Predictive performance of renal resistive index, semiquantitative power Doppler ultrasound score and renal venous Doppler waveform pattern for acute kidney injury in critically ill patients and prediction model establishment: a prospective observational study.

BACKGROUND: This study aimed to explore the performance of renal resistive index (RRI), semiquantitative power Doppler ultrasound (PDU) score and renal venous Doppler waveform (RVDW) pattern in predicting acute kidney injury (AKI) in critically ill patients and establish prediction models. METHODS: This prospective observational study included 234 critically ill patients. Renal ultrasound was measured within 24 h after intensive care unit admission. The main outcome was the highest AKI stage within 5 days after admission according to the Kidney Disease Improving Global Outcomes criteria. RESULTS: Patients in the AKI stage 3 group had significantly higher RRI, RVDW pattern and lower PDU score (p < 0.05). Only lactate, urine volume, serum creatinine (SCr) on admission, PDU score and RVDW pattern were statistically significant predictors (p < 0.05). Model 1 based on these five variables (area under the curve [AUC] = 0.938, 95% confidence interval [CI] 0.899-0.965, p < 0.05) showed the best performance in predicting AKI stage 3, and difference in AUC between it and the clinical model including lactate, urine volume and SCr (AUC = 0.901, 95% CI 0.855-0.936, p < 0.05) was statistically significant (z statistic = 2.224, p = 0.0261). The optimal cut-off point for a nomogram based on Model 1 was ≤127.67 (sensitivity: 95.8%, specificity: 82.3%, Youden's index: 0.781). CONCLUSIONS: The nomogram model including SCr, urine volume, lactate, PDU score and RVDW pattern upon admission exhibited a significantly stronger capability for AKI stage 3 than each single indicator and clinical model including SCr, urine volume and lactate.

Morphologic analysis of alveolar bone in maxillary and mandibular incisors on sagittal views.

PURPOSE: The aim of this study was to analyze the morphologic features of alveolus in relatively healthy maxillary and mandibular incisors using cone-beam-computed tomography (CBCT). METHODS: CBCT images of 318 patients were retrospectively acquired. Alveolar bone in incisive area was divided into: type 1 (thick), type 2 (relatively thick with mono-plate concavity), type 3 (thin with double-plate concavities), and type 4 (vulnerably thin). Alveolus prevalence and widths were analyzed statistically relative to age, gender, and molar relationship. RESULTS: Prevalence of type 1 alveolus was 78.9% in maxillary central incisors, 15.1% in maxillary lateral incisors, 24.1% in mandibular central incisors, and 5.0% in mandibular lateral incisors. Type 2 alveolus was commonly observed in the maxillary lateral incisors (82.2%), mandibular central incisors (66.2%), and mandibular lateral incisors (87.9%). Prevalence of type 3 and 4 alveoli ranged from 0.0 to 9.4%. As for maxillary central incisors, type 1 was the widest both at the alveolar crest (7.77 ± 0.58 mm) and apical area (9.05 ± 1.86 mm), while type 3 had the lowest width at the apical region (4.08 ± 0.51 mm). Among maxillary central incisors, prevalence of type 1 tended to decrease with age. At all maxillary and mandibular incisor sites, alveolus widths were significantly thicker in males than in females. At maxillary lateral incisor and mandibular incisor sites, prevalence of alveolus type was significantly different among three molar relationships. CONCLUSION: A 4-type classification system was suggested for alveolus morphology in incisive region. Identification of alveolus type might aid in the corresponding treatment.

Evaluation of Parotid Gland Function Before and After Endoscopy-Assisted Stone Removal.

PURPOSE: To quantify gland function before and after endoscopy-assisted lithectomy for patients with parotid stones and to analyze correlations among different evaluation modalities. MATERIALS AND METHODS: This study investigated 58 patients (27 men and 31 women) with a stone larger than 5 mm or multiple parotid stones who underwent successful endoscopy-assisted surgery at the authors' center from August 2007 through September 2017. Meticulous postoperative manipulations were administered routinely for 3 to 6 months to promote functional recovery of the affected gland. Gland function was evaluated preoperatively and 6 to 36 months (mean, 12 months) postoperatively by sialography, scintigraphy, and sialometry. Statistical analyses were conducted to quantify gland function recovery and to distinguish correlations among the 3 objective tests. RESULTS: Preoperative sialograms exhibited ductal ectasia at the stone site with ductal stenosis anterior to the stone (n = 53) or duct interruption at the stone site (n = 5). Postoperative sialograms of 45 patients without stones were categorized as approximately normal (type I; n = 17); showing ectasia or stenosis of the main duct without persistent contrast on the functional film (type II; n = 16); showing ectasia or stenosis of the main duct with mild contrast retention (type III; n = 6); or showing poor ductal shape with evident contrast retention (type IV; n = 6). Scintigraphy of 23 preoperative and 12 postoperative patients and sialometry of 24 preoperative and 12 postoperative patients indicated severe preoperative impairment and postoperative improvement of gland function. Postoperatively, although no relevant differences in saliva flow rate were found between the 2 sides, scintigraphy showed lower function of the affected gland compared with the control side. Statistical data showed positive correlations among the 3 methods. Sialography intuitively reflected the ductal shape, whereas sialometry and scintigraphy were more sensitive for evaluating gland function. CONCLUSION: For patients with parotid stones, minimally invasive endoscopic surgery and meticulous postoperative manipulations help preserve the glands and facilitate recovery of gland function. The 3 evaluating modalities have certain positive correlations.

[Influence on the expression of RHOA and ROCK-II after global cerebral ischemia-reperfusion in hippocampus by shenxiong huayu capsule].

OBJECTIVE: To investigate the effect of Shenxiong Huayu capsule on the expression of hippocampal CA1 recombinant protein A (small GTP binding protein A, RHOA) and ROCK-2 (RHO associated protein kinase-2, ROCK-II). METHODS: Clean SD male rats (n=96), divided into three groups with 32 rats for each group, gavage was applied 7 days before modeling until the morning of the day to put to death. The groups included the normal control group (normal saline), global cerebral ischemia model group (normal saline) and Shenxiong Huayu capsule+global cerebral ischemia group (Shenxiong Huayu capsule 0.048 g/kg, was dissolved in 0.5 mL double distilled water, once a day, orally 0.3 mL/100 g). Modified Pulsinelli four-vessel occlusion model was constructed in global cerebral ischemia model and Shenxiong Huayu treatment groups and at 1, 3, 7, 14 d after successful modeling, water maze learning test was applied to evaluate the memory abilities of different groups, histopathological changes in HE staining, expression and protein content of RHOA and ROCK-II in immunohistochemical staining and Western blot was observed. RESULTS: At each time point, escape latency in model group was prolonged (P<0.05) when compared with that in normal control group, and that in Shenxiong Huayu was shorter (P<0.05) than that of model group, but still longer (P<0.05) than that of normal control group. HE staining showed that, compared with the normal group, model hippocampal CA1 reduced gradually from 1 d to 14 d; an increased survival neurons (P<0.05) in Shenxiong Huayu treatment group at each time points was observed, but still less than that in normal group (P<0.05); immunohistochemistry and Western blot analysis demonstrated that the expression of RHOA and ROCK-II in normal control group was not obvious, in model group was decreased after an initial increasing, and that in Shenxiong Huayu treatment group was lower than that of model group (P<0.05), but still higher than that in normal group (P<0.05). CONCLUSION: Shenxiong Huayu capsule improve neuronal damage induced by global ischemia, decreased the expression of hippocampal CA1 region of RHOA and ROCK-II.

Effects of body mass index and body fat percentage on gestational complications and outcomes.

AIM: The aim of this study was to investigate the correlation between body mass index (BMI), body fat percentage (BFP) and gestational outcomes. MATERIAL AND METHODS: Maternal- and infant-related data of gestation and gestational outcomes of 411 pregnant women were retrospectively analyzed. BMI was used to classify the women as obese, overweight, or normal. BFP was measured by the segmental multi-frequency bioelectrical impedance method. The mothers' blood lipid profiles were assessed by automated chemical analysis. Logistic regression analysis was performed to determine the correlation of BMI and BFP with gestational complications. RESULTS: The rates of gestational diabetes and hypertension were significantly different between mothers who were obese (33.3%, 52.6%), overweight (10.3%, 32.2%) and normal (8.7%, 14.9%) (P < 0.001). The Apgar score at 1 min and intensive care unit admissions rate at birth were significantly different between infants born to obese (6.14 ± 0.80, 14.0%), overweight (6.64 ± 1.10, 8.9%) and normal (7.20 ± 0.78, 1.9%) mothers (P < 0.01). The Apgar score at 5 min and the birthweights were not significantly different between these three groups (P > 0.05). Additionally, the levels of serum total cholesterol (mmol/L), total triglycerides (mmol/L), and leptin (ng/mL) were significantly higher in obese (5.87 ± 2.26, 2.04 ± 1.65, 24.79 ± 18.38) and overweight (5.29 ± 1.85, 1.74 ± 1.05, 20.79 ± 15.19) women, compared to normal women (4.89 ± 1.05, 1.45 ± 0.77, 13.35 ± 6.51) (P < 0.05). Furthermore, BFP was more strongly correlated to gestational diabetes (rs = 0.57 vs 0.68) and hypertension (rs = 0.31 vs 0.43) than BMI. CONCLUSIONS: Obesity and overweight are associated with increased adverse maternal and neonatal complications. BFP is a more accurate predictor of gestational outcomes than BMI.

Adenovirus mediated BIMS transfer induces growth supression and apoptosis in Raji lymphoma cells.

OBJECTIVE: To transfer pro-apoptotic BIM directly into tumor cells bypass the complicated biological processes of BIM activation so as to reverse the chemoresistance of cancer cells. METHODS: BIMS was specifically amplified from HL-60 cells by RT-PCR, confirmed to be correct by sequencing and cloned into shuttle vector pAdTrack-CMV carrying a green fluorescence protein gene to generate a recombinant plasmid pAdTrack-CMV-BIMS. This plasmid and adenovirus backbone plasmid pAdEasy-1 were linearized and electroporated into E.coli BJ5183 host bacteria to mediate homologous recombination. The positive clone was identified by restrict endonuclease digestion. The recombinant pAdEasy-CMV-BIMS was transferred into HEK293 cells for packaging and amplification. The successful construction of recombinant human BIMS adenovirus (Ad-BIMS) was demonstrated by Western blot. To test whether Ad-BIMS has the capability of inducing apoptosis of tumor cells, Ad-BIMS was used to infect GC resistant Burkitt lymphoma Raji cells. RESULTS: After infected for 2-5 days, BIMS expression in Raji cells was detected by RT-PCR and Western blot. The significant growth retardation and apoptosis of Raji cells were also observed by MTT and flow cytometry. CONCLUSION: These results indicated that BIMS might be a potential candidate of gene therapy for chemoresistant tumor cells.

[Effect of shenxiong huayu capsule on cerebral ischemia/reperfusion injury and the expression of GAP43 in hippocampal CA1 of rats].

OBJECTIVE: To explore the effect of Shenxiong Huayu Capsule (SHC) on the cerebral ischemia-reperfusion (IR) injury and the expression of growth associated protein 43 (GAP43) after total cerebral IR in the hippocampal CA1 region of rats. METHODS: Totally 100 male adult SD rats were randomly divided into five groups, i.e., the control group, the model group, the group A (by taking SHC once daily), the group B (by taking SHC twice daily), and the group C (by taking SHC thrice daily), 20 in each group. The total IR model was prepared by improved Pulsinelli's 4-vessel occlusion method. Morphological changes of the hippocampal CA1 region were observed by HE staining at day 1, 3, 7, and 14. The expression of GAP43 in the hippocampal CA1 region was detected using immunohistochemical assay at day 1, 3, 7, and 14. Meanwhile, the behavioral score was determined. The expression of GAP43 in the hippocampal CA1 region was detected using Western blot at day 14. RESULTS: Compared with the control group, the expression of GAP43 increased in the model group, the behavioral score was elevated, degenerated neurons increased, and survival neurons decreased in the model group (all P < 0.05). Compared with the model group, the expression of GAP-43 increased (with the most significant difference seen in the group C, P < 0.01), the behavioral score significantly decreased, degenerated neurons decreased, and survival neurons increased in each HSC group (all P < 0.05). Survival neurons obviously increased at day 14, of which, most number of survival neurons and highest contents of GAP43 protein could be seen in the group C, showing statistical difference when compared with those of the group A and the group B (P < 0.01). CONCLUSION: SHC had protective effect on total cerebral IR in the hippocampal CA1, which might be associated with increased expression of GAP43.

Threatment Strategies for Recurrent Hepatocellular Carcinoma Patients: Ablation and its Combination Patterns.

With the development of guidance technology and ablation equipment, ablative procedures have emerged as important loco-regional alternatives to surgical resection for recurrent hepatocellular carcinoma (rHCC) patients. Currently, ablation modalities used in clinical practice mainly include radiofrequency ablation (RFA), microwave ablation (MWA), laser ablation (LA), cryoablation (CRA), high-intensity focused ultrasound (HIFU), and irreversible electroporation (IRE). Accumulated comparative data of ablation versus surgical resection reveal noninferior responses and outcomes but superior adverse effects. Moreover, studies demonstrate that ablation may serve as an excellent procedure for rHCC given its exact minimal invasiveness and immune modulation. We focus on the current status of ablation in clinical practice for rHCC and discuss new research in the field, including ablation combined with these other modalities, such as targeted therapy and immunotherapy.

[The relation of learning deficits with oxidative stress in rats exposed to severe intermittent hypoxia].

OBJECTIVE: To observe the relations between learning memory function and oxidative stress in rats exposed to severe intermittent hypoxia (IH). METHODS: Adult male Wistar rats (n = 48) were randomly assigned to 2 groups: untreated control group (UC) and 5% intermittent hypoxia group (5%IH). At 2, 4, 6 and 8 weeks, the learning and memory ability of the rats in each group were assessed with the Morris water maze (MWM) test. The ultrastructural changes in the hippocampus of the rats were observed with transmission electron microscopy (TEM). The levels of malondialdehyde (MDA) and superoxide dismutase (SOD) were detected by colorimetric method. RESULTS: The water maze test showed that the rats in the 5% IH group had prolonged latency in escaping, reduced target quadrant time in crossing and reduced frequency of crossing the platform, as compared to the UC group (P < 0.05). With longer time of hypoxia, the damage became more significant. It was observed that the structure of neuron cell was complete and organelles were abundant in UC groups. With the extension of exposure time, the number of hippocampus neurons and synaptic were decreased in 5%IH groups, nucleus shrank, synaptic frame became indefinite and synaptic cleft widen. Comparing with control group, the level of MDA in the hippocampal region group was significantly higher (P < 0.05) and the activity of SOD significantly was lower (P < 0.05) in 5%IH, along with the time expand, which aggravated. CONCLUSION: Severe intermittent hypoxia that results in learning and memory dysfunction. It is possible that oxidative stress change the quantity and structure of hippocampal neurons and synaptic, which aggravates along with the intermittent low oxygen time expand.

OsZIP11 is a trans-Golgi-residing transporter required for rice iron accumulation and development.

Iron (Fe) is a mineral nutrient necessary for plant growth and development. Whether the rice ZRT/IRT-like protein family metal transporter OsZIP11 is involved in Fe transport has not been functionally defined. The objective of the study is to figure out the essential role of the uncharacterized OsZIP11 played in rice growth, development, and iron accumulation, particularly in seeds. Transient subcellular location assays show that OsZIP11 was targeted to the trans-Golgi network. OsZIP11 was preferentially expressed in the rice tissues (or organs) at later flowering and seed development stages. Transcripts of OsZIP11 were significantly induced under Fe but not under zinc (Zn), copper (Cu) or manganese (Mn) deficiency. Yeast (Saccharomyces cerevisiae) transformed with OsZIP11 sequences displayed an active iron input which turned out that excessive iron accumulated in the cells. Knocking out OsZIP11 by CRISPR-Cas9 approach led to the attenuated rice growth and physiological phenotypes, depicting shorter plant height, reduced biomass, chlorosis (a symptom of lower chlorophyll concentration), and over-accumulation of malondialdehyde (complex representing the peroxidation of membrane lipids) in rice plantlets. The field trials demonstrated that OsZIP11 mutation impaired the capacity of seed development, with shortened panicle and seed length, compromised spikelet fertility, and reduced grain per plant or 1000-grain weight. Knocking out OsZIP11 also lowered the accumulation of iron in the brown rice by 48-51% compared to the wild-type. Our work pointed out that OsZIP11 is required for iron acquisition for rice growth and development.

A metal chaperone OsHIPP16 detoxifies cadmium by repressing its accumulation in rice crops.

Cadmium (Cd) is an environmentally polluted toxic heavy metal and seriously risks food safety and human health through food chain. Mining genetic potentials of plants is a crucial step for limiting Cd accumulation in rice crops and improving environmental quality. This study characterized a novel locus in rice genome encoding a Cd-binding protein named OsHIPP16, which resides in the nucleus and near plasma membrane. OsHIPP16 was strongly induced by Cd stress. Histochemical analysis with pHIPP16::GUS reveals that OsHIPP16 is primarily expressed in root and leaf vascular tissues. Expression of OsHIPP16 in the yeast mutant strain ycf1 sensitive to Cd conferred cellular tolerance. Transgenic rice overexpressing OsHIPP16 (OE) improved rice growth with increased plant height, biomass, and chlorophyll content but with a lower degree of oxidative injury and Cd accumulation, whereas knocking out OsHIPP16 by CRISPR-Cas9 compromised the growth and physiological response. A lifelong trial with Cd-polluted soil shows that the OE plants accumulated much less Cd, particularly in brown rice where the Cd concentrations declined by 11.76-34.64%. Conversely, the knockout oshipp16 mutants had higher levels of Cd with the concentration in leaves being increased by 26.36-35.23% over the wild-type. These results suggest that adequate expression of OsHIPP16 would profoundly contribute to Cd detoxification by regulating Cd accumulation in rice, suggesting that both OE and oshipp16 mutant plants have great potentials for restricting Cd acquisition in the rice crop and phytoremediation of Cd-contaminated wetland soils.

[Effect of sleep deprivation on p38MAPK phosphorylation in the rat hippocampus].

OBJECTIVE: To investigate the effect of sleep deprivation (SD) on the expression of p38Mitogen-activated protein kinase (p38MAPK) phosphorylation in the rat hippocampus. METHODS: Male Sprague-Dawley rats (n=60) were divided randomly into control and sleep deprivation groups. The sleep deprivation models were established with the modified multiple platform methods. At 1 d, 3 d, 5 d, and 7 d after sleep deprivations, changes of neuron morphous in the hippocampal region of the rats were observed by HE staining. The expression of p38MAPK phosphorylation was detected by immunohistochemistry and Western blot. The learning-memory function was tested with Morris water maze and 4-PTT dry path maze. RESULTS: More obvious neuronal morphous damages, increased p38MAPK phosphorylation cells and p38MAPK phosphorylation expression, and decreased learning-memory function were found in the rats subject to sleep deprivation than those in the control. The changes were enhanced with the length of sleep deprivation. CONCLUSION: p38MAPK can be activated by sleep deprivation, which mediates the process of neuronal injury.

Allergy-Related Sialodochitis: A Preliminary Cohort Study.

OBJECTIVES/HYPOTHESIS: To explore the clinically feasible diagnosis criteria and treatment outcomes of allergy-related sialodochitis (ARS). STUDY DESIGN: Prospective Cohort Study. METHODS: Ninety-six consecutive patients were enrolled by the following criteria: 1) recurrent swelling of ≥2 large salivary glands that lasted for ≥3 months; 2) with mucus plug exudations; 3) with atopic diseases; 4) ductal stenosis and/or ectasia. Sixty-four patients with elevation of peripheral blood eosinophil (PBE) and/or serum IgE level comprised group A (highly-suspected ARS group), while the remaining 32 comprised group B (patients without confirmed evidence of ARS). These patients were treated with interventional endoscopy. A chronic obstructive sialadenitis symptom (COSS) questionnaire was used to quantify the treatment outcomes. RESULTS: In group A, Serum IgE was elevated in 84.4% of patients and PBE was elevated in 34.4% of patients. Percentage of submandibular gland involvement was higher in group A than group B (48.4% vs. 18.8%). On sialograms, the snowflake changes of branch ducts were seen in higher percentage of group A compared with group B (59% vs. 35% for parotid glands, 27% vs. 8% for submandibular glands, respectively). Mucus plug smears showed abundant eosinophils in 14 group A patients. Biopsy of five group A patients revealed significant eosinophil infiltration around the main and interlobular ducts. During follow-up, the COSS scores were significantly decreased in both groups, and group B was improved better than group A. CONCLUSION: PBE and serum IgE are important diagnostic indexes of ARS. Mucus plug smear or histopathology verifies the diagnosis. Interventional endoscopy is helpful for ARS cases. LEVEL OF EVIDENCE: 3 Laryngoscope, 131:2030-2035, 2021.

Identification of a new function of metallothionein-like gene OsMT1e for cadmium detoxification and potential phytoremediation.

Cadmium (Cd) is a biologically non-essential and toxic heavy metal leaking to the environment via natural emission or anthropogenic activities, thereby contaminating crops and threatening human health. Metallothioneins (MTs) are a group of metal-binding proteins playing critical roles in metal allocation and homeostasis. In this study, we identified a novel function of OsMT1e from rice plants. OsMT1e was dominantly expressed in roots at all developmental stages and, to less extent, expressed in leaves at vegetative and seed filling stages. OsMT1e was mainly targeted to the nucleus and substantially induced by Cd exposure. Expression of OsMT1e in a yeast Cd-sensitive strain ycf1 conferred cellular tolerance to Cd, even though the ycf1 + OsMT1e cells accumulated more Cd than the control cells (ycf1 + pYES2). Both transgenic rice overexpressing (OX) and repressing OsMT1e by RNA interference (RNAi) were developed. Phenotypic analysis revealed that OsMT1e overexpression enhanced the rice growth concerning the increased shoot or root elongation, dry weight and chlorophyll contents, whereas the RNAi lines displayed a sensitive growth phenotype compared to wild-type. Assessment with 0.5, 2 and 10 µM Cd for two weeks revealed that the RNAi lines accumulated less Cd, while the OX lines had an increased Cd accumulation in root and shoot tissues. The contrasting Cd accumulation phenotypes between the OX and RNAi lines were further confirmed by a long-term study with 0.5 µM Cd for one month. Overall, the study unveiled a new function of OsMT1e in rice, which can be potentially used for engineering genotypes for phytoremediation or minimizing Cd in rice crops.

[Effect of edaravone on extracellular signal-regulated kinase 1/2 pathway following severe traumatic brain injury in rats].

OBJECTIVE: To study the protective effect of edaravone on severe traumatic brain injury (TBI) and its potential mechanism. METHODS: Two hundred and seventy-three male Sprague-Dawley (SD) rats were divided randomly into four groups: control group (n=45), model group (n=88), low-dose edaravone treatment group (n=72), high-dose edaravone treatment group (n=68). TBI rat model was reproduced by weight-dropping injury. One, 6, 24, 48 and 72 hours after injury, changes in brain tissue were observed with light and electron microscopy. The expression of phosphorylated extracellular signal-regulated kinase 1/2 (p-ERK1/2) was determined by Western blotting. The rate of neuron apoptosis was observed with immunohistochemistry and terminal-deoxynucleotidyl transferase mediated dUTP nick end labeling (TUNEL) method. Learning and memory function assessments were performed with Morris water maze from 7th day to 10th day after injury. RESULTS: Compared with control group, a part of neurons in hippocampus displayed histopathologic changes denoting necrosis 6, 24, 48 and 72 hours after injury. The p-ERK1/2 expression level (pg/unit) increased 1, 6, 24, 48 hours after injury (2.05 + or - 0.40, 4.40 + or - 0.96, 6.70 + or - 0.87, 3.67 + or - 0.28 vs. 0.40 + or - 0.04, 0.41 + or - 0.05, 0.43 + or - 0.06, 0.40 + or - 0.03), and the number of apoptotic cells increased 6, 24, 48, 72 hours after injury (9.60 + or - 2.69, 12.68 + or - 2.99, 16.94 + or - 3.92, 25.82 + or - 4.61 vs. 2.42 + or - 0.38, 2.58 + or - 0.57, 2.74 + or - 0.56, 2.61 + or - 0.58); latent period to find the safety platform (s) was significantly prolonged (119.8 + or - 25.0, 105.6 + or - 24.5, 98.5 + or - 21.8, 92.0 + or - 19.5 vs. 49.5 + or - 7.5, 32.7 + or - 6.3, 25.8 + or - 6.5, 24.8 + or - 5.5, all P<0.05). After treatment with edaravone, the degree of morphological injury, p-ERK1/2 level and number of apoptotic neurons decreased, latent period to find the safety platform was significantly shortened (in low-dose edaravone treatment group, p-ERK1/2 expression level at 6, 24, 48 hours was 2.46 + or - 0.22, 4.00 + or - 0.84, 2.38 + or - 0.32, and in high-dose edaravone treatment group was 1.67 + or - 0.15, 1.86 + or - 0.38, 1.27 + or - 0.28; in low-dose edaravone treatment group, the apoptotic cells at 6, 24, 48, 72 hours was 5.20 + or - 1.23, 7.10 + or - 1.72, 9.54 + or - 1.36, 14.12 + or - 3.19, and in high-dose edaravone treatment group was 3.40 + or - 0.49 , 4.39 + or - 0.73, 5.02 + or - 1.12, 8.78 + or - 2.16; in low-dose edaravone treatment group, latent period to find the safety platform at 7-10 days was 94.8 + or - 22.8, 65.2 + or - 19.0, 62.0 + or - 16.7, 59.5 + or - 15.6, and in high-dose edaravone treatment group it was 81.5 + or - 20.7, 55.4 + or - 18.5, 40.0 + or - 12.3, 32.2 + or - 11.0, all P<0.05). High-dose edaravone showed a better effect (all P<0.05). CONCLUSION: Edaravone gives good therapeutic effect on severe TBI, and the molecular mechanism is related to attenuation of ERK1/2 pathway and neuronal apoptosis following severe brain trauma.

[Effect of BuYangHuanWu recipe on cerebral microcirculation in gerbils with ischemia-reperfusion].

OBJECTIVE: To explore the protective mechanism of BuYangHuanWu recipe on neurofunction in gerbils with cerebral ischemia- reperfusion. METHODS: Gerbils (n = 48) were divided randomly into three groups: animal model group, BuYangHuanWu recipe group, and sham control group. The animal model of cerebral ischemia was established using bilateral common carotid artery occlusion followed by unclamp 45 min after occlusion. The microcirculation was observed with a Laser Doppler. The density of microvascular was measured using Tannic acid ferric chloride mordant dyeing. The BBB (blood brain barrier) permeability was assessed using evan's blue (EB) dye. The water content in brain tissues was tested with wet and dry method. The learning and memory function test was performed with a 4-PTT dry path maze. RESULTS: Compared with the animal model group, BuYangHuanWu recipe increased blood flow in the hippocampal region at 1 and 5 min after occlusion, inhibited hypoperfusion at 15 min after reperfusion, increased blood flow at 30, 60 and 120 min after reperfusion. Meanwhile, BuYangHuanWu recipe inhibited the increase of BBB permeability and water content in brain tissues after reperfusion (P < 0.05). BuYangHuanWu recipe also improved the scores of learning and memory function of the gerbils. CONCLUSION: BuYangHuanWu recipe protects the neurofunction in gerbils with ischemia-reperfusion through modulating cerebral microcirculation damages.

OsNHAD is a chloroplast membrane-located transporter required for resistance to salt stress in rice (Oryza sativa).

Salt stress is one of the major environmental factors limiting crop productivity. Although physiological and molecular characterization of salt stress response in plants has been the focus for many years, research on transporters for sodium ion (Na+) uptake, translocation and accumulation in plants, particularly in food crops like rice is limited. In this study, we functionally identified an uncharacterized sodium ion transporter named OsNHAD which encodes a putative Na+ / H+ antiporter in rice. Homology search shows its close relation to the Arabidopsis Na+/H+ antiporter AtNHD1 with 72.74% identity of amino acids. OsNHAD transcripts mainly express in leaves and are induced by Na+ stress. Confocal laser scanning microscopy analysis of OsNHAD::GFP fusion in tobacco leaves shows that OsNHAD resides in the chloroplast envelop. Knock-down of OsNHAD by RNA interference led to increased rice sensitivity to Na+, manifested by stunted plant growth, enhanced cellular damage, reduced PSII activity and changed chloroplast morphology. Mutation of OsNHAD also resulted in accumulation of more Na+ in chloroplasts and in shoots as well, suggesting that OsNHAD is involved in mediating efflux and detoxification of Na+ but does not affect K+ accumulation in plant cells. Complementation test reveals that OsNHAD was able to functionally restore the Arabidopsis mutant atnhd1-1 growth phenotype. These results suggest that OsNHAD possibly mediates homeostasis of sodium ions in the subcellular compartments and tissues of the plants when challenged to salt stress.

Treatment strategy of hilar and intraglandular stones in wharton's duct: A 12-year experience.

OBJECTIVES/HYPOTHESIS: To suggest a strategy for transoral removal of hilar and intraparenchymal submandibular stones. STUDY DESIGN: Retrospective case series. METHODS: Retrospective evaluation was performed for 514 consecutive patients with hilar and intraparenchymal submandibular stones treated via endoscopy-assisted surgery from January 2006 to June 2018. Three patients had bilateral stones. The stones were classified as: hilar (type I), posthilar (type II), intraparenchymal (type III), and multiple stones (type IV). RESULTS: The affected glands included 311 with type I, 84 with type II, 65 with type III, and 57 with type IV stones. Stones were successfully removed in 478 glands (92.5%, 478/517). Main treatment techniques included hilum ductotomy in 311 glands, intraparenchymal ductotomy in 68, submandibulotomy in 14, intraductal retrieval in 74, and hilum ductotomy accompanied by intraductal retrieval in 11. At a mean 40-months follow-up of 478 successful cases, clinical outcomes were good in 425, fair in 27, and poor in 26 glands. Postoperative sialograms in 75 stone-free patients were categorized as: type I, normal (n = 6); type II, ectasia or stenosis in the main duct and no persistent contrast on functional films (n = 44); type III, ectasia or stenosis in the main duct and mild contrast retention (n = 15); and type IV, poor shape of the main duct and evident contrast retention (n = 10). Postoperative sialometry of 32 patients revealed no significant differences of the gland function between the two sides. CONCLUSIONS: Appropriate use of various endoscopy-assisted approaches helps preserve the gland and facilitates recovery of gland function in patients with different depths of hilo-parenchymal submandibular stones. LEVEL OF EVIDENCE: 4 Laryngoscope, 130:2360-2365, 2020.

Developing a cadmium resistant rice genotype with OsHIPP29 locus for limiting cadmium accumulation in the paddy crop.

Widespread contamination of agricultural soil with toxic metals such as cadmium (Cd) is a major threat to crop production and human health. Metallochaperones are a unique class of proteins that play pivotal roles in detoxifying metallic ions inside cells. In this study, we investigated the biological function of an uncharacterized metallochaperone termed OsHIPP29 in rice plants and showed that OsHIPP29 resides in the plasma membrane and nucleus and detoxifies excess Cd and Zn. OsHIPP29 was primarily expressed in shoots during the vegetative stage and in leaf sheath and spikelet at the flowering stage. It can be differentially induced by excess Cd, Zn, Cu, Fe and Mn. To identify the function of OsHIPP29 in mediating rice response to Cd stress, we examined a pair of OsHIPP29 mutants, RNAi lines and transgenic rice overexpressing OsHIPP29 (OX) under Cd stress. Both mutant and RNAi lines are sensitive to Cd in growth as reflected in decreased plant height and dry biomass. In contrast, the OX lines showed better growth under Cd exposure. Consistent with the phenotype, the OX lines accumulated less Cd in both root and shoot tissues, whereas OsHIPP29 knockout led to higher accumulation of Cd. These results point out that expression of OsHIPP29 is able to contribute to Cd detoxification by reducing Cd accumulation in rice plants. Our work highlights the significance of OsHIPP29-mediated reduced Cd in rice plants, with important implications for further developing genotypes that will minimize Cd accumulation in rice and environmental risks to human health.

Morphologic Analysis of Maxillary Sinus Floor and its Correlation to Molar Roots using Cone Beam Computed Tomography.

OBJECTIVE: To analyse the anterior extension of the maxillary sinus, distribution of the sinus septa and vertical relationship between the maxillary sinus and molar roots using cone beam computed tomography (CBCT). METHODS: Imaging data of 970 consecutive patients who underwent CBCT scans were retrospectively collected. The anterior border, septa distribution of the maxillary sinus and relationship between the maxillary sinus and molar roots were analysed. The root-sinus relationship was divided into three types; the roots protruding into the sinus or touching the floor without a bony barrier was defined as Type I root-sinus relationship. RESULTS: Overall, 15.5% of the maxillary sinuses extended beyond the incisor region and 68.9% extended beyond the canine region. A bony septum of ≥ 2 mm was detected in 16.9% (328/1940) of the maxillary sinuses from 26.0% (252/970) of the patients. Among the 355 septa in the 328 sinuses with septa, 108 (30.4%) were located at the first and second premolar region, 180 (50.7%) at the first and second molar region and 67 (18.9%) posterior to the second molar. Among the first molars, a Type I root-sinus relationship was detected in 61.0% of palatine roots, 55.4% of distobuccal (DB) roots, and 52.7% of mesiobuccal (MB) roots. Moreover, among three-rooted second molars, a Type I relationship was detected in 62.0%, 58.2% and 45.8% of MB, DB and palatine roots, respectively. CONCLUSION: The maxillary sinus can extend beyond the incisor region; approximately 1/6 of sinuses have bony septa; and 1/2 of molar roots protrude into the maxillary sinus or touch the sinus floor without a bony barrier.