[Impact of combined nerve blocks on the outcome of hip replacement in elderly patients with acute cerebral infarction].

Objective: To investigate the impact of ultrasound-guided lumbar plexus, sciatic nerve and L1 paravertebral combined nerve blocks on the outcomes of elderly acute cerebral infarction patients with femoral neck fracture who underwent hip replacement. Methods: The clinical data of 114 elderly acute cerebral infarction patients with femoral neck fracture and underwent artificial hip replacement surgery from May 2013 to September 2018 in Renmin Hospital of Wuhan University were retrospectively analyzed. The patients were divided into two groups based on the different anesthetic methods they received: general anesthesia (G group, n=48), lumbar plexus, sciatic nerve and L1 paravertebral combined nerve blocks (N group, n=66). The operation time, anesthesia time, blood loss, urine volume, norepinephrine dose, length of intensive care unit (ICU) stay, hospital mortality and postoperative 6-month mortality were observed and compared between the two groups. The mini-mental state examination (MMSE) scores and the national institute of health stroke scale (NIHSS) scores were evaluated, respectively. Meanwhile, plasma D-Dimer and S100ß levels were measured 1 d before surgery, 3 d and 7 d after surgery. Results: There were no significant differences in the baseline characteristics, operation time, anesthesia time, blood loss and length of ICU stay between the two groups (all P>0.05). Compared with group G, the dosage of norepinephrine [(86±23) µg vs (184±28) µg], hospital mortality [7.6% (5/66) vs 25.0% (12/48)] and postoperative 6-month mortality [12.1% (8/66) vs 31.3% (15/48)] were significantly decreased in group N, while the urine volume [(265±58) ml vs (160±55) ml] was significantly increased (all P<0.01). The MMSE scores (9.9±3.0 vs 14.6±2.4) in group N were significantly higher than those in the group G 3 d after surgery, while the NIHSS scores (15.3±3.2 vs 9.9±3.5), plasma D-Dimer [(10.8±2.5) mg/L vs (7.3±2.2) mg/L] and S100ß levels [(326±35) ng/L vs (276±29) ng/L] were significantly lower than those in group G (all P<0.01). Conclusion: Combined nerve blocks can reduce the mortality of acute cerebral infarction patients undergoing hip replacement surgery, and improve the brain function and prognosis of the patients.

Research Progress on the Determination of Electrical Conductivity in Forensic Science.

ABSTRACT: Electrical conductivity （EC） is an important physical and chemical index in electrochemical analysis. In recent years, with the penetration and reference of transformation medicine and interdisciplinary theory and technology in the forensic field, new applications of EC in the field of forensic science have been developed. This paper reviews three aspects of the application of EC, the determination of biological tissue freshness, postmortem interval estimation and the application in forensic taphonomy, in order to provide reference for relevant scientific research and related practices.

Relationship between Electrical Conductivity and Chemical Content of Rat Skeletal Muscle Impregnating Solution and Postmortem Interval.

ABSTRACT: Objective To study the mechanism of change of the electrical conductivity （EC） of rat skeletal muscle impregnating solution that occurs with the change of postmortem interval （PMI）. Methods Healthy Sprague-Dawley rats were killed and kept at about 25 ℃. Skeletal muscles were extracted at different PMI--immediate （0 d）, 1 d, 2 d, 3 d, 4 d, 5 d, 6 d, and 7 d, then mixed with deionized water to make impregnating solution with a mass concentration of 0.1 g/mL. The solution's EC and nine common chemicals in it, such as potassium ion, calcium ion, and chloride ion, were determined. Results EC increased gradually with the extending of PMI （P=0.024） during the 7 days after the rats' death. The content of uric acid （P=0.032）, urea nitrogen （P=0.013） and phosphorus （P=0.022） also increased during the extension. However, the content of magnesium ions decreased with extending of PMI （P=0.047）. The correlation between potassium ion, sodium ion, chlorine ion, calcium ion, creatinine and PMI were weak （P>0.05）. Conclusion The molecular basis of skeletal muscle EC change in rats after their death is the changes of uric acid, urea nitrogen, inorganic phosphorus and other chemical components. Furthermore, combine use of various indicators can improve the accuracy of the EC method to infer PMI.

[Reduction of the atlantoaxial dislocation associated with basilar invagination through single-stage posterior approach: using Xuanwu occipital-cervical reduction surgical suite].

Objective: To examine the effect of posterior reduction in atlantoaxial dislocation (AAD) associated with basilar invagination(BI) using Xuanwu occipital-cervical fusion system in single stage. Methods: Thirty-seven AAD accompanied with BI cases treated at Department of Neurosurgery, Xuanwu Hospital, Capital Medical Universiy and the Second Hospital of Hebei Medical University were retrospective analyzed. There were 15 males and 22 females with age of (42.3±12.3)years (range: 18-69 yars). All the cases had congenital osseous abnormalities, such as assimilation of atlas and abnormal cervical fusion. Anterior tissue was released through posterior route followed by cage implantation into facet joint and occipital-cervical fixation with cantilever technique. The clinical results were evaluated using Japanese Orthopedic Association scale(JOA) and the main radiological measurements including anterior atlantodental interval (ADI),the distance of odontoid tip above Chamberlain line,clivus-canal angle (CCA) and the length of syrinx were collected.The preoperative and postoperative JOA score and radiological measurements were compared by paired t-test. Results: The mean JOA score of the patients increased from 10.5 to 14.4 at the one-year follow-up(t=14.3,P=0.00).Complete reduction of AAD and BI was achieved in 34 patients.The mean clivus-canal angle improved from 118.0 degrees preoperative to 143.7 degrees postoperative(t=6.2,P=0.00). Shrinkage of the syrinx was observed 1 week after surgery in 24 patients, and 6 months in 31 patients. Twenty-eight patients achieved bone fusion 6 months after surgery. All the patients achieved bone fusion 12 months after surgery. One-side vertebral artery occlusion was diagnosed in 1 case postoperatively for transient dizziness, and relieved in 2 weeks. Two patients developed moderate neck pain after surgery, and relieved in 1 month. No implant failure, spacer subsidence or infection was observed. Conclusions: The treatment of AAD associated with BI using Xuanwu occipital-cervical fusion system from posterior approach in single stage is effective and safe. Cage implantation intraarticularly and fixation with cantilever technique achieve complete reduction in most cases.

MiR-15a-3p suppresses the growth and metastasis of ovarian cancer cell by targeting Twist1.

OBJECTIVE: To investigate the roles of miR-15a-3p in ovarian cancer cell growth and metastasis. PATIENTS AND METHODS: A key role of miR-15a-3p was identified via gene profiling and bioinformatics analysis. The impact of miR-15a-3p on ovarian cancer cell growth, migration and invasion was measured by 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT), wound-healing and transwell invasion assays. Bioinformatics and luciferase reporter assays were applied to identify that twist family BHLH transcription factor 1 (Twist1) was the target gene of miR-15a-3p. The miR-15a-3p level and the expression of Twist1 were detected using quantitative Real-time polymerase chain reaction (qRT-PCR) assay. The expressions of N-cadherin and E-cadherin were measured by immunofluorescence staining. Small interfering RNA targeting Twist1 and pCDNA3.1 containing Twist1 were applied to decrease and increase the expression of Twist1, respectively. RESULTS: miR-15a-3p was markedly down-regulated in ovarian cancer. Exogenous up-regulation of miR-15a-3p inhibited the growth, colony formation, migration and invasion of ovarian cancer cell in vitro. Furthermore, a xenograft model indicated that miR-15a-3p inhibited tumour growth and the metastatic potential of ovarian cancer cell in vivo. We found that Twist1 was the direct target of miR-15a-3p in ovarian cancer and that its expression was negatively correlated with the level of miR-15a-3p in ovarian cancer tissues. Up-regulation of miR-15a-3p rescued the inhibitory impact of miR-15a-3p on ovarian cancer cell growth, migration and invasion. Finally, down-regulation of Twist1 mimicked the suppressive effects of miR-15a-3p on ovarian cancer cell. CONCLUSIONS: We demonstrated that miR-15a-3p is down-regulated in ovarian cancer. Up-regulation of miR-15a-3p restrains the growth and metastasis of ovarian cancer cell by regulating Twist1.

MiR-32-5p regulates the proliferation and metastasis of cervical cancer cells by targeting HOXB8.

OBJECTIVE: To investigate the effects of miR-32-5p on the biological behaviors of cervical cancer (CCa), the relevant mechanism was studied in CCa cell lines (HeLa) in vitro. PATIENTS AND METHODS: The expression level of miR-32-5p was detected by quantitative reverse transcription polymerase chain reaction (qRT-PCR). TargetScan, miRDB, microRNA databases and Luciferase method were conducted to predict and validate the target gene of miR-32-5p; the effects of miR-32-5p on cell proliferation, clone formation, invasion and migration capacity were analyzed in vitro study. RESULTS: We found miR-32-5p to be significantly inhibited in CCa tissues and cells. Bioinformatics approach together with Luciferase method screened Homeobox B8 (HOXB8) as a downstream regulatory target of miR-32-5p. Besides, HOXB8 was incredibly high expression in CCa tissues and cells. After transfection in HeLa cells by miR-32-5p mimics, HOXB8 expression was indicated to be negatively correlated with miR-32-5p both in qRT-PCR and Western blot (WB) assays. The subsequent experiments showed that decreased expression of HOXB8 resulting from up-regulation of miR-32-5p could weaken the cell proliferation, clone formation, invasion and migration ability of HeLa cells. CONCLUSIONS: MiR-32-5p could inhibit the cellular malignant behavior through regulating the expression of HOXB8 in HeLa cells. We provide a new clue for the study of molecular mechanisms of CCa. MiR-32-5p/HOXB8 axis might serve as potential target for the clinical diagnosis and treatment of CCa.

Relationship between Early Postmortem Interval and Electrical Conductivity of Rat Liver, Spleen and Kidney after Death in Rats.

OBJECTIVES: To determine the electrical conductivity （EC） of the liver, spleen and kidney of rats at different postmortem intervals （PMIs） within 24 hours for investigating the relationship between EC of different organs and early PMI. METHODS: Totally 45 SD rats were sacrificed by cervical dislocation and kept at a constant temperature of 25 ℃. Tissues were taken from the liver, spleen, and kidney of rats at 0, 3, 6, 9, 12, 15, 18, 21 and 24 h. Impregnating solution with a mass concentration 0.1 g/mL was prepared using deionized water. The EC value of impregnating solution with different organs was separately determined. The regression equations of EC and PMI for different organs were established, respectively. The relationship between EC of different organs and early PMI was analysed in deceased rats. RESULTS: The relationship between PMI and EC of the liver and spleen was well fitted with the linear equation. The liver showed the best fitting degree followed by the spleen, while the EC of the kidney showed no significant changes within 24 h. There was a good linear relationship between early PMI and the EC of the liver and spleen. CONCLUSIONS: A good linear relationship between early PMI and the EC of the liver and spleen can be found in rats after death, which can be used for the early PMI estimation.

[Molecular Identification of Sarcosaphagous Flies in Luoyang Based on 28S rRNA Gene Sequence].

OBJECTIVES: To detect 715 bp sequence of 28S rRNA in sarcosaphagous flies, and to identify their common species for solving the problem of morphological identification, as well as providing technical support for postmortem interval （PMI） estimation. METHODS: Twenty-nine common sarcosaphagous flies were collected in Luoyang and classified by morphological characteristics. The DNA was extracted from the fly's legs by Chelex-100 method and then the fragments of 28S rRNA were amplified and sequenced. The results were compared with twenty-eight corresponding fly species of GenBank and EMBL databases. All the sequences were analyzed by MEGA7.0 software, and sequence alignment was performed by the searching in BLAST. The nucleotide composition was analysed, and the intraspecific and interspecific genetic distance and phylogenetic tree were established. RESULTS: Twenty-nine sarcosaphagous flies were classified into 6 species of 5 genera, 3 families by morphological characteristics. In the obtained 715 bp sequence of 28S rRNA, the comparison result of online BLAST showed that the similarity was 100%. Five species were well clustered by a phylogenetic tree. Between different groups, the interspecific and intraspecific differences ranged from 0.007 to 0.045 and 0 to 0.001, respectively. CONCLUSIONS: The 28S rRNA target gene sequences shows a good identification capability, which can be a new genetic marker for the identification of sarcosaphagous flies.

[Relationship between Electrical Conductivity and Decomposition Rate of Rat Postmortem Skeletal Muscle].

OBJECTIVES: To analyze the relationship among electrical conductivity （EC）, total volatile basic nitrogen （TVB-N）, which is an index of decomposition rate for meat production, and postmortem interval （PMI）. To explore the feasibility of EC as an index of cadaveric skeletal muscle decomposition rate and lay the foundation for PMI estimation. METHODS: Healthy Sprague-Dawley rats were sacrificed by cervical vertebrae dislocation and kept at 28 ℃. Muscle of rear limbs was removed at different PMI, homogenized in deionized water and then skeletal extraction liquid of mass concentration 0.1 g/mL was prepared. EC and TVB-N of extraction liquid were separately determined. The correlation between EC (x1) and TVB-N (x2) was analyzed, and their regression function was established. The relationship between PMI (y) and these two parameters were studied, and their regression functions were separately established. RESULTS: The change trends of EC and TVB-N of skeletal extraction liquid at different PMI were almost the same, and there was a linear positive correlation between them. The regression equation was x2=0.14x1-164.91(R²=0.982). EC and TVB-N of skeletal muscle changed significantly with PMI, and the regression functions were y=19.38x1³-370.68x1²+2 526.03 x1-717.06(R²=0.994), and y=2.56x2³-48.39x2²+330.60x2-255.04(R²=0.997), respectively. CONCLUSIONS: EC and TVB-N of rat postmortem skeletal muscle show similar change trends, which can be used as an index for decomposition rate of cadaveric skeletal muscle and provide a method for further study of late PMI estimation.

[Relationship between the Change Rules of Volatile Organic Compounds in Rat Muscle and Postmortem Interval].

OBJECTIVES: To explore the relationship between the change rules of volatile organic compounds （VOCs） in rat muscle and postmortem interval （PMI）. METHODS: A total of 120 healthy rats were divided randomly into 12 groups （10 for each group）. After the rats were sacrificed by cervical dislocation, the bodies were kept at （25±1） ℃. Rat muscle samples were separately obtained at 12 PMI points, including 0, 0.5, 1, 2, 3, 4, 5, 6, 7, 8, 9 and 10 d. The VOCs in rat muscles were collected, detected and analyzed by headspace solid-phase microextraction （HS-SPME） coupled to gas chromatography-mass spectrometer （GC-MS）. RESULTS: In total, 15 species of VOCs were identified, including 9 aromatic compounds, 3 sulfur compounds, 2 aliphatic acids and 1 heterocyclic compound. The species of VOCs increased with PMI： no species were detected within 1 day, 3 species were detected on day 2, 9 on day 3, 11 on day 4, 14 from day 5 to 7, and 15 from day 8 to 10. Total peak area of 15 species of VOCs was significantly correlated to PMI （adjusted R²=0.15-0.96）： the regression function was y=-17.05 x²+ 164.36 x-246.36 （adjusted R²=0.96） from day 2 to 5, and y=2.24 x+101.13 （adjusted R²=0.97） from day 6 to 10. CONCLUSIONS: The change rules of VOCs in rat muscle are helpful for PMI estimation.

Study of the expression of GABA(A) receptor in rats during acute lung injury caused by endotoxin.

The objective of the present study was to investigate the role of γ-aminobutyric acid type A receptor (GABA(A)R) in lipopolysaccharide (LPS)-induced acute lung injury (ALI) in rats. Thirty-two male wistar rats were randomly divided into four groups. Rats in the GABA group were pretreated with LPS and GABA, while those in the bicuculline (BIC) group were pretreated with LPS and bicuculline. We assessed the arterial blood gas, dry/wet ratio, and the level of tumor necrosis factor-α (TNF-α), IL-6, malondialdehyde, and superoxide dismutase 6 h after the immunization. Paraffin sections of samples were detected using the steptavidin-peroxidase method. Protein expression was detected using sodium dodecyl sulfate-polyacrylamide gel electrophoresis and western blotting. PaO2 in the LPS group was significantly lower than that in the control rats. Activation of GABA-mediated signaling by GABA increased the expression of GABA(A)R in airway bronchial and alveolar epithelial cells. Blockade of the GABA(A)R by bicuculline limited the expression of this receptor. The GABA group rats had higher levels of tissue TNF-α and IL-6 than in ALI rats and control rats. The BIC group rats demonstrated an opposite expression level compared to the GABA group rats. Our results suggest that the GABA(A)R could aggravate the inflammatory response syndrome and oxidative stress in the lungs and play an essential role in LPS-induced acute lung injury. It provides a novel method to study the incidence and mortality of ALI during the peroperative period.

Role of mitophagy regulated by Parkin/DJ-1 in remote ischemic postconditioning-induced mitigation of focal cerebral ischemia-reperfusion.

OBJECTIVE: We evaluated the role of mitophagy controlled by Parkin/DJ-1 in remote ischemic post conditioning-induced mitigation of focal cerebral ischemia-reperfusion (I/R) injury in rats. MATERIALS AND METHODS: Ninety adult male rats were randomly assigned into 5 groups including a sham operation group (S) and ischemia-reperfusion group (I/R). Focal cerebral I/R was induced by right middle cerebral artery occlusion (MCAO). I/R+remote ischemic postconditioning (I/R+RIPoC), I/R+RIPoC+ mitophagy inhibitor Mdivi-1 (I/R+RIPoC+M), and I/R+RIPoC+ normal saline (I/R+RIPoC+NS) groups all received 3 cycles of 10 minutes reperfusion followed by 10 minutes ischemia in bilateral femoral arteries at the beginning of cerebral reperfusion. I/R+RIPoC+M received mitochondrial division inhibitor (Mdivi-1) before ischemia and after 24h of reperfusion, neurological deficit scores (NDSs) were measured and rats were then sacrificed. Brain was removed and size of the infarct was determined. Apoptosis index and LC3-II/I ratio, Parkin/DJ-1 proteins expression, SOD activity, MDA and 15-F2t-Isoprostane content in cerebral ischemic penumbra were studied. Linear correlation between Parkin/DJ-1 proteins expression and LC3-II/I ratio and cerebral infarct size were analyzed. RESULTS: In experimental groups the NDSs, percentage of cerebral infarct size, apoptosis index, LC3-II/I ratio, MDA and 15-F2t-Isoprostane content significantly increased and Parkin/DJ-1 proteins were up-regulated (p<0.05). In I/R+RIPoC and I/R+RIPoC+NS groups, NDSs, percentage of cerebral infarct size, apoptosis index, MDA and 15-F2t-Isoprostane content decreased significantly while LC3-II/I ratio and SOD activity increased compared to I/R group. Parkin/DJ-1 proteins were up-regulated in I/R+RIPoC, I/R+RIPoC+NS and I/R+RIPoC+M groups (p<0.05). LC3-II/I ratio and SOD activity significantly decreased (p<0.05). Parkin/DJ-1 proteins expression didn't changed in I/R+RIPoC+M group (p>0.05). The Parkin/DJ-1 proteins expression were positively correlated with LC3-II/I ratio, and negatively correlated with cerebral infarct size (p<0.05). CONCLUSIONS: Remote Ischemic Post Conditioning (RIPoC) promoted the mitophagy via up-regulation of Parkin/DJ-1 proteins expression and inhibiting the oxidative stress responses, thus mitigating focal cerebral I/R injury in rats.

Role of 15-F2t-isoprostane in intestinal injury induced by intestinal ischemia/reperfusion in rats.

15-F2t-isoprostane is not only a specific marker of lipid peroxidation but also demonstrated to have potent bioactivities and can exert deleterious effects via activating thromboxane A2 receptor (TxA2r). We already demonstrated that lipid peroxidation represents a mechanism of intestinal ischemia/reperfusion (I/R) injury. But no studies have focused on 15-F2t-isoprostane production and its biological actions on postischemic intestine during intestinal I/R. This study was carried to investigate whether the mechanism of endogenous 15-F2t-isoprostane action is involved in the pathogenesis of intestinal I/R and administration of synthetic 15-F2t-isoprostane could exacerbate intestinal insult after intestinal I/R in vivo and in vitro. In comparison with that of the sham control, we reported that endogenous 15-F2t-isoprostane was liberated following intestinal I/R injury in rats, and using the TxA2r antagonist SQ29548 resulted in significant intestinal protection, evidenced by reduced lipid peroxidation, inflammation, and alleviated intestinal mucosal microvascular vasoconstriction. Further research found that in vivo administration of synthetic 15-F2t-isoprostane exacerbated intestinal I/R injury by disturbing microvascular perfusion and accumulating anaerobic metabolism. Meanwhile, 15-F2t-isoprostane did not change Hypoxia/Reoxygenation-induced IEC-6 cell viability but aggravated HUVECs cell death in vitro. Collectively, our results showed that locally produced 15-F2t-isoprostane was in proportion to the severity of oxidative stress-induced intestinal injury and its detrimental effects can be attenuated through TxA2r inactivation. Exogenous 15-F2t-isoprostane exacerbated intestinal I/R injury, which may be contributable to its biological actions on endothelium, rather than intestinal epithelium.

Recombinant PTD-Cu/Zn SOD attenuates hypoxia-reoxygenation injury in cardiomyocytes.

BACKGROUND: Oxidative stress plays a pivotal role in myocardial ischemia-reperfusion injury. Increasing the protein expression of intracellular Cu/Zn SOD, which is the major endogenous antioxidant enzyme, may attenuate or prevent hypoxia-reoxygenation injury (HRI) in cultured cardiomyocytes. However, ectogenic Cu/Zn-SOD can hardly be transferred into cells to exert biological effects. In this study, we constructed PTD-Cu/Zn SOD plasmid with a kind of translocation structure-Protein transduction domain (PTD) and detected its transmembrane ability and antioxidant effects in H9c2 rat cardiomyocytes subjected to hypoxia/reoxygenation injury (HRI). METHODS: We constructed the pET-PTD-Cu/Zn SOD (CDs) prokaryotic expression vectors in plasmid that were inserted into E. coli BL21 to induce the protein expression of PTD-Cu/Zn SOD. H9c2 cardiomyocyte HRI was achieved by exposing cardiomyocytes to 12 h hypoxia followed by 2 h reoxygenation. Protein expression of PTD-Cu/Zn SOD in cardiomyocytes was assayed by Western blot and their enzyme activities were investigated by immunohistochemistry and flow cytometry. RESULTS: In cultured cardiomyocytes hypoxia-reoxygenation injury model, exogenous PTD-Cu/Zn SOD could penetrate cell membrane to clear superoxide anion and decrease hydrogen peroxide level in H9c2 cardiomyocytes subjected to HRI. The level of mitochondrial membrane potential was restored to normal, and the cell apoptosis was reduced in cardiomyocytes with PTD-Cu/Zn SOD treatment during HRI. CONCLUSION: Recombinant PTD-Cu/Zn SOD could scavenge intracellular-free superoxide anion, protect mitochondria from damages, and attenuate the hypoxia-reoxygenation injury in cultured cardiomyocytes.

Mycobacterium tuberculosis MPT64 stimulates the activation of murine macrophage modulated by IFN-γ.

BACKGROUND AND AIMS: MPT64, a major target of cell-mediated immunity in tuberculosis, is proposed to be a promising candidate for novel vaccines and diagnostic tests; it also involves in virulence mechanism of Mycobacterium tuberculosis. In this study, we investigated the effect of MPT64 on activation of RAW264.7 macrophage, and explored the possible mechanism. MATERIALS AND METHODS: MPT64 protein was prepared by cloning, expression and purification from Escherichia (E.) coli. Cytokines (IL-1ß, IL-6, IL-10 and TNF-α) expression in RAW264.7 macrophage induced by MPT64 was evaluated by xMAP technology. Cell counting kit (CCK8) assay was employed to detect the viability of MPT64-treated macrophage; moreover, flow cytometric analysis and Western Blot analysis were used to measure the effect of MPT64 on apoptosis in macrophage and cleaved caspase-3 expression respectively. RESULTS: MPT64 significantly promoted the levels of IL-1ß, IL-6, IL-10 and TNF-α; pretreatment of MPT64 followed by IFN-γ stimulation further up-regulated IL-6 production (p < 0.01, compared with MPT64-treated group). In CCK8 assay, significantly increased absorbance of MPT64-treated macrophage suggested that cell viability might be enhanced. Additionally, MPT64 modulated the apoptosis of RAW264.7 macrophage partly through caspase-3 pathway. CONCLUSIONS: MPT64 activated RAW264.7 macrophage to secrete IL-1ß, IL-6, IL-10 and TNF-α; it might down-regulate apoptosis of macrophage partially via caspase-3 pathway. Furthermore, the effect of MPT64 on RAW264.7 macrophage could be modulated by IFN-γ, and co-stimulation of MPT64 with IFN-γ was conducive to the host immune, which might be applied for vaccine design and provide a reference for the treatment of tuberculosis.

Effect of stenting on patients with chronic internal carotid artery occlusion.

AIM: Effects of carotid artery stenting (CAS) on patients with chronic internal carotid artery occlusion are unknown. METHODS: This study included 21 patients who underwent successful CAS treatment and 41 patients who received optimal medical therapy. Modified Rankin Scale (mRS) and cardiocerebral vascular events were compared between CAS and medical therapy group. RESULTS: The mRS in CAS group was lower than in control group during a 2-year follow up (P<0.05 or 0.01). The combined cerebrovascular events and mortality in study group was lower than in the control group (33.4% vs. 56.1%, P=0.045), but there was no statistically significant difference in the cerebrovascular event (28.6% vs. 46.3%, P=0.088) or mortality rate (4.8% vs. 9.8%, P=0.247) between the two groups. Cox regression analysis revealed that smoking (RR=3.189, 95% CI 1.020-9.968, P=0.046), diabetes (RR=2.717, 95% CI 1.113-6.631, P=0.028), and baseline National Institute of Health stroke scale (RR=2.984, 95% CI 1.049-8.485, P=0.040) were independent risk factors for major cerebrovascular events following CAS. CONCLUSION: CAS was superior to drug therapy in achieving better functional outcomes in patients with chronic internal carotid artery occlusion. However, CAS was not associated with a statistically significant reduction in cerebrovascular events or mortality. Larger and randomized clinical trials are required to ascertain the long-term benefits of CAS in patients with chronic internal carotid artery occlusion.

Impact of carotid artery stenting on plasma interleukin-6, tumor necrosis factor-α and C-reactive protein.

AIM: This study aimed to investigate the impact of carotid artery stenting (CAS) on plasma levels of interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α) and C-reactive protein (CRP). METHODS: The levels of CRP, IL-6, and TNF-α were measured in 61 patients before CAS, 1 h, 2 weeks, 1 month, 6 months, and 12 months after the stenting. RESULTS: The levels of CRP, IL-6 and TNF-α increased immediately after CAS (P<0.05 or <0.01). The levels of CRP, IL-6 and TNF-α in patients receiving two stents for multiple lesions or single diffusive lesions was also high than in patients receiving one stent for a single lesion (P<0.05 or <0.01). The levels of CRP, IL-6 and TNF-α in patients with restenosis (14/61, or 23%) were higher than in those without restenosis (P<0.05 or <0.01). CONCLUSION: CAS was associated with a significant increase in plasma CRP, IL-6 and TNF-α. The levels of these inflammatory factors in patients with post-CAS restenosis were higher than in those without restenosis.

Expression of P-selectin, von Willebrand and endothelin-1 after carotid artery stenting.

BACKGROUND: This study was designed to investigate the impact of carotid artery stenting (CAS) on plasma levels of P-selectin, von Willebrand (vWF) and endothelin-1. PATIENTS AND METHODS: Sixty-seven patients who received CAS were divided into group 1 (one stent for a simple lesion, n = 38) and group 2 (two stents for complex lesions, n = 29). The levels of P-selectin, vWF and endothelin-1 were measured before CAS, 1 h, 6h, 24 h and 2 weeks after the stenting. RESULTS: Sixty-one patients completed one-year follow up. Restenosis was noted in 14 (23 %) patients, among these three (4.8 %) had a restenosis of > 50 % of the vascular lumen. In all patients, the levels of P-selectin, vWF and endothelin-1 increased immediately after CAS (P < 0.05 or < 0.01). The levels of vWF and endothelin-1 in group 2 were higher than in group 1 (P < 0.05 or 0.01). There was no significant difference in P-selectin and endothelin-1 between the restenosis and non-restenosis group (P > 0.05). The 24 h vWF in patients with restenosis were higher than in non-restenosis group (P < 0.05). CONCLUSIONS: CAS results in a significant increase in plasma P-selectin, vWF and endothelin-1. The post-CAS levels of P-selectin, vWF and endothelin-1 are related to the extent of endothelial injury. Whether they are associated with restenosis 12 months after the treatment requires further investigation.

[Clinical observation on gastrointestinal protective effect of Composite Salviae injection in patients undergoing cardio-pulmonary bypass heart surgery].

OBJECTIVE: To observe the gastrointestinal protective effect of Composite Salviae Injection (CSI) in patients undergoing cardio-pulmonary bypass (CPB) heart surgery. METHODS: Eighteen patients, who were scheduled to cardiac surgery (either atrial or ventrical septal repairing) undergoing CPB were randomized equally into two groups. Before CPB, the CSI group was treated with CSI 0.5 ml/kg by intravenous dripping and the control group was treated with normal saline in equal volume. The intragastric mucosa pH value (pHi) of patients was monitored by tensiometer. RESULTS: As compared with the pre-CPB value, pHi lowered significantly during, 1 h and 2 hrs after CPB in the control group (P < 0.05 or P < 0.01), while in the CSI group, pHi lowered significantly only during CPB (P < 0.05), but with insignificant change at 1 h and 2 hrs after CPB. Comparison between the two groups showed that pHi value in the CSI group was higher significantly than that in the control group at all respective monitoring period (P < 0.05). CONCLUSION: CSI has gastrointestinal protective effect in patients undergoing CPB cardiosurgery to some extent.