Mechanism of lncRNA-N1LR in blood-brain barrier injury during cerebral ischemia reperfusion / 中华老年心脑血管病杂志

Objective To investigate the action mechanism of long non-coding RNA(lncRNA)-N1LR on blood-brain barrier(BBB)after cerebral ischemia-reperfusion(I/R)injury.Methods Primary rat brain microvascular endothelial cells(BMECs)were cultured and treated with OGD/R to simulate cerebral I/R injury.The experiment was divided into normal control group,ln-cRNA-N1LR OGD group,overexpression group(lncRNA-N1LR overexpression after OGD treat-ment)and silence group(lncRNA-N1LR silence after OGD treatment).The mRNA levels of ln-cRNA-N1LR,claudin-5 and occludin in each group were detected by RT-qPCR.The BBB permea-bility was detected by FITC-dextran infiltration assay.The expression of claudin-5 and occludin were detected by Western blotting.Results The mRNA levels of lncRNA-N1LR,occludin and claudin-5 were significantly decreased(0.31±0.01 vs 1.00±0.10,0.42±0.03 vs 1.01±0.13,0.38±0.03 vs 1.00±0.15,P＜0.05),and the BBB permeability was significantly increased(58.79± 3.04 vs 8.87±0.63,P＜0.05)in the OGD group than the control group.The lncRNA-N1LR over-expression group increased the mRNA expression of lncRNA-N1LR,occludin and claudin-5(0.67±0.07 vs 0.31±0.01,0.92±0.02 vs 0.42±0.03,0.70±0.08 vs 0.38±0.03,P＜0.05),and decreased the BBB permeability(41.57±2.43 vs 58.79±3.04,P＜0.05)than the OGD group.lncRNA-N1LR silence resulted in lower mRNA levels of lncRNA-N1LR,occludin and claudin-5(0.21±0.02 vs 0.31±0.01,0.31±0.03 vs 0.42±0.03,0.22±0.02 vs 0.38±0.03,P＜0.05),and enhanced BBB permeability(72.34±1.43 vs 58.79±3.04,P＜0.05)when compared with the OGD group.Conclusion Up-regulation of lncRNA-N1LR may play a neuroprotective role by reducing BBB permeability.

Ethical Thoughts on the Quality Evaluation of the Kidneys from Expanded Criteria Donors / 中国医学伦理学

In the case of extremely shortage of donor kidney sources, the number of Expanded Criteria Donors (ECD) with relatively poor kidney quality and transplantation effect is increasing. In order to alleviate the contradiction between supply and demand by using transplantable kidneys as much as possible and avoid the failure or poor effect of transplantation caused by poor quality kidneys, the quality assessment and evaluation criteria of ECD kidney have become a research hotspot in the field of kidney transplantation. This paper analyzed the possible ethical defects in the research process, and put forward some suggestions for the transplantation team to strictly follow the ethical principles of "no harm", "beneficial" and "informed consent", and the organ transplantation ethics committee to pay attention to the ethical review of the quality evaluation process of ECD donor kidney.

Application of rhG-CSF in the treatment of chemotherapy-induced oral mucositis in children / 中国现代医生

@#Objective To explore the application effect of recombinant human granulocyte colony stimulating factor(rhG-CSF)in the treatment of chemotherapy-induced oral mucositis in children.Methods Totally 60 children with chemotherapy-induced oral mucositis who underwent chemotherapy in the tumor surgery of our hospital from January 2020 to June 2022 were randomly divided into two groups,30 cases each.The control group was given physiological saline oral care,and the experimental group was given rhG-CSF oral care.Compare the intervention effect,oral mucositis grading,quality of life[short form of health survey(SF-36)]and nursing satisfaction of parents of the two groups.Results The total effective rate of the experimental group was higher than that of the control group(P<0.05).After 5 days of intervention,the score of oral mucositis in the experimental group was better than that in the control group(P<0.05).After 5 days of intervention,the SF-36 score of children in the two groups was higher than that before intervention,and that in the experimental group was higher than that in the control group(P<0.05).The parents'satisfaction in the experimental group was higher than that in the control group(P<0.05).Conclusion rhG-CSF oral care can effectively improve the intervention effect of chemotherapy-induced oral mucositis in children,reduce the grade of oral mucositis,improve the quality of life of children,and improve the nursing satisfaction of parents of children.

Electroacupuncture for acute exacerbation of chronic obstructive pulmonary disease complicated with gastrointestinal dysfunction: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the clinical effect of electroacupuncture (EA) for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with gastrointestinal dysfunction.@*METHODS@#A total of 100 patients with AECOPD complicated with gastrointestinal dysfunction were randomly divided into an EA group (50 cases, 2 cases dropped off, 1 case excluded) and a medication group (50 cases). Both groups were treated with symptomatic and supportive treatment such as low flow oxygen, nebulized inhalation of short-acting β2 agonist (SABA) or short-acting muscarinic antagonist (SAMA) combined with inhaled corticosteroid (ICS). The EA group was treated with EA at Zusanli (ST 36), Yinlingquan (SP 9), Zhongwan (CV 12), Shuifen (CV 9), Tianshu (ST 25), Chize (LU 5) and Lieque (LU 7), with discontinuous wave, 2 Hz in frequency, 30 min each time, once a day. In the medication group, oral mosapride citrate tablets were given, 3 times a day, 5 mg each time. Both groups were treated for 5 d. Before and after treatment, the gastrointestinal symptom rating scale (GSRS) score was observe, serum procalcitonin (PCT), C-reactive protein (CRP), and plasma oxygenation index (PaO2/FiO2) were detected, and patient satisfaction degree was evaluated in the two groups.@*RESULTS@#Compared with before treatment, except for diarrhea dimension in the medication group, the total scores and each dimension scores of GSRS were decreased (P<0.05), serum PCT and CRP were decreased (P<0.05), plasma PaO2/FiO2 was increased (P<0.05) in the two groups after treatment. After treatment, in the EA group, the total score and abdominal pain, dyspepsia, constipation and diarrhea scores of GSRS were lower than those in the medication group (P<0.05), meanwhile serum PCT and CRP were lower and plasma PaO2/FiO2 was higher than those in the medication group (P<0.05). The improvement of gastrointestinal symptoms, life quality and overall satisfaction degree in the EA group were superior to those in the medication group (P<0.05).@*CONCLUSION@#EA could improve the symptoms of patients with AECOPD complicated with gastrointestinal dysfunction, reduce inflammatory response, improve oxygenation and patient satisfaction degree.

Heixiaoyao Powder interferes with microglia polarization in AD model mice by regulating NOX2/ROS/NF-κB signaling pathway / 中国中药杂志

The effect and mechanism of Heixiaoyao Powder on the polarization of microglia(MG) in APP/PS1 double transgenic mice were explored based on NADPH oxidase 2(NOX2)/reactive oxygen species(ROS)/nuclear factor kappaB(NF-κB) signaling pathway. Fifty 4-month-old male APP/PS1 mice were randomly divided into a model group, an MCC950 group(10 mg·kg~(-1)), and low-, medium-, and high-dose Heixiaoyao Powder groups(6.45, 12.89, and 25.78 g·kg~(-1)). Thirty male C57BL/6J mice of the same age and strain were randomly divided into a blank group, a blank + intragastric intervention group, and a blank + intraperitoneal injection group. Drug intervention lasted 90 days. Morris water maze test was used to detect learning and cognitive ability. Nissl staining and transmission electron microscopy were used to observe the pathological morphology and ultrastructure of hippocampal neurons. Immunofluorescence was used to detect the positive expression of M1-type marker CD16/32~+/Iba-1~+, M2-type marker CD206~+/Iba-1~+ of MG and the expression of hippocampal ROS. The colorimetric method was used to detect the content of malondialdehyde(MDA) and superoxide dismutase(SOD) in the hippocampus. Enzyme linked immunosorbent assay(ELISA) was used to detect the levels of inflammatory factors, including interleukin-6(IL-6), interleukin-8(IL-8), and tumor necrosis factor-α(TNF-α), in the hippocampus. Western blot was used to detect the protein expression of β-amyloid protein(Aβ), Iba-1, CD16/32, CD206, NOX2, NF-κB, p-NF-κB, NF-κB inhibitor alpha(IκBα), and p-IKBα in the hippocampus. The results showed that as compared with the blank group, the model group showed prolonged target quadrant movement distance and escape latency(P<0.01), shortened target quadrant retention time and percentage(P<0.01), disorganized neuronal cells with swelling, nuclear disappearance or bias, reduced number of cells, dissolved or absent Nissl bodies, and a clear area in the cytoplasm, damaged and shrunk cell membrane with abnormal cell morphology, few organelles in the cytoplasm, reduced and swollen mitochondria, increased MG M1-type marker CD16/32~+/Iba-1~+(P<0.01), decreased M2-type marker CD206~+/Iba-1~+(P<0.01), increased ROS activity and MDA content(P<0.01), decreased SOD level(P<0.01), elevated inflammatory factors IL-6, IL-8, and TNF-α(P<0.01), up-regulated protein expression and phosphorylation of Aβ, CD16/32, Iba-1, NOX2, NF-κB, and IKBα(P<0.01), and down-regulated CD206(P<0.01). There was no statistically significant difference between the blank group, the blank + intragastric intervention group, and the blank + intraperitoneal injection group. After the intervention of Heixiaoyao Powder, the Heixiaoyao Powder groups showed shortened target quadrant movement distance and escape latency(P<0.01), prolonged target quadrant retention time and percentage(P<0.01), increased and neatly arranged cells with relieved swelling, increased Nissl bodies, regular cell morphology, and intact cell membrane, relieved swelling of mitochondria, slightly expanded endoplasmic reticulum, decreased CD16/32~+/Iba-1~+(P<0.05 or P<0.01), increased CD206~+/Iba-1~+(P<0.01), decreased ROS activity and MDA content(P<0.01), increased SOD level(P<0.01), decreased content of inflammatory factors IL-6, IL-8, and TNF-α(P<0.01), down-regulated protein expression and phosphorylation of Aβ, CD16/32, Iba-1, NOX2, NF-κB, and IKBα(P<0.01), and up-regulated CD206(P<0.01). In conclusion, Heixiaoyao Powder can alleviate neuronal damage and improve the learning and memory abilities of APP/PS1 mice. The mechanism of action may be related to the inhibition of NOX2/ROS/NF-κB signaling pathway, regulating the polarization of MG, increasing the expression of M2 type, inhibiting the expression of M1 type, and reducing the release of inflammatory factor.

Mechanism of Metformin on Oxygen-glucose Deprivation/reoxygenation-induced U251 Cells Injury through Wnt/β-catenin Signaling Pathway / 医学研究杂志

Objective To investigate the mechanism of metformin on oxygen-glucose deprivation/reoxygenation(OGD/R)injury in U251 cells.Methods Human glioma cell line U251 cells were cultured and divided into 6groups:blank control group,model group,metformin medium dose group,metformin high dose group,agonist group(Wnt3a,Wnt/β-catenin signaling pathway agonist),inhibitor group(metformin+XAV939,Wnt/β-catenin signaling pathway inhibitor).Except for the blank control group,the cells in the other groups were subjected to OGD/R for 2h and then reperfusion for 24h to establish the OGD/R model.The animals were treated with met-formin,Wnt3a and XAV939 24h before modeling.Cell viability and toxicity were detected by CCK-8method and lactate dehydrogenase(LDH)assay.ROS formation was detected by DHE staining.Glutathione peroxidase(GSH-Px),superoxide dismutase(SOD)malond-ialdehyde(MDA),interleukin-6(IL-6),inducible nitric oxide synthase(iNOS)and tumor necrosis factor-α(TNF-α)were de-tected by enzyme-linked immunoadsordent assay(ELISA).The protein expression levels of β-catenin,cyclin D1,p-GSK-3β(Ser9)and GSK-3β were detected by Western blot.Results Compared with blank control group,LDH,ROS,MDA,IL-6,iNOS and TNF-α in model group,metformin group,agonist group and inhibitor group were significantly increase.The relative expression lev-els of SOD,GSH-Px,β-catenin,cyclin D1,p-GSK-3β(Ser9)and cell viability were significantly decreased.Compared with mod-el group,the levels of LDH,ROS,MDA,IL-6,iNOS and TNF-α in metformin group and agonist group were significantly decreased,while the relative expression levels of SOD,GSH-Px,β-catenin,cyclin D1,p-GSK-3β(Ser9)and the cell viability were signifi-cantly increased.Compared with metformin group,LDH,ROS,MDA,IL-6,iNOS and TNF-α in metformin group and inhibitor group were significantly increase,the relative expression levels of SOD,GSH-Px,β-catenin,cyclin D1,p-GSK-3 β(Ser9)and the cell viability were significantly decreased.Conclusion Metformin may play a protective role in OGD/R of U251 cells through Wnt/β-cate-nin signaling pathway.

Long-term curative effects of uterine artery embolization with polyvinyl alcohol granules on adenomyosis / 中国基层医药

Objective:To investigate the long-term efficacy and the adverse reactions of uterine artery embolization with polyvinyl alcohol granules in the treatment of adenomyosis.Methods:Sixty patients with adenomyosis who received treatment in The Second People's Hospital of Qinzhou from January 2009 to February 2017 were retrospectively included in this study. They were divided into an observation group ( n = 31) and a control group ( n = 29) according to different treatment methods. The observation group was treated by embolization of the uterine artery with a polyvinyl alcohol granule. The control group was treated with a levonorgestrel-releasing intrauterine system. After treatment, all patients were followed up for 2-5 years. The long-term efficacy was evaluated, including the symptoms of dysmenorrhea, average menstrual fluid volume, sex hormone, and change in uterine size. Results:After 2 years of treatment, the response rate in the observation group was 93.5% (29/31), which was significantly higher than 72.4% (21/29) in the control group ( χ2 = 4.81, P = 0.028). After 5 years of treatment, the response rate in the observation group was 93.5% (29/31), which was significantly higher than 65.5% (19/29) in the control group ( χ2 = 7.35, P = 0.007). After treatment, the improvements in uterine size, menstrual fluid volume, and visual analogue scale score were greater in the observation group than those in the control group (all P < 0.05). After treatment, all patients were followed up for 5 years. There was no significant difference in the incidence of long-term adverse reactions between the observation and control groups [3.2% (1/31) vs. 6.9% (2/29), P > 0.05]. The recurrence rate in the observation group was 3.45% (1/29), which was significantly lower than 23.81% (5/21) in the control group ( χ2 = 4.78, P = 0.029). After 2 and 5 years of treatment, ovarian function was not affected in both groups of patients. Conclusion:Uterine artery embolization with polyvinyl alcohol granules for the treatment of adenomyosis has identified long-term curative effects, is safe, and has a low recurrence rate.

Expression of serum miR-384 and LIN28B in diabetic retinopathy and their diagnostic value / 局解手术学杂志

Objective To investigate the expression levels of microRNA-384(miR-384)and LIN28B in serum of patients with diabetic retinopathy(DR)and their diagnostic value.Methods A total of 100 patients with type 2 diabetes diagnosed in our hospital from January 2020 to November 2021 were selected as the research subjects.According to the occurrence of retinopathy,the patients were divided into the non-DR group(40 cases)and the DR group(60 cases).In addition,40 healthy person who underwent physical examination in our hospital during the same period were regarded as the control group.The relative expression levels of serum miR-384 and LIN28B were detected by qRT-PCR,and the relationship between the two indexes and the general clinical data of DR patients was analyzed.Pearson method was applied to analyze the correlation between the expression of miR-384 and LIN28B in serum of DR patients.Logistic regression was applied to analyze the influencing factors of DR.The diagnostic value of serum miR-384 and LIN28B levels for DR patients was analyzed by receiver operating characteristic(ROC)curve.Results The level of serum miR-384 in the DR group was obviously lower than that in the non-DR group and the control group(P<0.05),and the non-DR group was lower than the control group(P<0.05).The level of serum LIN28B in the DR group was obviously higher than that in the non-DR group and the control group(P<0.05),and the non-DR group was higher than the control group(P<0.05).The expression levels of miR-384 and LIN28B were related to the course of diabetes and blood glucose(P<0.05).Pearson's correlation analysis showed that the expression of miR-384 was negatively correlated with LIN28B in serum of DR patients(r=-0.296,P<0.05).Logistic regression analysis showed that miR-384 and LIN28B were the independent influencing factors for DR(P<0.05).The results of ROC curve analysis showed that the area under the curve(AUC)of miR-384,LIN28B and the combination of two in DR patients was 0.625,0.646,and 0.682,respectively,and the specificity was 67.50%,85.00%,and 97.50%,respectively.Conclusion The serum expression of miR-384 is low and LIN28B is high in DR patients.Both miR-384 and LIN28B are the influencing factors for the occurrence of DR and are expected to be potential serological markers for the diagnosis of DR.

Potential categories of lifestyle behavior and its relation with traditional Chinese medicine constitutions among higher vocational medical students / 中国学校卫生

Objective@#To understand potential categories of lifestyle behaviors and its association with traditional Chinese medicine (TCM) constitution among higher vocational medical students, so as to provide reference for the physical health management of them.@*Methods@#From October to December 2022, 2 720 medical students from three higher vocational medical colleges in Anhui Province were selected by stratified cluster sampling method and were investigated with a questionnaire of lifestyle and TCM body constitution. Potential category analysis (LCA) and multiple linear regression were used to explore the relationship between potential categories of lifestyle behaviors and TCM constitutions.@*Results@#The lifestyle behavior of vocational medical students were classified into three potential categories:general health group (83.60%), smoking and drinking group (4.85%) and diet preference group (11.55%). There were significant differences in the distribution of TCM constitution types among the three groups ( χ 2=46.32, P < 0.01 ). The proportion of general health group was the higher in balanced constitution (46.39%), and the proportion of smoking and drinking type was higher in phlegm dampness (25.00%). The dietary preferences were higher in phlegm dampness (20.38%), Yin deficiency (15.92%) and damp heat (20.70%). Taking balanced constitution as a reference, the occurrence risk of phlegm and dampness in smoking and drinking type and diet preference type was 1.75 times higher (95% CI =1.09-2.77) and 1.78 times higher (95% CI = 1.26-2.49) than that in general health group ( P <0.05).@*Conclusion@#There are certain aggregation characteristics in lifestyle behaviors among higher vocational medical students, which show significant relations with TCM constitutions. Targeted intervention should be carried out according to the demographic characteristics of higher vocational medical students, potential categories of behavior and lifestyle characteristics and TCM constitutions.

Changes of new coagulation markers in healthy pregnant women and establishment of reference intervals in Changsha / 中南大学学报(医学版)

OBJECTIVES@#There is a high coagulation state in pregnant women, which is prone to coagulation and fibrinolysis system dysfunction. This study aims to explore the latest coagulation markers-thrombomodulin (TM), thrombin-antithrombin complex (TAT), plasmin-α2 plasmin inhibitor complex (PIC), and tissue plasminogen activator/plasminogen activator inhibitor compound (tPAI-C) in different stages of pregnancy, establish reference intervals (RIs) for healthy pregnant women of Chinese population, and to provide an effective and reliable reference for clinicians.@*METHODS@#A total of 492 healthy pregnant women, who underwent pregnancy examination and delivery in the Department of Obstetrics, Second Xiangya Hospital of Central South University from October 2019 to October 2020, were enrolled for this study. They were assigned into the first trimester group, the second trimester group, the third trimester group, and the puerperium group according to the pregnancy period, and 123 healthy non-pregnant women were selected as the controls. Plasma levels of TM, TAT, PIC and tPAI-C were analyzed by automatic chemiluminescence immunoassay analyzer. The RIs for TM, TAT, PIC, and tPAI-C were defined using non-parametric 95% intervals, determined following Clinical and Laboratory Standards Institute Document C28-A3c (CLSI C28-A3c), and Formulation of Reference Intervals for the Clinical Laboratory Test Items (WS/T402-2012).@*RESULTS@#TM and TAT levels increased gradually in the first, second, and third trimester women and decreased in the puerperium women (P<0.05 or P<0.01). PIC level of healthy non-pregnant women was lower than that of pregnant women (P<0.05 or P<0.01), but PIC level of pregnant and puerperium women did not differ significantly (P>0.05). tPAI-C level in healthy non-pregnant women was lower than that of pregnant women (P<0.05 or P<0.01), and tPAI-C level was significantly decreases in the puerperium women (P<0.01). The RIs for TM were as follows: Healthy non-pregnant women at 3.20-4.60 TU/mL, the first and second trimester at 3.12-7.90 TU/mL, the third trimester at 3.42-8.29 TU/mL, puerperium at 2.70-6.40 TU/mL. The RIs for TAT were as follows: Healthy non-pregnant women at 0.50-1.64 ng/mL, the first and second trimester at 0.52-6.91 ng/mL, the third trimester at 0.96-12.92 ng/mL, puerperium at 0.82-3.75 ng/mL. The RIs for PIC were as follows: Healthy non-pregnant women at 0.160-0.519 ng/mL, pregnant women at 0.162-0.770 μg/mL. The RIs for tPAI-C were as follows: Healthy non-pregnant women at 1.90-4.80 ng/mL, the first and second trimester at 2.03-9.33 ng/mL, the third trimester at 2.80-14.20 ng/mL, puerperium at 1.10-8.40 ng/mL.@*CONCLUSIONS@#The levels of 4 new coagulation markers TM, TAT, PIC, and tPAI-C in pregnant women are increased significantly during pregnancy and gradually return to normal after delivery. The RIs for TM, TAT, PIC, and tPAI-C in pregnant women by trimester are established according to CLSI C28-A3c, thus providing a clinical reference for clinician in judgement of thrombotic risk.

Normoalbuminuric diabetic kidney disease and hyperuricaemia in elderly type 2 diabetic patients / 中华内分泌代谢杂志

Objective:To assess the correlation between hyperuricaemia and normoalbuminuric diabetic kidney disease(NADKD) in elderly type 2 diabetic patients.Methods:This retrospective case-control study enrolled 910 patients with type 2 diabetes mellitus who were hospitalized in the Geriatric Department of Nanjing Drum Tower Hospital from 2015 to 2020. The patients were divided into NADKD group [urinary albumin/creatinine(UACR)<30 mg/g and estimated glomerular filtration rate(eGFR) <60 mL·min -1·(1.73 m 2) -1, n=169)], albuminuria DKD group [UACR ≥30 mg/g and eGFR <60 mL·min -1·(1.73 m 2) -1, n=234], and control group [UACR <30 mg/g and eGFR≥60 mL·min -1·(1.73 m 2) -1, n=507]. Medical history, physical examination, and laboratory tests were collected. Results:The proportion of women in the NADKD group was significantly higher than that in the albuminuric DKD group(50.89% vs 40.60%, P<0.05). Duration of diabetes, HbA 1C, fasting plasma glucose(FPG), the prevalences of hypertension and hyperuricaemia, blood urea nitrogen, blood creatinine, and blood uric acid were significantly lower in the NADKD group than those in the albuminuric DKD group(all P<0.05). Blood urea nitrogen, serum creatinine, triglycerides, serum uric acid and the prevalence of hyperuricemia were significantly higher in the NADKD group compared the control group(all P<0.001) while the proportion of hypertension, systolic blood pressure, LDL-C, HbA 1C, and FPG were lower(all P<0.05). Multivariate linear regression analysis showed that eGFR was negatively associated with urea nitrogen and serum uric acid while positively associated with HbA 1C in normoalbuminuric elderly type 2 diabetic patients(all P<0.001). Logistic regression analysis revealed that hyperuricaemia was a risk factor for NADKD in elderly type 2 diabetic patients after adjusting for BMI, blood pressure, lipids, and glucose( OR=1.963, 95% CI 1.157-3.332, P=0.012). Conclusion:Hyperuricaemia is significantly associated with NADKD in elderly patients with type 2 diabetes.

Ethical Thoughts on the Quality Evaluation of the Kidneys from Expanded Criteria Donors / 中国医学伦理学

In the case of extremely shortage of donor kidney sources, the number of Expanded Criteria Donors (ECD) with relatively poor kidney quality and transplantation effect is increasing. In order to alleviate the contradiction between supply and demand by using transplantable kidneys as much as possible and avoid the failure or poor effect of transplantation caused by poor quality kidneys, the quality assessment and evaluation criteria of ECD kidney have become a research hotspot in the field of kidney transplantation. This paper analyzed the possible ethical defects in the research process, and put forward some suggestions for the transplantation team to strictly follow the ethical principles of "no harm", "beneficial" and "informed consent", and the organ transplantation ethics committee to pay attention to the ethical review of the quality evaluation process of ECD donor kidney.

Endoscopic cryoablation for upper tract urothelial carcinoma: pilot clinical experience / 中华泌尿外科杂志

Objective:To evaluate the safety and efficacy of endoscopic cryoablation (ECA) in patients with upper tract urothelial carcinoma (UTUC).Methods:The clinical data of 9 patients with UTUC treated with ECA from April 2018 to September 2019 were retrospectively analyzed. Patients consisted of 3 males and 6 females, with median age of 76 years old (ranging from 50 to 88 years old). Among the patients, 6 cases had tumors of ureter, 1 case had tumor of renal pelvis and 2 cases had tumors of renal pelvis combined with ureter. Of the 9 patients, two had bilateral UTUC, six were presented with single lesion, three were presented with multiple lesion. The size of tumors were (1.53±0.91)cm. The tumors of all cases were localized (≤stage T 2), and there was no carcinoma or suspicious lymph node/distant metastasis. All patients enrolled in this study had strong will to choose kidney-sparing therapy. Biopsy, resection of intraluminal lesion with laser and cryoablation under ureteroscopy or percutaneous nephroscopy was performed under general aneasthesia.Ureteroscopy was performed 3 months after cryoablation. Perioperative complications and follow-up results were recorded and assessed. Results:Cryoablation was successfully performed in patients under ureteroscopy (n=8) or nephroscopy (n=1). The median cryoablation time was 6 (ranging from 4-16) minutes. The median follow-up was 16 months (ranging from 4-24 months). No tumor recurrence was observed at primary sites during follow-up. Two patients with multiple lesions were observed denovo ureteral neoplasms outside the primary sites 3 months and 6 months after cryoablation and treated with second cryoablation. One case died due to cardiovascular events 4 months after surgery. One patient underwent ureteral stricture during follow-up and received ureteroscopic balloon dilatation. No recurrent stricture was found in this case during the subsequent follow-up of 16 months. The other 5 cases showed no recurrence or complications like stricture during follow-up.Conclusions:ECA could probably be a promising treatment for localized UTUC. No recurrence in primary site and low incidence of ureteral stricture was observed during follow-up. The efficacy and safety of ECA need to be verified with large sample study.

Role of multi-modality magnetic resonance imaging for early diagnosis and response evaluation of neoadjuvant chemotherapy in inflammatory breast cancer / 中华普通外科杂志

Objective:To investigate the characteristics of magnetic resonance imaging and clinical application of multi-modality magnetic resonance imaging (MRI) for evaluating the response of neoadjuvant chemotherapy (NACT) in inflammatory breast cancer (IBC).Methods:A total of 36 IBC patients were enrolled in the study.The morphological, hemodynamic and diffusion-weighted imaging features of MRI were analyzed. Eleven patients underwent MRI examination before and after NAT. The imaging changes were analyzed and the efficacy of NACT was evaluated.Results:There were 38 identified breast carcinoma in these 36 cases, among which abnormal skin thickening and enhancement, extensive edema was found in 37 breast lesions. Enhancement of breast lesions in 25 cases was non-mass-like enhancement. Diffusion limitation was found in all lesions. The number of vessels in affected side was more than that in healthy side in MIP images. Thirty three cases had axillary lymph node enlargement.The sensitivity and specificity of MRI in evaluating residual breast tumors and vascular thrombus were high, but the evaluation of axillary lymph nodes was relatively low.Conclusions:Multi-modal MRI can be used for early and accurate diagnosis of IBC. It can also be used to predict and evaluate the effect of neoadjuvant chemotherapy.

Development of a fast and sensitive method for direct analysis of insulin aspart in human plasma / 药学学报

A fast and sensitive UPLC-MS/MS method was established for the direct quantification of insulin aspart in human plasma. The plasma samples were extracted by solid phase extraction (SPE), an ESI ion source was used and operated in the positive ion mode with multiple reaction monitoring (MRM). Bovine insulin was chosen as internal standard and the chromatographic separation of insulin aspart was performed on Waters ACQUITY UPLC CSH C18 column (50 mm×2.1 mm, 1.7 μm). A mixture of acetic acid aqueous solution and acetonitrile with acetic acid at a flow rate of 0.6 mL·min-1 in gradient elution mode was employed as mobile phase. We found that the method was validated over the range of 0.200-10.0 ng·mL-1 for insulin aspart and showed excellent linearity. The intra-and inter-assay accuracy and precision were below 14.5% and the recovery was 36.7%-41.7% over the three concentration levels evaluated. The UPLC-MS/MS method was selective, accurate, sensitive and robust, and the method was successfully applied in supporting the pharmacokinetic research of two insulin aspart injections (Test Product and NovoRapid®) in heathy male subjects. This clinical trial was approved according to the Ethics Committee of West China Hospital, Sichuan University (2017 Clinical Trial (Western Medicine) Approval (148)).

Comparison on short-term safety outcomes between off-pump and on-pump coronary artery bypass grafting by experienced surgeons: a single center study with 31 075 cases / 中华心血管病杂志

Objective: To compare the short-term outcomes between off-pump and on-pump coronary artery bypass graft (CABG) by experienced surgeons with similar surgical team in a single large-volume cardiac surgery center. Methods: A total of 31 075 patients with multivessel coronary disease who underwent isolated off-pump or on-pump CABG between January 1, 2009 and December 31, 2019 by experienced surgeons in Fuwai hospital were enrolled in this retrospective study. Patients was divided into on-pump CABG group and on-pump CABG group on an intention-to treat basis. Short term safety endpoints, including 30 days mortality, composite endpoint of major morbidity or mortality, prolonged postoperative length of stay (PLOS), and prolonged ICU length of stay (PICULOS), and distal anastomosis were compared between the two groups. Mortality was evaluated on 30 days post operation, other endpoints were collected before discharge. After 1∶1 propensity-score matching of baseline characteristics for on-pump and off-pump CABG, postoperative endpoints were compared with use of McNemar's test and further adjusted with the use of a logistic regression model. Results: After propensity-score matching, 10 243 matched pairs of patients were included in the final analysis, there were 4 605(22.5%) females and mean age was (60.7±8.6) years. The standardized differences were less than 5% for all baseline variables in matched cohort. Univariate analysis indicated lower risk of 30 days mortality (0.2% vs. 0.7%, P<0.001), major morbidity or mortality (5.7% vs. 8.8%, P<0.001), PLOS (3.2% vs. 4.9%, P<0.001), PICULOS (9.4% vs. 12.2, P<0.001), and lower number of distal anastomosis ((3.3±0.8) vs. (3.6±0.8), P<0.001) in off-pump CABG group than in on-pump CABG group. After adjustment of cofounders, multivariate analysis showed that off-pump CABG was still associated with a lower risk of 30 days mortality (OR=0.29, 95%CI: 0.09-0.87, P=0.027), composite endpoint of major morbidity or mortality (OR=0.60, 95%CI: 0.53-0.68, P<0.001), PLOS (OR=0.64, 95%CI 0.54-0.75, P<0.001), PICULOS (OR=0.76, 95%CI: 0.69-0.84, P<0.001). Conclusions: Off-pump CABG is related with superior short-term safety outcomes than on-pump CABG by experienced surgeons in our center.

Research advances on high-intensity interval training and cognitive function / 生理学报

High-intensity interval training (HIIT) has proven to be a time-saving and efficient exercise strategy. Compared with traditional aerobic exercise, it can provide similar or even better health benefits. In recent years, a number of studies have suggested that HIIT could be used as a potential exercise rehabilitation therapy to improve cognitive impairment caused by obesity, diabetes, stroke, dementia and other diseases. HIIT may be superior to regular aerobic exercise. This article reviews the recent research progress on HIIT with a focus on its beneficial effect on brain cognitive function and the underlying mechanisms. HIIT may become an effective exercise for the prevention and/or improvement of brain cognitive disorder.

Changes of serum immunoglobulin level in healthy pregnant women and establishment of its reference interval / 中南大学学报(医学版)

OBJECTIVES@#Pregnant women in a special physiological period, the body's blood indicators will change to a certain extent. This study aims to explore the changes of serum immunoglobulin levels in healthy pregnant women and establish its reference interval (RI).@*METHODS@#A total of 369 healthy pregnant women, who underwent pregnancy examination in the Department of Obstetrics, Second Xiangya Hospital of Central South University from August 2019 to October 2019, were enrolled for this study. They were divided into an early pregnancy group, a middle pregnancy group, and a late pregnancy group according to the pregnancy period, and 123 healthy non-pregnant women were selected as the controls. The levels of immunoglobulin G (IgG), immunoglobulin M (IgM), and immunoglobulin A (IgA) were determined by immune transmission turbidities. The level of immunoglobulin E (IgE) was determined by electrochemiluminescence. The differences in immunoglobulin levels between pregnant women and non-pregnant women and among different gestational periods were analyzed, and the RI of serum immunoglobulin level during pregnancy was established.@*RESULTS@#Compared to the non-pregnant women, the levels of serum IgG, IgM, IgA, and IgE in pregnant women were significantly decreased (all @*CONCLUSIONS@#The levels of immunoglobulin in pregnant women are decreased significantly. The establishment of RIs of IgG, IgM, IgA and IgE in healthy pregnant women could provide scientific basis for clinical decision-making.

Effect of advanced glycation end products on autophagic ability in osteoblasts / 中南大学学报(医学版)

OBJECTIVES@#Excessive production of AGEs in diabetic patients will affect the normal function of osteoblasts, and this process may be related to autophagy of osteoblasts. This study aims to explore the effect of advanced glycation end products (AGEs) on autophagic activity during osteogenic differentiation in rat bone marrow mesenchymal stem cells (BMSCs).@*METHODS@#BMSCs were isolated and cultured in vitro, treated with different concentrations (0, 50, 100, 200, and 400 mg/L) of AGEs for different time (3, 6, 12, 24, 48, and 72 h). The proliferation activity was detected by CCK-8 method. The mRNA and protein expression levels of Beclin1 and LC3 in cells were detected by real-time PCR and Western blotting, respectively.The autophagic vacuoles were observed under the transmission electron microscope. The cells were treated with autophagy promoter rapamycin or autophagy inhibitor 3MA. After 7 days of osteogenic induction, we performed alkaline phosphatase (ALP) staining and real-time PCR to detect the mRNA expression levels of osteogenesis-related genes.@*RESULTS@#In the low-concentration groups, the proliferation activity in BMSCs was increased (@*CONCLUSIONS@#Low concentration of AGEs can enhance the proliferative activity of BMSCs and promote osteogenic differentiation by accelerating autophagy. High concentration of AGEs can suppress the proliferation of BMSCs and inhibit osteogenic differentiation by reducing autophagy.

Evaluation of the accuracy of the right superior pulmonary vein sheath compression in the closure of atrial septal defect based on multi-layer perceptron by ultrasound / 中华超声影像学杂志

Objective:To evaluate the accuracy of measuring the siae of atrial septal defect(ASD) by transthoracic echocardiography(TTE) on " compression of right superior pulmonary vein sheath during operation" (compression-size) using multi-layer perceptron.Methods:From January 2016 to January 2019, 460 cases of ASD with soft margin, thin growth or central type with atrial septal tumor in the First Hospital Affiliated of Air Force Medical University were analyzed retrospectively. The age was (34.32±18.84)years, 129 males and 331 females. Preoperative TTE and intraoperative TTE were performed to measure the size of ASD and compression-size. With the final occluder size selected as the dependent variable, the preoperative and intraoperative ultrasound measurements were used as covariates, and all patients were randomly divided into training set, test set and verification set according to the proportion of 5∶2∶3, which were imported into multi-layer perceptron. Gradient descent method was used to optimize and adjust the weight, and 10 operations were carried out respectively, and the average value was calculated to evaluate the two ultrasound methods for blocking.Results:The mean values of ASD were (15.26±5.33)mm for preoperative, (23.83±6.39)mm for compression-size intraoperative TTE, and (25.14±6.55)mm for the occluder, respectively. The difference was statistically significant (χ 2=850.450, P<0.001). There were significant differences between the pairwise ( P<0.001). Ten times of multi-layer perceptron were used to obtain a training model for predicting the size of the occluder based on preoperative transthoracic ultrasound and TTE measurement after right upper pulmonary vein sheath compression. The average relative error of the model obtained by preoperative ultrasound measurement in the validation set was (16.55±0.02)%, and that of the model obtained by intraoperative ultrasound measurement in the validation set was (4.81±0.01)%. The difference between the two methods was statistically significant ( t=16.185, P<0.001). Conclusions:It is more accurate to measure the ASD size for selection of occluder by the use of the right superior pulmonary vein sheath compression and TTE, especially for ASD patients with soft margin, thin growth or atrial septal tumor.