Herbal Textual Research on Bletillae Rhizoma in Famous Classical Formulas / 中国实验方剂学杂志

In order to provide basic information for the utilization and development of famous classical formulas containing Bletillae Rhizoma， this article systematically analyzes the historical evolution of the name， origin， harvesting and processing of Bletillae Rhizoma by reviewing the ancient materia medica， prescription books， medical books and modern literature. The research results showed that Baiji（白及） was the main name， some scholars took Baiji（白芨） as its main name， and there were many other names such as Baiji（白给）， Baigen（白根）， Baiji（白苙）. The mainstream source of Bletillae Rhizoma was the tubers of Bletilla striata， and drying， large， white， solid， root-free and skin removed completely were the good quality standards. With the promotion of wild to cultivated medicinal materials， there were certain differences between their traits， and the quality evaluation indexes should be adjusted accordingly. The origin of records in the past dynasties was widely distributed， with Guizhou and Sichuan having high production and good quality in modern times. The harvesting period is mostly in spring and autumn， and harvested in autumn was better. The processing and processing technology is relatively simple， and it was used fresh or powdered in past dynasties， while it is mainly sliced for raw use in modern times. Based on the results， it is suggested that the tubers of Bletilla striata of Orchidaceae should be used in the famous classical formulas， and it should be uniformly written as Baiji（白及）. And if the original formula indicates the requirement of processing， it should be operated according to the requirement， if the requirement of processing is not indicated， it can be used in raw form as medicine.

Effect of modified Baduanjin exercise on cardiopulmonary function, motor function and activities of daily living for stroke patients / 中国康复理论与实践

ObjectiveTo investigate the effect of modified Baduanjin exercise, as an rehabilitation exercise, on cardiopulmonary function, motor function and activities of daily living in patients with stroke. MethodsFrom January to September, 2023, 42 stroke patients in the Nanjing Qixia District Hospital were randomly divided into control group (n = 21) and experimental group (n = 21). The control group received routine rehabilitation, and the experimental group received modified Baduanjin exercise in addition, for four weeks. They were assessed with peak oxygen uptake (VO2peak), anaerobic threshold (AT), peak oxygen pulse (VO2peak/HR), forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), peak expiratory flow (PEF), Fugl-Meyer Assessment-upper extremities (FMA-UE), Berg Balance Scale (BBS) and modified Barthel Index (MBI) before and after intervention. ResultsVO2peak, AT, and the scores of FMA-UE, BBS and MBI improved in the control group after intervention (|t| > 2.256, |Z| > 2.936, P < 0.05); while VO2peak, AT, VO2peak/HR, FVC, FEV1, PEF, and the scores of FMA-UE, BBS and MBI improved in the experimental group (|t| > 4.390, |Z| > 3.451, P < 0.001); and all the indexes were better in the experimental group than in the control group (|t| > 4.136，|Z| > 2.751，P < 0.01), except the scores of BBS and MBI. ConclusionModified Baduanjin exercise can improve the cardiopulmonary function and upper limb motor function for stroke patients.

Effect of botulinum toxin type A on children with odorihidrosis / 中华医学美学美容杂志

Objective:To investigate the effect of botulinum toxin type A on children with odorihidrosis.Methods:From March 2017 to February 2021, 121 children with odorihidrosis, including 48 males and 73 females, aged 13 to 17 (15.9±1.2) years, were admitted to the Burn and Plastic Surgery Department of the 980 Hospital of PLA. There were 24 cases in mild group, 50 cases in moderate group and 47 cases in severe group. Botulinum toxin A was injected into 20-50 points on each side, and 1 U was injected into each point. The total amount of botulinum toxin A was 50-100 U on both sides.Results:Three groups of children were evaluated for efficacy, 24 cases of mild group was significantly effective in 23 cases, accounting for 95.8%. In the moderate group, 46 (92.0%) of 50 cases showed obvious effect. 49 cases (98.0%) were effective; In the severe group, 40 cases (85.1%) showed obvious effect and 45 cases (95.7%) were effective. Three groups of children with different efficacy had no statistical significance ( P>0.05). The significant efficiency in mild and moderate groups was higher than that in severe group, and the difference was statistically significant ( P<0.05). Conclusions:Botulinum toxin type A is effective in the treatment of children with mild and moderate bromhidrosis, and is worthy of clinical application.

Effects of lung-protective ventilation strategies on postoperative pulmonary complications in patients undergoing long-time neurosurgery: a retrospective study / 中华麻醉学杂志

Objective:To retrospectively evaluate the effects of lung-protective ventilation strategies on postoperative pulmonary complications in the patients undergoing long-time neurosurgery.Methods:Based on the duration of anesthesia>8 h, the clinical data from patients underwent elective first craniotomy under general anesthesia from January 1, 2019 to December 31, 2021 were retrospectively collected. Patients were divided into lung-protective ventilation group (group L) and conventional mechanical ventilation group (group C) according to whether lung-protective ventilation was performed during operation. The baseline characteristics, intraoperative condition, postoperative pulmonary complications and hospitalization of patients in the two groups were recorded.Results:Compared with group C, the tidal volume was significantly decreased, positive end-expiratory pressure and respiratory rate were increased, the incidence of intraoperative hypoxemia was decreased, the number of patients with grade 1 according to the severity grade of postoperative pulmonary complications was significantly increased, and the length of hospital stay was shortened in group L ( P<0.05). There were no statistically significant differences in the baseline characteristics, incidence of postoperative pulmonary complications at 7 days after surgery and other parameters between group L and group C ( P>0.05). Conclusions:Lung-protective ventilation strategies can reduce the severity of postoperative pulmonary complications in the patients undergoing long-time neurosurgery.

Correlation analysis of apparent diffusion coefficient combined with C-reactive protein on delayed encephalopathy caused by carbon monoxide poisoning / 中华急诊医学杂志

Objective:To investigate the Correlation between ADC combined with serum C-reactive protein (CRP) and delayed encephalopathy after carbon monoxide poisoning (DEACMP), It provides scientific basis for early prediction of DEACMP.Methods:According to the design principle of case-control study, the data of acute carbon monoxide poisoning (ACOP) patients admitted to Shandong Provincial Hospital from December 2017 to December 2021 were retrospectively selected. Among them, patients with DEACMP were selected as the case group, without DEACMP were used as the control group. Univariate and multivariate analyses were performed on the two groups. Receiver operating characteristic curve (ROC) was used to evaluate the diagnostic efficacy of ADC combined with CRP as a combined predictor for disease.Results:A total of 89 patients with ACOP were included, including 33 patients with DEACMP and 56 patients without DEACMP. There were no significant differences in gender, age, smoking, drinking, and underlying diseases (hypertension, coronary heart disease) between groups ( P>0.05). Logistic regression analysis showed that white blood cell count (WBC) ( OR=1.64, 95% CI: 1.19-2.26, P=0.003), CRP ( OR=1.22, 95% CI: 1.03-1.45, P=0.019) and ADC value of central semiovale white matter ( OR=0.99, 95% CI: 0.98-1.00, P=0.010) were associated with DEACMP in patients with ACOP. The ROC curve results showed that the area under the ROC of ADC combined with CRP in the center of semiovale was 0.765 (95% CI: 0.656-0.845), the specificity was 87.9%, the sensitivity was 23.2%, and the cut-off value was 3.5°. Conclusions:WBC, CRP and ADC value of central semiovale are independent factors for DEACMP. ADC value of central semiovale combined with CRP has more clinical value in the early diagnosis of DEACMP. For ACOP patients with DEACMP triggering factors, the diagnosis and treatment awareness of early screening of brain magnetic resonance imaging should be strengthened to avoid DEACMP.

Establishment of a RILD model in C57BL/6J mice treated with precise radiotherapy / 中国辐射卫生

Objective To provide a reliable and stable animal model for investigating the molecular pathogenesis of radiation-induced liver disease (RILD). Methods Ninety C57BL/6J mice were divided into control, 20 Gy, 25 Gy, 30 Gy and 35 Gy radiation groups. The mice were executed at 4 weeks after radiation and the levels of alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase in the liver serum were measured. HE staining was performed on the pathological liver tissues. Masson staining was performed at 36 weeks after radiation. Results Compared with the control group, the fatality rate was higher in the 30 and 35 Gy radiation groups, and the body weight significantly decreased in the 20 and 25 Gy radiation groups. Compared with the control group, alanine aminotransferase significantly increased in mice exposed to 20 Gy, while aspartate aminotransferase and alanine aminotransferase increased in mice exposed to 25 Gy. No significant changes were observed in the livers of the mice in the 20 and 25 Gy radiation groups, but pathological examination showed liver damage induced by both 20 and 25 Gy radiation. Conclusion A stable and reliable mouse model of RILD was constructed for treatment with linear accelerator. The mouse model of RILD constructed for stereotactic body radiation therapy using linear accelerator has significant research implications for the exploration of RILD.

Study on relationship between platelet transfusion efficacy and KIR-HLA receptor-ligand compatibility / 中国输血杂志

【Objective】 To study the correlation between platelet transfusion efficacy and KIR receptor-HLA ligand. 【Methods】 Thirty-three leukemia patients with positive HLA antibody were tested for cross-matching with donor platelets. Platelets from suitable donors were selected for transfusion, and the 24-hour platelet corrected count increment (CCI) was used to determine the transfusion effect. KIR and ligand genotyping were performed on blood samples from patients and donors by PCR-SSP method, and the relationship between platelet transfusion effects and KIR receptor-HLA ligand was analyzed. 【Results】 In 74 occasions of platelet transfusion, 42 were ineffective and 32 were effective. When the donor had C2 gene and HLA-B Bw4-80T gene, the frequency of ineffective platelet transfusion in the recipient was 69.0% (29/42) and 52.4% (22/35), respectively, which was significantly higher than that in the effective group [25.0% (8/32) and 25.0% (8/32)]. When the donor had C1 gene, and the frequency of effective platelet transfusion in the recipient was 100.0%(32/32), which was higher than that in the ineffective group [83.3%(35/42)]. When the recipient-donor matching mode was KIR2DL1-C2 and KIR3DL1-(HLA-B Bw4-80T), the frequency of ineffective platelet transfusion was 69.0%(29/42) and 40.5%(22/42),higher than that of the effective group [25% (8/32) and 18.8% (6/32)]. When the recipient-donor matching model was KIR2DL3-C1, the rate of effective platelet transfusion in 32 patients (100.0%), which was higher than that (35 patients 83. 3%) in the ineffective group. When the mismatch mode of recipient iKIR+donor HLA ligand receptor was KIR2DL1-C2, the frequency of effective platelet transfusion in the recipient was 78.1% (25/32), which was much higher than that in the ineffective group [31.0% (13/42)]. When the mismatch mode was KIR3DL1-(HLA-B Bw4-80T), the rate of effective platelet transfusion in the recipient was 68.8% (22/32), which was higher than that in the ineffective group (42.9%, 18/42). The difference between the above groups was statistically significant(P<0.05). 【Conclusion】 HLA-C1 and HLA-C2 genes are the key factors affecting the efficacy of platelet transfusion.For platelet refractorines, HLA-C1 is the protective gene, while HLA-C2 and HLA-B Bw4-80T are the susceptible genes. The recipient iKIR+donor HLA ligand receptor model may play an important role in platelet refractoriness.

Predictive effect of combined procalcitonin, interleukin-6 and antithrombin III on the severity and prognosis of patients with sepsis / 中华危重病急救医学

OBJECTIVE@#To investigate the correlation of procalcitonin (PCT), interleukin-6 (IL-6) and antithrombin III (AT III) with the severity of sepsis, and to compare the predictive value of the above indicators alone or in combination.@*METHODS@#A retrospective cohort study was conducted. Eighty-five patients with sepsis admitted to the department of intensive care medicine of Shandong Provincial Hospital Affiliated to Shandong First Medical University from April 2021 to September 2022 were enrolled. General information, sequential organ failure assessment (SOFA) score and acute physiology and chronic health evaluation II (APACHE II) score within 24 hours of admission, inflammatory indicators [PCT, IL-6, serum amyloid A (SAA), neutrophil to lymphocyte ratio (NLR), and C-reactive protein (CRP)] and coagulation indicators (D-dimer and AT III) levels at admission, and 28-day prognosis were collected. The differences of the above indicators were compared among patients with different prognosis at 28 days and different severity of sepsis. The correlation between PCT, IL-6, AT III and the severity of sepsis was analyzed by Spearman rank correlation method. Receiver operator characteristic curve (ROC curve) was drawn to evaluate the predictive value of PCT, IL-6 and AT III alone or in combination on the 28-day death of patients with sepsis.@*RESULTS@#Eighty-five patients were enrolled finally, 67 cases survived and 18 cases died at 28 days. The mortality was 21.2%. There were no statistical significant differences in gender, age and other general data between the two groups. The patients in the death group were more serious than those in the survival group, and PCT, IL-6, and CRP levels were significantly higher than those in the survival group [PCT (μg/L): 4.34 (1.99, 14.42) vs. 1.17 (0.31, 3.94), IL-6 (ng/L): 332.40 (50.08, 590.18) vs. 61.95 (31.64, 194.20), CRP (mg/L): 149.28 (75.34, 218.60) vs. 83.23 (48.22, 174.96), all P < 0.05], and AT III activity was significantly lower than that in the survival group [(53.67±28.57)% vs. (80.96±24.18)%, P < 0.01]. However, there were no significant differences in D-dimer, NLR and SAA between the two groups. Among the 85 patients, 36 had sepsis with single organ dysfunction, 29 had sepsis with multiple organ dysfunction, and 20 had septic shock with multiple organ dysfunction. With the increase of the severity of sepsis, PCT and IL-6 levels gradually increased [PCT (μg/L): 0.36 (0.19, 1.10), 3.00 (1.22, 9.94), 4.34 (2.18, 8.86); IL-6 (ng/L): 43.99 (20.73, 111.13), 100.00 (45.37, 273.00), 332.40 (124.4, 693.65)], and the activity of AT III decreased gradually [(89.81±21.42)%, (71.97±24.88)%, and (53.50±25.41)%], all with statistically significant differences (all P < 0.01). Spearman rank correlation analysis showed that PCT and IL-6 levels in sepsis patients were significantly positively correlated with the severity of the disease (r values were 0.562 and 0.517, respectively, both P < 0.01), and AT III activity was significantly negatively correlated with the severity of the disease (r = -0.523, P < 0.01). ROC curve analysis showed that PCT, IL-6, and AT III alone or in combination had some predictive value for the death of sepsis patients at 28 days. The area under the ROC curve (AUC) of the above three indicators in combination was higher than that of the individual tests (0.818 vs. 0.722, 0.725, and 0.770), with a sensitivity of 83.3% and a specificity of 73.1%.@*CONCLUSIONS@#PCT, IL-6, and AT III were significantly correlated with the severity of sepsis patients. The combined assay of the above three indicators can effectively improve the prediction of the prognosis of sepsis patients.

Effects of hydrogen gas on NOD-like receptor protein 3 inflammasomes in the cerebral cortex of rats with traumatic brain injury / 中华危重病急救医学

OBJECTIVE@#To investigate the effect of hydrogen gas on NOD-like receptor protein 3 (NLRP3) inflammasomes in the cerebral cortex of rats with traumatic brain injury (TBI).@*METHODS@#120 adult male Sprague-Dawley (SD) rates were randomly divided into 5 groups (n = 24): sham operation group (S group), TBI model group (T group), TBI+NLRP3 inhibitor MCC950 group (T+M group), TBI+hydrogen gas group (T+H group), TBI+hydrogen gas+MCC950 group (T+H+M group). TBI model was established by controlled cortical impact. NLRP3 inhibitor MCC950 (10 mg/kg) was intraperitoneally injected for 14 consecutive days before TBI operation in T+M and T+H+M groups. 2% hydrogen inhalation was given for 1 hour at 1 hour and 3 hours after TBI operation in T+H and T+H+M groups. At 6 hours after TBI operation, the pericontusional cortex tissues were obtained, the content of Evans blue (EB) was detected to evaluate the permeability of the blood-brain barrier. Water content in brain tissue was detected. The cell apoptosis was detected by TdT-mediated dUTP nick end labeling (TUNEL) and the neuronal apoptosis index was calculated. The expressions of Bcl-2, Bax, NLRP3, apoptosis-associated speck-like protein containing CARD (ASC) and caspase-1 p20 were detected by Western blotting. The levels of interleukins (IL-1β, IL-18) were detected by enzyme-linked immunosorbent assay (ELISA).@*RESULTS@#Compared with the S group, the content of EB in cerebral cortex, water content in brain tissue, apoptosis index and the expressions of Bax, NLRP3, ASC, caspase-1 p20 in T group were significantly increased, the expression of Bcl-2 was down-regulated, the levels of IL-1β and IL-18 were increased [the content of EB (μg/g): 87.57±6.89 vs. 10.54±1.15, water content in brain tissues: (83.79±2.74)% vs. (74.50±1.19)%, apoptotic index: (62.66±5.33)% vs. (4.61±0.96)%, Bax/β-actin: 4.20±0.44 vs. 1, NLRP3/β-actin: 3.55±0.31 vs. 1, ASC/β-actin: 3.10±0.26 vs. 1, caspase-1 p20/β-actin: 3.28±0.24 vs. 1, Bcl-2/β-actin: 0.23±0.03 vs. 1, IL-1β (ng/g): 221.58±19.15 vs. 27.15±3.27, IL-18 (ng/g): 87.26±7.17 vs. 12.10±1.85, all P < 0.05]. Compared with the T group, the T+M, T+H and T+H+M groups had significant reductions in the content of EB and water content in brain tissue, apoptotic index of the cerebral cortex, the expressions of Bax, NLRP3, and caspase-1 p20 in the brain tissue and the levels of IL-1β and IL-18, significant increases in the expression of Bcl-2. However, there was no significant difference in ASC expression. Compared with the T+H group, the content of EB in the cerebral cortex, water content in brain tissue, and apoptotic index, and the expressions of Bax, NLRP3 and caspase-1 p20 were further down-regulated in T+H+M group, the expression of Bcl-2 was further up-regulated, the levels of IL-1β and IL-18 were further decreased [the content of EB (μg/g): 40.49±3.15 vs. 51.96±4.69, water content in brain tissue: (76.58±1.04)% vs. (78.76±1.16)%, apoptotic index: (32.22±3.44)% vs. (38.54±3.89)%, Bax/β-actin: 1.92±0.16 vs. 2.56±0.21, NLRP3/β-actin: 1.94±0.14 vs. 2.37±0.24, caspase-1 p20/β-actin: 1.97±0.17 vs. 2.31±0.19, Bcl-2/β-actin: 0.82±0.07 vs. 0.52±0.04, IL-1β (ng/g): 86.23±7.09 vs. 110.44±10.48, IL-18 (ng/g): 40.18±3.22 vs. 46.23±4.02, all P < 0.05], but there were no statistical significance in all the indicators between T+M group and T+H group.@*CONCLUSIONS@#The mechanism by which hydrogen gas alleviates TBI may be related to inhibiting NLRP3 inflammasomes in the cerebral cortex of rats.

Research progress of miRNA in ischemic stroke-related risk factors / 国际生物医学工程杂志

Stroke is an important cause of global population death and long-term disability. The incidence, disability, and mortality of ischemic stroke are high, which brings a heavy social and economic burden to society and families. MiRNA is involved in a variety of biological processes, such as proliferation, differentiation, metabolism, synaptic formation, angiogenesis, apoptosis, and so on. MiRNA plays an indispensable regulatory role in the risk factors of a variety of cerebrovascular diseases. In particular, some circulating miRNA have significant changes in the peripheral blood of patients with acute stroke, which may become an important biomarker for rapid diagnosis and treatment of stroke. Intervention on stroke risk factors provides an important way for the prevention of cerebrovascular disease. In this review, the studies on the expression and mechanism of miRNA related to common stroke risk factors, including hypertension, diabetes, coronary heart disease, atherosclerosis, carotid stenosis, depression, age, and stimulating hormones, were summarized to provide new ideas for disease prevention and diagnosis.

Effects of hydrogen-rich saline on acute lung injury in rats with traumatic brain injury and role of Nrf2/HO-1 signaling pathway / 中华麻醉学杂志

Objective:To evaluate the effects of hydrogen-rich saline on acute lung injury in rats with traumatic brain injury (TBI) and the role of nuclear factor erythroid 2-related factor 2(Nrf2)/heme oxygenase-1 (HO-1) signaling pathway.Methods:Forty-eight adult male Sprague-Dawley rats, weighing 220-250 g, were divided into 4 groups ( n=12 each) using a random number table method: sham operation group (S group), TBI group (T group), TBI plus hydrogen-rich saline group (T+ H group), and TBI plus hydrogen-rich saline plus brusatol group (T+ H+ B group). TBI model was developed by controlled cortical impact.Nrf2 inhibitor brusatol 0.4 mg/kg was intraperitoneally injected every other day starting from 10 days before development of TBI model in T+ H+ B group.Hydrogen-rich fluid 10 ml/kg was intraperitoneally injected at 1 and 6 h after development of TBI model in T+ H group and T+ H+ B group.At 24 h after development of TBI model, the bronchoalveolar lavage fluid (BALF) was collected to detect the concentration of protein, blood samples from the right common carotid artery were collected and lung tissues were obtained for determination of the levels of tumor necrosis factor-alpha (TNF-α), interleukin-10 (IL-10) and high-mobility group box 1 protein (HMGB1) in serum and lung tissues (by enzyme-linked immunosorbent assay), wet to dry lung weight ratio (W/D ratio), expression of nuclear-Nrf2, total-Nrf2 and HO-1 in lung tissues (by Western blot), and expression of HO-1 mRNA (by real-time polymerase chain reaction) and for microscopic examination of histopathologic changes (by haematoxylin and eosin staining) which were scored. Results:Compared with S group, the concentrations of protein in BALF, W/D ratio of lung tissues and lung injury score were significantly increased, the levels of TNF-α, HMGB1 and IL-10 in serum and lung tissues were increased, and the expression of nuclear Nrf2, total Nrf2 and HO-1 protein and mRNA in lung tissues was up-regulated in T and T+ H groups ( P<0.05). Compared with T group, the concentrations of protein in BALF, W/D ratio of lung tissues and lung injury score were significantly decreased, the levels of TNF-α and HMGB1 in serum and lung tissues were decreased, the level of IL-10 in serum and lung tissues was increased, and the expression of nuclear Nrf2, total Nrf2 and HO-1 protein and mRNA in lung tissues was up-regulated in T+ H group ( P<0.05), and no significant changes were found in the parameters mentioned above in T+ H+ B group ( P>0.05). Compared with T+ H group, the concentrations of protein in BALF, W/D ratio of lung tissues and lung injury score were significantly increased, the levels of TNF-α and HMGB1 in serum and lung tissues were increased, the level of IL-10 in serum and lung tissues was decreased, and the expression of nuclear Nrf2, total Nrf2 and HO-1 protein and mRNA in lung tissues was down-regulated in T+ H+ B group ( P<0.05). Conclusions:Hydrogen-rich solution can alleviate acute lung injury in rats with traumatic brain injury, and the mechanism is related to activation of Nrf2/HO-1 signaling pathway and inhibition of the inflammatory responses.

The challenging blood cross-matching and resolution for multiple myeloma patients in different disease stages / 中国输血杂志

【Objective】 To explore the challenging blood cross-matching and resolution for multiple myeloma (MM) patients in different disease stages. 【Methods】 For a patient who was first diagnosed as MM and scheduled for blood transfusion, his blood was cross matched with donors’ blood by microcolumn gel method and tube test. When the major side of cross-matching was agglutinated, the patient’s plasma was cross matched with donors’ red blood cell (RBC) by polybrene test, then plasma dilution cross matched with donors’ RBC by microcolumn gel method. For a patient who was diagnosed as recurrent refractory MM and scheduled for blood transfusion, his blood was cross matched with donors’ blood by microcolumn gel method. 【Results】 1) Case 1 was a first-visit outpatient. The major side of microcolumn cross-match test was agglutinated with the shape of fine line. The result of tube method also showed agglutination of major sides, and the rouleaux were detected by the microscopy. Then polybrene method and microcolumn gel method (after plasma diluted) were applied for cross-matching again with the above two donors’ blood and showed compatibility. 2) Case 2 was a recurrent refractory MM patient. The major and minor sides of microcolumn cross-match test were both agglutinated with the shape of granular. The patient was treated with anti-CD38 monoclonal antibody. The RBCs, after treated with dithiothreitol (DTT) was used to cross match with patient plasma by microcolumn test, and the result was compatible. 【Conclusion】 Polybrene method and microcolumn gel method after plasma diluted are suitable for blood cross-matching of newly diagnosed MM patients, also for those treated with CD38 monoclonal antibody, as the drug interference with cross-matching can be eliminated by DTT.

Expression of silent information regulator 1 and 3 and hypoxia-inducible factor 1α in cutaneous squamous cell carcinoma tissues and cells / 中华皮肤科杂志

Objective:To determine the expression of silent information regulator 1 (Sirt1) , Sirt3 and hypoxia-inducible factor 1α (HIF-1α) in cutaneous squamous cell carcinoma (CSCC) tissues and cells, and to explore their role in the occurrence and development of CSCC.Methods:From January 2019 to December 2020, 30 lesional skin tissues were obtained from patients with histopathologically confirmed poorly-, moderately- or well-differentiated CSCC, and 30 normal skin tissues were obtained from patients with non-cancerous diseases in Department of Dermatology, General Hospital of Ningxia Medical University. A CSCC cell line A431 and a human keratinocyte cell line HaCaT were cultured. Immunohistochemical study, Western blot analysis and real-time quantitative PCR (RT-PCR) were performed to determine the protein and mRNA expression of Sirt1, Sirt3 and HIF-1α in CSCC tissues of different grades of differentiation and normal skin tissues, cytochemical and immunofluorescence staining and RT-PCR were conducted to determine the protein and mRNA expression of Sirt1, Sirt3 and HIF-1α in A431 and HaCaT cells, respectively. Comparisons of measurement data among multiple groups were performed by using one-way analysis of variance, and comparisons between two groups by using t test. Results:Immunohistochemical study showed that the expression level of Sirt3 (expressed as the average optical density) was 100 ± 12.12, 117.72 ± 26.23, 127.32 ± 24.45, 132.71 ± 31.61 in the normal skin tissues and well-, moderately- and poorly-differentiated CSCC tissues respectively, and there was a significant difference among these groups ( F = 20.14, P < 0.001) ; the expression of Sirt1 and HIF-1α increased in turn from the normal skin tissues to the well-, moderately- and poorly-differentiated CSCC tissues, and significantly differred in these groups ( F = 174.50, 225.00, respectively, both P < 0.001) . As Western blot analysis revealed, the expression level of Sirt3 significantly differed among the normal skin tissues, well-, moderately- and poorly-differentiated CSCC tissues (expressed as relative gray value: 1.000 ± 0.132, 1.403 ± 0.411, 1.387 ± 0.393, 1.677 ± 0.683, respectively; F = 34.97, P < 0.001) , and so did the expression levels of Sirt1 and HIF-1α ( F = 69.29, 199.90, respectively, both P < 0.00l) , with a gradually increasing trend in their expression levels from the the normal skin tissues to well-, moderately- and poorly-differentiated CSCC tissues. RT-PCR showed that the mRNA expression of Sirt3, Sirt1 and HIF-1α was sequentially increased from the normal skin tissues to well-, moderately- and poorly-differentiated CSCC tissues, and significant differences were observed among these groups ( F = 113.00, 174.50, 50.33, respectively, all P < 0.001) . The protein expression levels of Sirt3, Sirt1 and HIF-1α were significantly higher in the A431 cells than in the HaCaT cells ( t = 16.75, 18.34, 27.76, respectively, all P < 0.001) , and so were their mRNA expression levels ( t= 14.22, 9.62, 16.86, respectively, all P < 0.001) . Conclusion:Increased expression of Sirt3, Sirt1 and HIF-1α was observed in CSCC tissues and cells, which may promote the occurrence and development of CSCC.

Role of HO-1 in sevoflurane-induced improvement in sepsis-associated encephalopathy in mice / 中华麻醉学杂志

Objective:To evaluate the role of heme oxygenase-1 (HO-1) in sevoflurane-induced improvement in sepsis-associated encephalopathy (SAE) in mice.Methods:A total of 136 adult male mice, aged 6-8 weeks, weighing 20-25 g, were divided into 4 groups ( n=34 each) using a random number table method: sham operation group (group Sham), SAE group, SAE+ sevoflurane group (group SAE+ Sevo) and SAE+ sevoflurane+ HO-1 inhibitor Zn Protoporphyrin Ⅸ (ZnPPⅨ) group (group SAE+ Sevo+ ZnPPⅨ). The model of SAE was established by cecal ligation and puncture (SAE) in anesthetized mice.In SAE+ Sevo and SAE+ Sevo+ ZnPPⅨ groups, 2% sevoflurane-33% oxygen was inhaled for 2 h starting from the time point immediately after establishment of the model, while 33% oxygen was inhaled for 2 h in Sham and SAE groups.ZnPPⅨ 25 mg/kg was intraperitoneally injected at 30 min before the model was established in group SAE+ Sevo+ ZnPPⅨ.Six mice were sacrificed at 6, 12 and 24 h after establishment of the model for determination of levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), high mobility group protein B1 (HMGB1) and HO-1 in cortical tissues (by enzyme-linked immunosorbent assay) and the expression of HO-1 (by Western blot). Another 6 mice were sacrificed for determination of apoptosis in cortical tissue (by TUNEL staining), and apoptotic index (AI) was calcultated.Ten mice in each group were selected, Y maze test was performed at 3, 5, 7 and 14 days after establishment of the model, and the percentage of spontaneous alternation was calculated. Results:Compared with Sham group, the levels of TNF-α, IL-1β and HMGB1, AI, HO-1 activity and its expression level in cortex were significantly increased, and the percentage of spontaneous alternation was decreased in SAE, SAE+ Sevo and SAE+ Sevo+ ZnPPⅨ groups ( P<0.05). Compared with group SAE, the levels of TNF-α, IL-1β and HMGB1 and AI were significantly decreased, and HO-1 activity and its expression level and the percentage of spontaneous alternation were increased in group SAE+ Sevo, the levels of TNF-α, IL-1β and HMGB1 in cortex were decreased ( P<0.05), and no significant change was found in the other parameters in group SAE+ Sevo+ ZnPPⅨ ( P>0.05). Compared with group SAE+ Sevo, the levels of TNF-α, IL-1β and HMGB1 and AI were significantly increased, and HO-1 activity and its expression level and the percentage of spontaneous alternation were decreased in group SAE+ Sevo+ ZnPPⅨ ( P<0.05). Conclusion:The mechanism by which sevoflurane improves SAE is related to increasing HO-1 activity and reducing inflammatory response in cortical tissues of mice.

Efficacy of Xiatianwu eye drops combined with raceanisodamine eye drops in the treatment of pseudomyopia in children / 中国基层医药

Objective:To investigate the efficacy and safety of Xiatianwu eye drops in the treatment of pseudomyopia in children. Methods:A total of 8 000 children with pseudomyopia who received treatment in Jiaxing Hospital of Traditional Chinese Medicine between June 2018 and June 2019 were included in this study. They were randomly assigned to receive treatment with either raceanisodamine eye drops (control group, n = 4 000) or Xiatianwu eye drops combined with raceanisodamine eye drops (observation group, n = 4 000) for 30 successive days (1 treatment course). The uncorrected visual acuity and diopter in each group were detected by an 'E' chart and optometry. Axial eye length and intraocular pressure in each group were measured using an ophthalmic A/B ultrasound scanner and a non-contact tonometer to assess the therapeutic effects. The incidence of adverse reactions during the treatment period was calculated. Results:After 30 days of treatment, the uncorrected visual acuity in the observation group was significantly higher than that in the control group [(0.88 ± 0.33) vs. (0.81 ± 0.29), t = 10.077, P < 0.001]. The diopter in the observation group was significantly lower than that in the control group [(-0.99 ± 0.36) D vs. (-1.07 ± 0.39) D, t = 9.533, P < 0.001]. Total effective rate in the observation group was significantly higher than that in the control group (91.10% vs. 88.18%, χ2 = 18.422, P < 0.001). There were no significant differences in the axial eye length, intraocular pressure and the incidence of adverse reactions between the two groups (all P > 0.05). Conclusion:Xiatianwu eye drops combined with raceanisodamine eye drops in the treatment of pseudomyopia in children can improve uncorrected visual acuity, increase therapeutic effects, and does not increase the incidence of adverse reactions.

Effects of vitamin K 2 on sevoflurane-induced cognitive decline in aged mice / 中华麻醉学杂志

Objective:To evaluate the effects of vitamin K 2 on sevoflurane-induced cognitive decline in aged mice. Methods:A total of 72 SPF healthy female C57BL/6J mice, aged 12 months, weighing 20-25 g, were divided into 4 groups ( n=18 each) using a random number table method: control+ corn oil group (group Con+ Oil), sevoflurane+ corn oil group (group Sevo+ Oil), control+ vitamin K 2 group (group Con+ K 2) and sevoflurane+ vitamin K 2 group (group Sevo+ K 2). The mice in Sevo+ Oil and Sevo+ K 2 groups were anesthetized with 2.5% sevoflurane+ 33% oxygen for 2 h. The mice in Con+ Oil and Con+ K 2 groups were treated with 33% oxygen only.The animals in Con+ Oil and Sevo+ Oil groups were intraperitoneally injected with corn oil 100 μl at 30 min before oxygen or sevoflurane inhalation.Vitamin K 2 (dissolved in corn oil, concentration 1 mg/ml) 100 mg/kg was injected intraperitoneally in Con+ K 2 and Sevo+ K 2 groups.At 24 h after sevoflurane inhalation, 8 mice from each group were randomly selected and sacrificed, and the hippocampal tissues were removed for determination of activity of ATPase, contents of interleukin-1beta (IL-1β), IL-6 and tumor necrosis factor-alpha (TNF-α) (by enzyme-linked immunosorbent assay) and the expression of AT8 and PHF1 (by Western blot). The remaining 10 mice in each group received standardized feeding, and the cognitive function was assessed using Y-maze at 1, 3, 5, 7 and 14 days after sevoflurane inhalation. Results:Compared with group Con+ Oil, the contents of IL-1β, IL-6 and TNF-α were significantly increased, expression of AT8 and PHF1 were up-regulated, activity of ATPase was decreased, and spontaneous alternation percentage was decreased at 1, 3, 5, 7 and 14 days after sevoflurane inhalation in group Sevo+ Oil ( P<0.05). Compared with group Sevo+ Oil, the contents of IL-1β, IL-6 and TNF-α were significantly decreased, expression of AT8 and PHF1 were down-regulated, activity of ATPase was increased, and spontaneous alternation percentage was increased at 1, 3, 5, 7 and 14 days in group Sevo+ K 2 ( P<0.05). There was no significant difference in the above indicators between group Con+ K 2 and group Sevo+ K 2 ( P>0.05). Conclusion:Vitamin K 2 can improve sevoflurane-induced cognitive decline in aged mice, the mechanism is related to increasing activity of ATPase and inhibiting the up-regulation of AT8 and PHF1 expression in hippocampus.

Assessment of platelet function using a Platelet Function Analyzer-100 for metabolic syndrome patients / 中华健康管理学杂志

Objective:Metabolic syndrome (MS) patients and determine factors related to platelet hyperactivation.Methods:A total of 999 participants (822 males and 177 females) were enrolled. Participants were divided into two groups according to the metabolic index: MS group (501) and normal control (NC) group (498). Platelet function was tested with PFA100 (Siemens USA, Deerfield, Illinois) which measures the time it takes for blood to occlude an aperture (closure time, CT) following stimulation with collagen and adenosine diphosphate. Statistical analyses were performed using the SPSS statistical software package, version 22.0 (IBM Corporation, Armonk, NY, USA).Results:MS group had significantly shorter CT values compared with NC group (106.6±27.8s) vs (113.7±27.9s). Higher BMI, WC, BP, TC, TG, LDL-C, UA, and PRL were correlated with shorter CT values (all P<0.05). Conclusion:Our results indicated platelet hyperactivation exists in MS which was related to obesity and elevated blood pressure, blood lipids, uric acid, and PLR.

The clinical significance of plasma PTX3 in patients with secondary hemophagocytic lymphohistiocytosis / 中华内科杂志

Objective:To investigate the significance of plasma pentraxin 3 (PTX3) in patients with secondary hemophagocytic lymphohistiocytosis (sHLH).Methods:Plasma PTX3 levels were tested by ELISA in 48 newly diagnosed sHLH patients, 18 healthy volunteers and 9 lymphoma controls in the First Affiliated Hospital of Nanjing Medical University from January 2017 to July 2019. Clinical parameters were collected, and the correlations with PTX3 levels were analyzed.Results:PTX3 level in newly diagnosed group was significantly higher than that of healthy control group [16.29(1.17-66.00) vs. 0.76(0.01-7.86) μg/L, P<0.01]. Patients with lymphoma-associated HLH(LHLH) had higher plasma level of PTX3 than Fhose with infection-associated HLH (IHLH) [24.29(3.36-66.00) vs. 9.56(1.17-36.50)μg/L, P<0.05]. Plasma PTX3 levels in 48 sHLH patients were positively correlated with serum ferritin ( P<0.05). Receiver operating characteristic (ROC) curve for plasma PTX3 levels of sHLH and healthy controls produced a cutoff value at 3.9 μg/L, with its 86.7% sensitivity and 94.4% specificity. And ROC analysis showed that PTX3 17.5 μg/L was the critical value for diagnosis of LHLH from non-LHLH group, that the sensitivity and specificity were 63.0% and 76.2% respectively. The 1-year overall survival (OS) rate in patients with PTX3≥17.5 μg/L was significantly lower in those with PTX3<17.5 μg/L (18.5% vs. 75.8%, P<0.01). Conclusion:These results indicate the potential of PTX3 as a biomarker for diagnosis and prognosis in patients with sHLH.

Effect of dexmedetomidine on intestinal barrier function in mice with traumatic brain injury and the role of Nrf2/HO-1 signaling pathway / 中华麻醉学杂志

Objective:To evaluate the effect of dexmedetomidine on intestinal barrier function in mice with traumatic brain injury (TBI) and the role of nuclear factor E2-related factor 2 (Nrf2)/heme oxygenase-1 (HO-1) signaling pathway.Methods:Thirty ICR male wild-type (WT) and 30 Nrf2 knockout (Nrf2-KO) mice, aged 6-8 weeks, weighing 20-25 g, were divided into 3 groups ( n=10 each) using a random number table method: control group (group C), TBI group (group T) and TBI+ dexmedetomidine group (group T+ D). A 100 g of stainless steel impactor was used to produce a free fall acceleration strike on the head from 12 cm height in anesthetized animals.Dexmedetomidine 30 μg/kg was intraperitoneally injected at 30 min before TBI in group T+ D, while the equal volume of normal saline was given instead in C and TBI groups.The mouse bladder was emptied at 18 h after TBI, the test solution 200 μl containing 13.3 mg lactulose and 10.1 mg mannitol was given via a gastric tube.Urine was collected at 24 h after TBI, and the ratio of lactulose to mannitol was measured to estimate the intestinal barrier permeability.Blood samples were collected from heart to measure the concentration of lipopolysaccharide in plasma.Then the mice were sacrificed, and the tissues of ileum were collected to detect the contents of tumor necrosis factor-alpha(TNF-α), interleukin-1beta(IL-1β), IL-6 and 8-iso-prostaglandin F 2α (8-iso-PGF 2α) (by enzyme-linked immunosorbent assay), contents of superoxide dismutase (SOD) and catalase (CAT) (by hydroxylamine method and ammonium molybdate colorimetric method, respectively), content of malondialdehvde (MDA) (by thibabituric acid method), and expression of Nrf2 and HO-1 (by Western blot). Results:For WT mice Compared with group C, the intestinal barrier permeability, concentration of LPS in plasma, and contents of TNF-α, IL-1β, IL-6, MDA and 8-iso-PGF 2α were significantly increased, the activities of intestinal CAT and SOD were decreased, and the expression of Nrf2 and HO-1 was up-regulated in T and T+ D groups ( P<0.05). Compared with group T, the intestinal barrier permeability, concentration of LPS in plasma, and contents of TNF-α, IL-1β, IL-6, MDA and 8-iso-PGF 2α were significantly decreased, the activities of intestinal CAT and SOD were increased, and the expression of Nrf2 and HO-1 was up-regulated in group T+ D ( P<0.05). For Nrf2-KO mice Compared with group C, the intestinal barrier permeability, concentration of LPS in plasma, and contents of TNF-α, IL-1β, IL-6, MDA and 8-iso-PGF 2α were significantly increased, and no significant change was found in the activities of intestinal CAT and SOD in T and T+ D groups( P>0.05). There was no significant difference in the expression of HO-1 among the three groups ( P>0.05). Conclusion:Dexmedetomidine can improve the intestinal barrier dysfunction in mice with TBI, and the mechanism is related to activating Nrf2/HO-1 signaling pathway.

The effect of respiratory motion states on dynamic IMRT dose distribution / 中华放射医学与防护杂志

Objective To investigate the effect of respiratory movement of different amplitude,period and direction on the dose distribution of target area in dynamic intensity modulated radiation therapy.Methods A total of 30 cases of lung cancer were selected and divided into three groups according to the volume size of the target area,including groups A (72.0-200.2 cm3),B (271.7-380.0 cm3) and C (498.9-684.9 cm3).The average volume was 151.5,327.1 and 583.3 cm3,respectively.Breathing motion simulation platform was used to drive the mode body with two-dimensional ionization chamber matrix along the Gun-Target direction,then turn the collimator to 0° and 90°,respectively.The doses were collected at the central level in different amplitudes of 0,4,8,12 and 15 mm,periodic respiratory movement at the intervals of 3,4 and 5 s and respiratory motion measurement with a cycle of 4 s 5 times.The difference of dose distribution between the collected dose and TPS output was analyzed by taking the absolute dose and γ-passing rate (3 mm/3％) as indicators.Results In the two-sided upward,respiratory movement reduced the dose at the medial edge of the target area and increased the dose at the lateral edge of the target area.The difference of γ-passing rate between respiration cycle was up to 3.54％ (t=2.301,P＜0.05),and when the respiration movement was more than 8 mm,the γ-passing rate was less than 90％ and decreased with the increase of amplitude.The difference of γ-passing rate between static and respiratory motion was negatively correlated with the volume of target area,and the average γ-passing rate of A,B and C three groups increased gradually.The γ-passing rate of 5 composited dose was higher than that of single dose,and the difference was statistically sigificant(t=-9.36--5.95,P＜0.05).Conclusions The dose distribution of dynamic IMRT target area is mainly influenced by respiration range and its own volume,and the respiration cycle has an effect on dose distribution under partial amplitude.After implementing the multiple doses,some single dose implementation errors can be eliminated.Physicians need to expand the target area reasonably according to the range of respiratory movement,and optimize the amount of marginal tissue in the target area in the direction of respiratory movement.For patients with small target volume and large respiratory movement,respiratory management technology should be adopted to improve the accuracy of target dose implementation.