Risk factors for recurrent intussusception in children after ultrasound-guided saline enema reduction / 中华普通外科杂志

Objective:To explore the risk factors for recurrence of intussusception in children after successful ultrasound-guided saline enema reduction.Methods:The clinical and follow up data of 355 hospitalized children with intussusception at the First Affiliated Hospital of Zhengzhou University from Feb 2018 to Feb 2023 were reviewed.Patients were divided into two groups by recurrence develped and the differences were compared, Data with significant differences were incorporated into multi-factor logistic analysis.Results:The overall recurrence rate was 15.8% (56/355). By univariate variable analysis model, there were statistically significant differences between the two groups in age, previous intussusception history, vomiting, maximum diameter of concentric circles shown by ultrasound, and concurrent bowel organic diseases (lead points) (all P<0.05). In multivariate Logistic regression model, age, previous intussusception history, maximum diameter of concentric circles, and lead points were independent risk factors for recurrent intussusception after saline enema.The optimal cut-off values for age and maximum diameter of concentric circles were 2 years and 33.5 mm, respectively, according to ROC curve analysis. Conclusion:Age older than 2 years, previous intussusception history, maximum diameter of concentric circles longer than 33.5 mm, and lead points are independent risk factors for recurrence after saline enema.

Intracranial activity of first-line immune checkpoint inhibitors combined with chemotherapy in advanced non-small cell lung cancer / 中华医学杂志(英文版)

BACKGROUND@#Immune checkpoint inhibitors (ICIs) are increasingly used as first-line therapy for patients with advanced non-small cell lung cancer (NSCLC) harboring no actionable mutations; however, data on their efficacy among patients presenting with intracranial lesions are limited. This study aimed to explore the efficacy and safety of ICIs combined with chemotherapy in advanced NSCLC patients with measurable brain metastasis at initial diagnosis.@*METHODS@#Our study retrospectively analyzed clinical data of a total of 211 patients diagnosed with driver gene mutation-negative advanced NSCLC with measurable, asymptomatic brain metastasis at baseline from Hunan Cancer Hospital between January 1, 2019 and September 30, 2021. The patients were stratified into two groups according to the first-line treatment regimen received: ICI combined with chemotherapy ( n = 102) or chemotherapy ( n = 109). Systemic and intracranial objective response rates (ORRs) and progression-free survival (PFS) were analyzed. Adverse events were also compared between the groups.@*RESULTS@#Compared with the chemotherapy-based regimen, the ICI-containing regimen was associated with a significantly higher intracranial (44.1% [45/102] vs . 28.4% [31/109], χ2 = 5.620, P = 0.013) and systemic (49.0% [50/102] vs . 33.9% [37/109], χ2 = 4.942, P = 0.019) ORRs and longer intracranial (11.0 months vs . 7.0 months, P <0.001) and systemic (9.0 months vs . 5.0 months, P <0.001) PFS. Multivariable analysis consistently revealed an independent association between receiving ICI plus platinum-based chemotherapy as a first-line regimen and prolonged intracranial PFS (hazard ratio [HR] = 0.52, 95% confidence interval [CI]: 0.37-0.73, P <0.001) and systemic PFS (HR = 0.48, 95% CI: 0.35-0.66, P <0.001). No unexpected serious adverse effects were observed.@*CONCLUSION@#Our study provides real-world clinical evidence that ICI combined with chemotherapy is a promising first-line treatment option for driver gene mutation-negative advanced NSCLC patients who present with brain metastasis at initial diagnosis.@*CLINICAL TRIAL REGISTRATION@#https://www.clinicaltrials.gov/ , OMESIA, NCT05129202.

Physiological and transcriptional responses to heat stress in a typical phenotype of Pinellia ternata / 中国天然药物

Pinellia ternata is an important medicinal plant, and its growth and development are easily threatened by high temperature. In this study, comprehensive research on physiological, cytological and transcriptional responses to different levels of heat stress were conducted on a typical phenotype of P. ternata. First, P. ternata exhibited tolerance to the increased temperature, which was supported by normal growing leaves, as well as decreased and sustained photosynthetic parameters. Severe stress aggravated the damages, and P. ternata displayed an obvious leaf senescence phenotype, with significantly increased SOD and POD activities (46% and 213%). In addition, mesophyll cells were seriously damaged, chloroplast thylakoid was fuzzy, grana lamellae and stroma lamellae were obviously broken, and grana thylakoids were stacked, resulting in a dramatically declined photosynthetic rate (74.6%). Moreover, a total of 16 808 genes were significantly differential expressed during this process, most of which were involved in photosynthesis, transmembrane transporter activity and plastid metabolism. The number of differentially expressed transcription factors in MYB and bHLH families was the largest, indicating that these genes might participate in heat stress response in P. ternata. These findings provide insight into the response to high temperature and facilitate the standardized cultivation of P. ternata.

Correlation study of serum creatinine/cystatin C and sarcopenia / 中华老年医学杂志

Objective:To explore the correlation between serum creatinine/cystatin C(Scr/CysC)ratio and sarcopenia, and search for serum markers specific to sarcopenia.Methods:A retrospective case-control study of 142 hospitalized patients in the Department of Geriatrics, Xiangya Second Hospital, Central South University from November 2020 to February 2022 were collected, including 43 sarcopenia cases and 99 non sarcopenia cases.The correlation between Scr/CysC ratio and sarcopenia was analyzed and explored.Results:The Scr/CysC ratio of 71.5±12.5 in the sarcopenia group was significantly lower than that of 81.9±15.8 in the non-sarcopenia group( t=3.823, P<0.001), and Scr/CysC was positively correlated with muscle mass and grip strength( r=0.52, 0.69, both P<0.001).The results of the analysis of receiver operating characteristic curves of the subjects showed that in male inpatients, the area under the curve(AUC)of the Scr/CysC ratio in the diagnosis of sarcopenia was 0.770(95% CI: 0.655 to 0.886, P<0.001), with a diagnostic reference value of 80.97, which gave a sensitivity of 72.2% and a specificity of 68.4%.In female inpatients the AUC was 0.621(95% CI: 0.474 to 0.768, P=0.099), with a diagnostic reference value of 65.20, giving a sensitivity of 77.8% and a specificity of 58.3%. Conclusions:The serum Scr/CysC ratio may be a serum marker for male sarcopenia patients, and sarcopenia may be considered when it is below 80.97; The diagnostic value in female sarcopenia needs further research.

Effects of bisoprolol combined with levamlodipine on renin-angiotensin-aldosterone system and carotid artery elasticity in patients with hypertension / 中国医师进修杂志

Objective:To analyze the effects of bisoprolol combined with levamlodipine on renin-angiotensin-aldosterone system (RAAS) and carotid artery elasticity in patients with hypertension.Methods:The 90 hypertensive patients who treated in the Wangjiangjing Hospital of Jiaxing Xiuzhou District from January 2021 to August 2021 were enrolled in this study, and they were divided into the control group and the combination group according to the treatment methods, each with 45 cases. The control group was treated with levoamlodipine, and the combination group was treated with bisoolol plus levoamlodipine. Three months of treatment was a course, and both groups were treated for 5 consecutive courses. The clinical efficacy, ventricular remodeling indicators, RAAS related hormone levels, carotid artery vascular elasticity function, and adverse reactions were compared between the two groups.Results:The total effective rate in the combination group was higher than that in the control group: 95.56%(43/45) vs. 82.22%(37/45), there was statistical difference ( χ2 = 4.05, P<0.05). After treatment, the interventricular septal thickness, left ventricular end-diastolic diameter, left ventricular posterior wall thickness and left ventricular mass index in combination group were lower than those in control group: (8.52 ± 1.84) mm vs. (9.41 ± 2.09) mm, (48.53 ± 1.94) mm vs. (50.47 ± 2.35) mm, (9.12 ± 2.10) mm vs. (11.06 ± 2.38) mm, (88.96 ± 12.72) g/m 2 vs. (96.56 ± 13.39) g/m 2, there were statistical differences ( P<0.05). After treatment, the serum levels of angiotensin Ⅱ, renin, angiotensin converting enzyme and aldosterone in combination group were lower than those in control group: (44.47 ± 4.27) ng/L vs. (48.63 ± 5.34) ng/L, (0.34 ± 0.07) μg/(L·h) vs. (0.41 ± 0.08) μg/(L·h), (9.09 ± 0.66) U/L vs. (9.45 ± 0.75) U/L, (123.43 ± 14.08) ng/L vs. (131.36 ± 15.7) ng/L, there were statistical differences ( P<0.05). There were no significant differences in left and right carotid intima media thickness and carotid resistance index before and after treatment between the two groups ( P>0.05). After treatment, the pulse wave conduction velocity at the beginning of left and right common carotid artery contraction(PWV-BS) and the pulse wave conduction velocity at the end of contraction (PWV-ES) were decreased in both groups, and the left and right PWV-BS and PWV-ES in the combination group were lower than those in the control group: (5.42 ± 0.64) m/s vs. (6.02 ± 0.8) m/s, (4.89 ± 0.67) m/s vs. (5.86 ± 0.98) m/s, (8.02 ± 0.86) m/s vs. (9.34 ± 1.24) m/s, (6.98 ± 0.67) m/s vs. (8.02 ± 0.87) m/s, there were statistical differences ( P<0.05). Conclusions:Bisoprolol combined with levamlodipine can effectively improve the blood pressure control effect of hypertensive patients, improve the levels of RAAS related hormones, reverse ventricular remodeling, and improve carotid artery vascular elasticity function, without increasing the risk of adverse reactions.

Analysis of the efficacy of anal dimple anorectoplasty on female infants with congenital anal atresia combined rectal vestibular fistula / 中华实用儿科临床杂志

Objective:To investigate the clinical efficacy of anal dimple anorectoplasty on female infants with congenital anal atresia combined rectal vestibular fistula.Methods:Clinical data of 69 female infants with congenital anal atresia combined rectal vestibular fistula admitted to Department of Pediatric Surgery, the First Affiliated Hospital of Zhengzhou University from July 2012 to July 2022 were retrospectively analyzed.They were divided into 2 groups according to the surgical methods: 34 cases of anal dimple anorectoplasty(group A) and 35 cases of anterior sagittal anorectoplasty(group B). The operation time, length of stay, short-term complications, long-term complications and bowel function (determined by the Rintala score at 6 months postoperatively) of the two groups were compared.The difference in the incidence of postoperative complications between groups was compared by Chi- square test, and the remaining differences between groups were compared by the paired t-test. Results:The operative time [(80.18±9.29) min vs.(103.85±8.26) min] and postoperative hospital stay[(6.10±1.52) d vs.(7.63±2.40) d] in group A were significantly shorter than those of group B ( t=11.40, 2.62; all P<0.05). The Rintala total score at 6 months postoperatively in group A was significantly higher than that of group B[(19.36±0.93) points vs.(18.76±0.44) points]( t=3.20, P<0.05). There were no significant differences in the incidences of short-term [(4/34, 11.8%) vs.(7/35, 20.0%)] and long-term complications [(2/34, 5.9%) vs.(4/35, 11.4%)]between group A and group B ( χ2=0.75, 0.75; all P>0.05). Conclusions:Anal dimple anorectoplasty for female infants with congenital anal atresia combined rectal vestibular fistula is safe and effective.

Feasibility study of optical surface imaging assisted postmastectomy radiotherapy set-up / 中华放射医学与防护杂志

Objective:To investigate the performance of optical surface imaging (OSI) in the postmastectomy radiotherapy setup and to assess the effects of 3D printed silicone bolus on OSI detection precision.Methods:A retrospective analysis was conducted for 16 patients treated with left-sided postmastectomy radiotherapy (PMRT) in West China Hopital, Sichuan University from January to April, 2021. The setup errors of 16 patients without bolus detected using OSI (OSI no-bolus, OSI n) were obtained before error correction was conducted using cone-beam CT (CBCT). The correlation between OSI n and CBCT was analyzed, and then the diagnostic efficacy of OSI was assessed using the receiver operating characteristic (ROC) curves. The setup errors of six patients with 3D printed silicone bolus detected using OSI (OSI bolus, OSI b) were obtained through off-line image registration, and then the detection precision of OSI n and OSI b in the translational directions was compared. Results:The setup errors in the case of OSI n were highly correlated with CBCT in the translational direction ( r ≥ 0.80), but were weakly correlated in the rotation direction ( r < 0.40). In the ROC analysis, the area under the curve (AUC) in the y direction was the lowest and was in the order of AUC 5 mm ≥AUC 3 mm > 0.75 for any translational direction. The difference in the detection precision between OSI n and OSI b was not statistically significant in the x and z directions ( P > 0.05), but was statistically significant in the y direction ( Z = -2.56, P = 0.01). In the y direction, the systematic error of detection precision in the case of OSI b was 3.11 mm higher than that in the case of OSI n, and the random error of detection precision in the case of OSI b was 1.9 mm higher than that in the case of OSI n. Conclusions:OSI cannot yet substitute CBCT in the postmastectomy radiotherapy setup, but its detection error is still within the clinically acceptable range. The performance of OSI-assisted setup is expected to be further improved by mitigating the interference of factors such as bolus in the imaging path through operational training.

Expression of serum galectin-3 in elderly patients with atrial fibrillation and its impact on prognosis / 中华老年医学杂志

Objective:To investigate the expression of serum galectin-3 in elderly patients with or without atrial fibrillation and to explore its impact on the prognosis of patients with atrial fibrillation.Methods:In this retrospective study, 100 patients aged 60 years or older treated at the Department of Geriatric Cardiovascular Medicine, Second Xiangyang Hospital, Central South University between March 2018 and September 2018 were enrolled.Based on electrocardiogram and previous history of atrial fibrillation, 73 participants were assigned to the atrial fibrillation group and 27 patients with sinus rhythm and no history of atrial fibrillation during the same period served as the control group.Elisa kits were used to measure the expression of galectin-3 in both groups, and echocardiography was used to measure the size of each cardiac chamber in patients.The Mann-Whitney test was used to compare galectin-3 levels between the two groups, and binary logistic regression analysis was used to determine risk factors for atrial fibrillation in the elderly.Kaplan-Meier survival curves and Cox proportional risk regression were used to analyze survival and the relationship between galectin-3 and prognosis.Results:Serum galectin-3 levels of patients in the atrial fibrillation group were higher than in the control group[(395.13±113.24)ng/L vs.(328.53±89.11)ng/L, t=2.626, P<0.01]. The level of galectin 3 in participants aged ≥ 65 years(n=48)was higher than in those aged<65 years(n=52), (414.01±105.03)ng/L vs.(343.11±106.01)ng/L( t=2.626, P<0.01). The galectin-3 level had a positive correlation with age( r=0.40, P<0.01), duration of atrial fibrillation( r=0.224, P<0.05)and C-reactive protein( r=0.305, P<0.01), but no correlation with N-terminal pro-B-type natriuretic peptide, atrial or ventricular size and the score of CHA2DS2-VASc in patients with atrial fibrillation, .Galectin-3 was a risk factor in patients with atrial fibrillation( P<0.01). Galectin-3 levels did not affect survival(log-rank=0.990)or prognosis( P>0.05)in patients with atrial fibrillation. Conclusions:Galectin-3 levels in elderly atrial fibrillation patients are higher than in people without atrial fibrillation and are positively correlated with age, duration of atrial fibrillation, and C-reactive protein.Galectin-3 is a risk factor for atrial fibrillation in elderly patients.

A meta-analysis on peripheral defocus soft contact lens controlling myopia progression in children and adolescents / 中华实验眼科杂志

Objective:To evaluate the effect of peripheral defocus soft contact lenses (PDSCLs), single-vision spectacles and single-vision contact lenses (SVCLs) on the progression of myopia in children and adolescents.Methods:A meta-analysis was conducted.To collect relevant studies on the myopia control effect of PDSCLs in children, English databases including PubMed, Medline, Embase and Cochrane library were searched with myopia, contact lens, children, adolescents, myopia progression, axial length, refractive error and relevant free English terms as key words.Chinese databases including CNKI, Wanfang and VIP were searched with corresponding Chinese phrases and relevant free Chinese terms as key words.Randomized controlled trials (RCTs) on the myopia control effect in children and adolescents, with PDSCLs wearer as experimental group and single-vision spectacles or SVCLs wearer as control group, were independently collected by two researchers.Quality of included studies was evaluated with the Cochrane tool to assess risk of bias for RCTs.Combined effects of change in refraction and axial length between experimental and control groups was calculated by weighted mean difference (WMD) and 95%confidence interval ( CI). The heterogeneity of included studies was evaluated by I2 statistic.The refraction and axial length of experimental and control groups were compared by Z test.Myopia control effect of different PDSCLs add powers was analyzed by subgroup analysis.The experimental data with add power ≤+ 2.00 D, low aberration and low depth of focus were assigned to low-medium add power subgroup, and the experimental data with add power >+ 2.00 D, high aberration and high depth of focus were assigned to high add power subgroup. Results:A total of 378 publications were retrieved.Finally, 10 high-quality RCTs and 14 groups of data were included in this meta-analysis.In these studies, 1 645 myopic children aged from 6 to 18 years were enrolled, including 808 cases in experimental group and 837 in control group.The follow-up ranged from 10 to 36 months.Among the 10 studies, there were two crossover trials without a washout period, so only the first intervention results were included.According to the meta-analysis, the change in refraction in experimental group was significantly less than that in control group (WMD=0.22 D, 95% CI: 0.15-0.30, Z=5.65; P<0.05). The change in axial elongation was significantly less in experimental group than control group (WMD=-0.10 mm, 95% CI: -0.12--0.09, Z=12.28; P<0.05). Subgroup analysis showed that the WMD of refraction change and axial elongation between experimental and control groups were 0.21 D (95% CI: 0.10-0.31) and-0.10 mm (95% CI: -0.13-0.08) in the low-medium add power subgroup, respectively, and were 0.26 D (95% CI: 0.13-0.38) and -0.13 mm (95% CI: -0.15--0.10) in the high add power subgroup, respectively. Conclusions:PDSCLs have better myopia control effect than single-vision spectacles and SVCLs in children and adolescents.When the add power is higher, PDSCLs can slow the progression of myopia more effectively.

Recent advance in mechanism of cognitive impairment patients with comorbid metabolic syndrome through PI3K/Akt signaling pathway / 中华神经医学杂志

Multiple studies has indicated an increased risk of cognitive decline in patients with metabolic syndrome (MetS), and treatments targeting the abnormal metabolic components of MetS are considered to be able to prevent and delay the onset of dementia. Phosphatidylinosito-3 kinase/protein kinase B (PI3K/Akt) signaling pathway plays an important role in peripheral metabolism and brain biological function, and is a common signaling pathway in the pathogenesis of MetS and cognitive impairment. PI3K/Akt signaling pathway has been attempted to use as an entry point for treatment of cognitive impairment related with MetS. In our research, the mechanism of cognitive impairment in MetS through PI3K/Akt signaling pathway is reviewed from aspects of glucose uptake, cholesterol synthesis, acetylcholine level, Aβ aggregation and tau protein phosphorylation in brain, which aims to clarify how PI3K/Akt signaling pathway participates in cognitive impairment related to comorbid MetS, and to find new targets for treating cognitive impairment related to comorbid MetS.

Identification and diagnosis of autism spectrum disorder among Chinese children in early stage / 中国学校卫生

Objective@#To investigate and explore the changes of the diagnosis of Chinese children with autism spectrum disorder (ASD).@*Methods@#The families of two groups of children aged 1-6 and 6-16 years who were diagnosed with ASD were selected from ALSOLIFE platform, and the online questionnaire was used to investigate the symptoms and its diagnosis related information. ANOVA was applied to compare the mean values, and χ 2 analysis was taken to compare the differences of two groups in the time of finding symptoms, the time of the first diagnosis, the time of treatment, and the diagnosis delayment.@*Results@#The initial recognition age of symptoms was 26.05 months age (2.17 years) in the young group (1-6 years), and 30.76 months age (2.56 years) in the old group (6-16 years). The age of first visit doctor was 28.21 months age (2.35 years) in the young group and 34.29 months (2.86 years) in the old group, while the average delay was only 3.43 months, of which the average delay was 4.52 months in the old group and 2.78 months in the young group. The age of diagnosed as ASD was 38.01 months age (3.17 years) in the young group and 31.07 months age (2.59 years) in the old group, while the average delay from first diagnosis to last diagnosis was 3.16 months. The delay from first diagnosis to last one was 3.71 months age in old age group, and 2.83 for the younger age group, The above differences were statistically significant ( F =328.30, 535.64, 507.71, 103.03, 17.79, P <0.01). Most of the children were still in the top hospitals to get diagnosed, but the role of child care was becoming more and more important.@*Conclusion@#The diagnosis efficiency of ASD children has been greatly improved, the time of symptom identification and diagnosis is advanced, and the delay of seeing a doctor and diagnosis is shortened.

Extracellular signal regulated kinase 5 promotes cell migration, invasion and lung metastasis in a FAK-dependent manner

This study was designed to evaluate ERK5 expression in lung cancer and malignant melanoma progression and to ascertain the involvement of ERK5 signaling in lung cancer and melanoma. We show that ERK5 expression is abundant in human lung cancer samples, and elevated ERK5 expression in lung cancer was linked to the acquisition of increased metastatic and invasive potential. Importantly, we observed a significant correlation between ERK5 activity and FAK expression and its phosphorylation at the Ser

Paired associative stimulation improves recovery of neurological function after cerebral infarction through modulating neuronal autophagy / 中华物理医学与康复杂志

Objective:To investigate the effect of paired associative stimulation (PAS) on the recovery of neurological function after cerebral infarction, and to explore whether any such effect is associated with autophagy in the ischemic penumbra.Methods:Sixty adult male Sprague-Dawley rats were randomly divided into a sham operation group ( n=20) and an experimental group ( n=40). The rats of the experimental group underwent 90 minutes of right middle cerebral artery occlusion (MCAO), while the sham group received a sham operation. The experimental group was subsequently divided into a model group ( n=20) and a PAS group ( n=20). The PAS group received 14 days of paired associative stimulation (PAS) beginning 24 hours after the operation. Neurological dysfunction was evaluated with a modified neurological severity scale (mNSS) and the elevated body swing test (EBST) on the 1st, 7th and 14th day after the MCAO. The rats were then euthanized and the expression of LC3Ⅰ, LC3Ⅱ, Beclin1, and Cathepsin B in the ischemic penumbra were detected using Western blotting, while the distribution of LC3 in neurons was detected using double immunofluorescent staining. Results:Compared with the sham group, the average mNSS scores and EBST values of the model and PAS groups were both higher on the 7th and 14th day after the MCAO, with those of the PAS group significantly lower than those of the model group on those days. The average mNSS score on the 14th day was significantly lower than on the 7th day. Compared with the sham group, the average LC3Ⅱ/Ⅰ values, Beclin 1 and Cathepsin B levels of both the model group and the PAS group were significantly higher on the 7th and 14th day after the MCAO, with the LC3Ⅱ/Ⅰ values of the PAS group significantly lower than those of the model group at both time points. The PAS group also had significantly lower Beclin1 and Cathepsin B levels on day 14. On the 7th and 14th days after the MCAO, the average number of LC3-positive cells and the ratio of LC3-positive neurons to total neurons in the model and PAS groups were significantly greater than the those of sham group, with the PAS group′s values significantly lower than those of the model group at each time point.Conclusion:PAS can significantly promote neurological recovery after stroke. The beneficial effects may involve inhibition of neuronal autophagy in the ischemic penumbra.

Discussion about the safety of outpatient thyroid surgery / 中华耳鼻咽喉头颈外科杂志

Thyroid tumors are one of the most common diseases, and the thyroidectomy surgery increases. The outpatient surgery is the new trend in clinic. Is it suited for the thyroidectomy? In this article, we will analyse the setting of hospital, surgeon, surgery, patients, and so on, to prove the safety for the outpatient thyroidectomy. After the analysis, the safety of outpatient thyroidectomy surgery will be ensured only if strictly controlling the condition of hospital, surgeons and patients, and following the relation indications.

Effects of paired associative stimulation on synaptic ultrastructure, neuron apoptosis and BDNF in rats with cerebral infarct / 中华物理医学与康复杂志

Objective@#To observe the effects of paired associative stimulation (PAS) on synaptic ultrastructure, neuron apoptosis and BDNF in rats with cerebral infarct, and explore the possible underlying mechanisms.@*Methods@#Forty-five male Sprague-Dawley rats were randomly divided into three groups: a sham operation group, a model group and a PAS group, with 15 rats in each. All the rats underwent a surgical operation for transient middle cerebral artery occlusion (MCAO) on the right side to model focal cerebral ischemia, with those in the sham operation group left without real occlusion. PAS treatment was given to rats in the PAS group 24h after MCAO model was successfully established, while no special intervention was given to those in the sham operation group and model group. After 28 days of treatment, transmission electron microscopy was used to investigate the ultrastructure of the ischemic penumbra, TUNEL was used to observe the apoptosis of cortex neurons, and real time-PCR to investigate BDNF mRNA expression.@*Results@#It was found that after 28 days treatment: ①The synaptic curvature, the synapse length and the post-synaptic density (PSD) decreased significantly in the rats of model group in contrast to those of the sham control group (P<0.05). And compare to model group, the synaptic curvature, the synapse length and the PSD increased significantly in the rats of PAS group (P<0.05). ②Compare to sham control group, the apoptosis rate of model group and PAS group increased significantly (P<0.05). And the apoptosis rate of PAS group decreased significantly in contrast to those of model group (P<0.05). ③Compare to sham control group, BDNF mRNA expression of the PAS group increased significantly(P<0.05), while BDNF mRNA expression of the model group decreased significantly(P<0.05). BDNF mRNA expression of the PAS group increased significantly in contrast to those of model group (P<0.05).@*Conclusion@#PAS promotes neural plasticity and inhibits apoptosis of cortex neurons of the ischemic penumbra in rats with ischemic cerebral infarction. One of the underlying mechanisms might be related to the up-regulation of BDNF mRNA expression.

Acquisition and the immunogenicity of the outer membrane FomA protein of Fusobacterium nucleatum / 中华口腔医学杂志

Objective@#To express and purify outer membrane protein FomA of Fusobacterium nucleatum (Fn) through gene recombination technique with Escherichia coli (Ec) expression system, and to detect the immunogenicity and the immune effects of the recombinant protein on gingival tissues.@*Methods@#The gene recombination technique and Ec expression system were used to express and purified the FomA protein. Totally 20 C57 mice were immuned with the protein or the phosphate buffer solution (PBS) buffer by subcutaneous injection (each 10 mice), and the specific FomA antibody was detection in mice serum. The immunogenicity of FomA protein was assessed by comparing the differences between groups. Furthermore, the model of mice gum abscess was constructed with Fn or Fn and Porphyromonas gingivalis (Pg) mixed suspension used the above mice. The score of the gingival abscess was recorded and the interleukin (IL)-1β in gum tissue and mice serum was determined by enzyme-linked immunosorbent assay method, and the differences of the indexes between groups were compared to evaluate the effect of the FomA protein immunization.@*Results@#Totally 1.0-1.5 g FomA protein were successfully obtained and the protein purity was over 90%. The FomA specific antibody was detected in the serum of mice by subcutaneous injection of the protein, and the antibody titer reached the highest level in 2 weeks after secondary immunization. The model of submaxillary gingival abscess was successfully constructed. In the Fn model, the score of the FomA protein immune group was (1.82±0.35), and the PBS control group was (2.62±0.71), with statistically significant difference between the two groups (P=0.049). In the Fn+Pg mixture model, the score of gingival abscess in the FomA immune group (2.31±0.55) was lower than that in PBS group (3.63±0.45), and the difference was statistically significant (P=0.003). Both in Fn and Fn+Pg injection group, the concentration of IL-1β in the serum of FomA immune mice and gingival tissues was lower than that of PBS control mice (P<0.001).@*Conclusions@#The recombinant FomA protein can be acquired by Ec expression system, and it can produce a certain level antibodies in the mice serum. The way of mice subcutaneously injected with the recombinant FomA protein can reduce the severity of periodontal infections caused by Fn and Pg.

Changes in circulating microparticles in mice with ventilator-induced lung injury / 中华危重病急救医学

Objective To investigate the changes in serum level of microparticles (EMPs) in mice with ventilator-induced lung injury (VILI), and explore its significance in VILI. Methods Forty-eight grade SPF male C57BL/6J mice were randomly divided into two groups, with 24 mice in each group: the mice in mechanical ventilation (MV) group were given high tidal volume (VT 30 mL/kg) MV for 4 hours after tracheal intubation, and those in spontaneous breathing group were spontaneously breathed for 4 hours. The apical blood of 12 mice in each group were collected, and serum levels of interleukins (IL-1β, IL-6) and tumor necrosis factor-α (TNF-α) were determined by enzyme linked immunosorbent assay (ELISA), and serum EMPs levels were determined by flow cytometer. The correlations between EMPs and IL-1β, IL-6, and TNF-α were analyzed by linear regression analysis. The lung tissues of other 12 mice in each group were harvested, and wet/dry weight (W/D) ratio was assessed. After hematoxylin-eosin (HE) staining, the morphological changes in lung tissue were observed under light microscope. After double staining of uranium acetate and lead citrate, the ultrastructural changes in lung tissue were observed with electron microscope. Results Compared with spontaneous breathing group, the levels of lung W/D ratio in MV group was significantly increased (5.47±0.14 vs. 4.34±0.11), the levels of IL-1β, IL-6, TNF-α and EMPs were also significantly increased [IL-1β (ng/L): 42.4±4.4 vs. 7.7±3.6, IL-6 (ng/L): 1 239.5±66.3 vs. 21.7±4.6, TNF-α (ng/L):237.6±25.8 vs. 37.1±19.1, EMPs (cells/μL): 28.6±1.8 vs. 5.9±1.8, all P < 0.01]. It was shown by correlation analysis that EMPs were positively related with IL-1β, IL-6, and TNF-α (r value was 0.968, 0.932, 0.945, respectively, all P = 0.000). It was shown by fitting linear regression analysis that when EMPs increased by 1 cell/μL, IL-1β increased by 2.4 ng/L [95% confidence interval (95%CI) = 1.9-2.8, P < 0.001], IL-6 increased by 34.5 ng/L (95%CI = 25.1-44.0, P < 0.001), and TNF-α increased by 13.6 ng/L (95%CI = 10.3-16.9,P < 0.001). It was shown by light microscope that the structure of lung tissue and alveolar of mice in spontaneous breathing group appeared normal, while the shrinks of alveolar and disappearance of alveolar architecture were found in MV group. It was shown by electron microscopy that alveolar wall edema and thickening and broken alveolar septa were found in MV group, by contrast, the structure of alveolar was normal in spontaneous breathing group. Conclusion 30 mL/kg VT ventilation for 4 hours could induce VILI with increase in EMPs, suggesting EMPs closely related to VILI, and EMPs level may be putative biomarker of VILI.

The role of integrin involved heparin-binding protein secretion in acute lung injury / 中华急诊医学杂志

Objective To study the relationship between heparin-binding protein(HBP) and β2 integrin on the surface of neutrophil in acute lung injury.Methods A total of 30 mice from animal center of Tongji University were divided into control group,CLP group and antibody-treatment group by random number method.Acute lung injury animal model was established by cecal Ligation and puncture in the mice of CLP group and antibody-treatment group.Sham operations were performed on the mice in control group.Mice in antibody-treatment group received anti-CD18 antibody injected via tail vein 30 min before establishing acute lung injury animal model.Twenty-four hours after operation,mice were sacrificed and lung tissue was taken.After HE staining,lung injury were evaluated by Smith score.Lung tissue wet/dry weight ratio,BALF protein level,plasma HBP level and β2 integrin on neutrophil were measured.T test were used to compare the difference among groups.Pearson correlation was used to study the correlation between HBP,integrin and lung injury index.Results Compared with control group,mice in CLP group had higher Smith score(t=10.607,P＜0.01),lung wet/dry ratio(t=3.968,P=0.001),BALF protein level(t=4.331,P＜0.01) and as well as higher plasma HBP(t=3.515,P=0.002) and β2 integrin(t=4.816,P＜0.01) level.After CD18 antibody treatment,anti-treat group mice had lower Smith score (t=2.307,P=0.033),lung wet/dry ratio(t=3.080,P=0.006),BALF protein level(t=2.484,P=0.023) and as well as higher plasma HBP level(t=2.218,P=0.046) than mice in CLP group.Pearson correlation analysis showed HBP had obvious correlation with wet/dry ratio(r=0.527,P=0.017),BALF protein(r=0.508,P=0.022) and as well as β2 integrin(r=0.674,P=0.001).Conclusions Both HBP and β2 integrin involved in the lung injury pathogenesis.HBP level is interrelated with the severity of lung injury.The β2 integrin is associated with the release of HBP by neutrophil.Inhabiting the function of integrin could decrease HBP level and alleviate the severity of lung injury.

Effects of iliopsoas tensile vibration training on the walking ability of stroke survivors / 中华物理医学与康复杂志

Objective To observe the effect of iliopsoas tensile vibration training on the walking ability of stroke survivors.Methods Thirty stroke survivors were randomly divided into an observation group and a control group,each of 15.Both groups were given traditional rehabilitation treatment,while the observation group was additionally provided with iliopsoas tensile vibration training.Both groups were evaluated in terms of the root mean square (RMS) of iliopsoas,active range of motion (A-ROM) of the hip joint,the kinematic parameters of gait and Berg balance scale (BBS) scores before and after the 4-week treatment.Results Before the treatment there were no significant differences between the two groups in any of the measurements.After the treatment improvement in all of the measurements was observed in both groups,with the average RMS iliopsoas,A-ROM,step length,step velocity and BBS score of the observation group significantly better than those of the control group.Conclusions Tensile vibration training of the iliopsoas can significantly improve the muscle excitability of the affected iliopsoas in stroke survivors,and improve their balance and walking ability.

The effects of paired associative stimulation on sensorimotor function and the expression of MAP-2 and GAP-43 after focal cerebral ischemia and reperfasion / 中华物理医学与康复杂志

Objective To observe the effect of paired associative stimulation ( PAS) on the recovery of sensorimotor function and to explore the mechanism in terms of neural plasticity. Methods Ninety male adult Sprague-Dawley rats were randomly divided into a sham operation group (Sham group), a model group (Model group) and a paired associative stimulation group ( PAS group) , each of 30. Each group was then subdivided into 7-, 14-and 28-day subgroups with 10 rats in each. A model of focal cerebral ischemia and reperfusion was estab-lished using the Longa suture method in the Model and PAS groups. The rats in the Sham group underwent the same surgical procedure except for the occlusion of the middle cerebral artery. The rats received 30 minutes of paired pe-ripheral nerve stimulation and transcranial magnetic stimulation comprising 90 pairs at 0.05 Hz beginning 24 h after the occlusion. The impulse wave width of the peripheral nerve stimulation was 200 μs and the intensity was 6 mA. The intensity of the transcranial magnetic stimulation was 120％ of the resting motor threshold. The other two groups weren't given any intervention. Neurological function was tested using Garcia scores on the 1st, 7th, 14th and 28th day after surgery. The rats were then sacrificed and the expression of MAP-2 and GAP-43 in the ischemic penumbra were detected using western blotting and immunohistochemistry. Results No neurological dysfunction was ob-served in the Sham group at any time. Compared with the Sham group at the same time points, the average Garcia scores of the Model and PAS groups were significantly lower (P≤0.05). However, the average Garcia scores on the 7th, 14th and 28th day were significantly higher in the PAS group compared with the Model group at the same time points ( P≤0.05) . The average Garcia scores of the Model and PAS groups on the 28th day after surgery were significantly higher than those on the 1st day (P≤0.05), but only the PAS group's average Garcia score on the 28th day was significantly higher than that on the 7th day. Compared with the Sham group at the same time points, the expression of MAP-2 and GAP-43 protein in the Model and PAS groups was significantly higher, but with that of the Model group significantly lower than that of the PAS group ( all P≤0.05) . The protein expression of MAP-2 and GAP-43 protein in the PAS group on the 14th day was significantly higher than on the 7th and 28th day ( P≤0.05 for both) . Conclusions PAS can promote the recovery of sensorimotor function after cerebral thrombosis, at least in rats. That may be due to its promoting the expression of the neuroplasticity-associated proteins MAP-2 and GAP-43 in the ischemic penumbra.