWT of patients in survival group and death group on 14 d post admission was significantly smaller than that on 7 d post admission within the corresponding group (t=6.97, 6.15, P<0.01). (3) The total areas under ROC curves of inhalation injury rating at admission and BWT at admission for predicting death of 43 patients were 0.880 and 0.956, respectively (with 95% confidence intervals 0.768-0.991, 0.882-1.000, P<0.05). Grade 1.5 and 2.75 mm were respectively chosen as the optimal threshold values of inhalation injury rating at admission and BWT at admission, with sensitivity of 87.50%, 83.33% and specificity of 77.78%, 96.00%, respectively.@*Conclusions@#The BWT of survived and dead patients with severe burn and inhalation injury increases significantly post burn, while the BWT of survived patients restores to normal level faster. BWT can be used to assess the severity of inhalation injury and to predict death in severely burned patients combined with inhalation injury.

Impact of Remote Ischemic Conditioning on Circulating miR-208b Level and Cardiac Function in Patients With ST Segment Elevation Myocardial Infarction Undergoing Primary Angioplasty / 中国循环杂志

Objectives: To investigate whether remote ischemic conditioning (RIC) applied to patients with ST-segment elevation myocardial infarction (STEMI) before percutaneous coronary intervention (PCI) could affect circulating miR-208b level or not. Methods:Patients diagnosed with STEMI undergoing PCI from January 2016 to July 2017 were enrolled from the Department of Cardiology, Affiliated Zhongshan Hospital of Dalian University.The patients were randomly allocated to two groups: (1) control group (n=25), PCI alone; (2) RIC group (n=50), PCI combined with RIC (three cycles of 5 min inflation and 5 min deflation of the right lower limb with blood pressure cuff performed before reperfusion). Serum miR-208b was measured before and immediately, at 24 h, and 48 h after PCI with real-time quantitative polymerase chain reaction. Results: The expression of miR-208b was significantly higher immediately post PCI than that before operation in the control group (84.1±9.0 vs 77.8±9.4; P=0.032), while it was significantly lower immediately post PCI than that before operationin RIC group (71.0±9.3 vs 77.4±8.8; P=0.028).miR-208b level was similar before PCI between the control and RIC groups (P=0.874), which was significantly reduced immediately post PCI in RIC group as compared with the control group (P=0.021).The peak value of creatine kinase isoenzyme (CK-MB) in the limb RIC group was significantly lower than that in the control group ([135.2±18.6] U/L vs [167.7±17.2] U/L; P=0.038).The area under the CK-MB curve of the RIC group was significantly smaller than that of the control group ([3 060.7±17.1] U/L vs [3 635.9±15.1] U/L); P=0.047]. The left ventricular ejection fraction (LVEF) in RIC group was significantly higher than that in the control group ([57.8±7.8]% vs [51.9±7.9]%; P=0.003) post PCI. The expression level of serum miR-208b was positively correlated with CK-MB AUC in RIC group (r=0.498, P<0.001). Conclusions: RIC of the lower limb prior to PCI could reduce miR-208b level and improve cardiac functionin STEMI patients.

Sensory Impairment and Movement Restriction after Mastectomy:A Case Report / 中国康复理论与实践

Objective To explore the diagnosis and management of post-mastectomy sensory impairment and movement restriction. Methods A case was reviewed. Results She was diagnosed as radiation-induced brachial plexus injury with rotator cuff tear from the history,signs and tests.Her movement was improved and numbness was relieved after rehabilitation. Conclusion The sensory impairment after mastectomy is mainly caused by brachial plexus injuries,and needs to be dif-ferentiated from scapulohumeral periarthritis and rotator cuff tear when patients have shoulder movement restric-tion.