Effect of metformin preconditioning on AMPK/PINK1 signaling pathway during myocardial ischemia-reperfusion injury in diabetic rats / 中华麻醉学杂志

Objective:To evaluate the effect of metformin preconditioning on adenosine monophosphate-activated protein kinase(AMPK)/PTEN-induced putative protein kinase(PINK1) signaling pathway during ischemia-reperfusion (I/R) injury in diabetic rats.Methods:Thirty-six clean-grade healthy male Sprague-Dawley rats, aged 6 weeks, weighing 120-160 g, were divided into 3 groups ( n=12 each) by the random number table method: diabetic sham operation group (DS group), diabetic myocardial I/R group (DI/R group) and diabetic myocardial I/R+ metformin preconditioning group(DI/R+ Met group). After 4 weeks of feeding a high-fat and high-glucose diet, the model of type 2 diabetes mellitus was induced by a single intraperitoneal injection of 1% streptozotocin 40 mg/kg. The myocardial I/R injury was induced by blocking the anterior descending branch of the left coronary artery for 30 min followed by 120-min reperfusion in anesthetized animals. In DI/R+ Met group, metformin 200 mg/kg was given by intragastric gavage once a day within 1 week before myocardial ischemia. Blood samples from the femoral vein were collected at 120 min of reperfusion for determination of the serum creatine kinase isoenzymes (CK-MB) and cardiac troponin I (cTnI) concentrations by enzyme-linked immunosorbent assay. Then the rats were sacrificed and myocardial tissues were obtained for examination of the pathological changes(by HE staining) and for determination of the percentage of myocardial infarct size (by the double staining of Ewan blue and TTC) and expression of myocardial autophagy-related protein Beclin-1, PTEN-induced putative kinase 1 (PINK1), phosphorylated 5′-adenosine monophosphate-activating protein kinase (p-AMPK), and ratio of microtubule-associated protein 1 light chain 3Ⅱ/Ⅰ (LC3Ⅱ/Ⅰ) (by Western blot). Results:Compared with DS group, the percentage of myocardial infarct size and serum CK-MB and cTnI concentrations were significantly increased, the expression of Beclin-1, p-AMPK and PINK1 in myocardial tissues was up-regulated, the ratio of LC3II/I was increased( P<0.05), and the pathological changes were aggravated in DI/R group and DI/R+ Met group. Compared with DI/R group, the percentage of myocardial infarct size and serum CK-MB and cTnI concentrations were significantly decreased, the expression of Beclin-1, p-AMPK and PINK1 in myocardial tissues was up-regulated, the ratio of LC3Ⅱ/Ⅰ was increased ( P<0.05), and the pathological changes were significantly reduced in DI/R+ Met group. Conclusions:The mechanism by which metformin preconditioning reduces myocardial I/R injury is related to activation of AMPK/PINK1 signaling pathway and up-regulation of mitochondrial autophagy in diabetic rats.

Clinical study on modified Duhuo Jisheng Decoction combined with Traditional Chinese Medicine fumigation in the treatment of knee osteoarthritis / 国际中医中药杂志

Objective:To explore the effects of modified Duhuo Jisheng Decoction combined with Traditional Chinese Medicine (TCM) fumigation on joint function and inflammatory mediators in synovial fluid of patients with knee osteoarthritis.Methods:A total of 203 patients with knee osteoarthritis who met the inclusion criteria between March 2020 and March 2021 in the hospital were divided into observation group (102 cases) and control group (101 cases) according to the random number table method. The control group was given oral administration of celecoxib capsules + TCM fumigation, and the observation group was given modified Duhuo Jisheng Decoction on the basis of the control group. Both groups were treated for 3 months. TCM symptoms were scored before and after treatment, and Japanese Orthopaedic Association scores (JOA) was used to evaluate the knee function. Immunoturbidimetry was adopted to detect serum high-sensitivity C-reactive protein (hs-CRP), and ELISA was used for the detection of levels of TNF-α and IL-6 in synovial fluid, and the clinical efficacy was evaluated.Results:The total effective rate was 90.2% (92/102) in observation group and was 79.2% (80/101) in control group ( χ2=4.74, P=0.030). The JOA scores at 1 month and 3 months after treatment in observation group were significantly higher than those in the control group ( t=3.17, 7.74, all Ps<0.01). The scores of cold and painful knee joint, soreness and weakness of waist and knees, joint swelling and inhibited bending and stretching were significantly in the observation group after treatment lower than those in the control group ( t=7.61, 10.81, 6.62, 8.77, all Ps<0.001). The levels of TNF-α and IL-6 in synovial fluid and level of serum hs-CRP were significantly in the observation group after treatment lower than those in the control group ( t=7.97, 9.52, 9.56, all Ps<0.001). During treatment, the incidence rate of adverse reactions was 32.7% (33/101) in control group and that of observation group was 19.6% (20/102) ( χ2=4.49, P=0.034). Conclusion:Modified Duhuo Jisheng Decoction combined with TCM fumigation can improve the clinical symptoms and knee function, relieve the inflammatory response and enhance the clinical efficacy of patients with knee osteoarthritis.

Effect of continuous positive airway pressure on oxidative stress reaction and neurological function in patients of acute cerebral infarction combined with obstructive sleep apnea syndrome / 中国脑血管病杂志

Objectives To observe the effect of continuous positive airway pressure (CPAP)for the treatment of patients with acute cerebral infarction combined with obstructive sleep apnea syndrome (OSAS)and to investigate the influence of CPAP therapy on the recovery of neurological function in patients. Methods From April 2014 to September 2015,68 consecutive patients with acute cerebral infarction combined with OSAS admitted to the Department of Neurology,General Hospital of Wanbei Coal and Electricity Group were enrolled retrospectively. According to whether received the CPAP therapy,they were divided into an observation group (n = 31)and a control group (n = 37). The control group was treated with conventional therapy,and on the basis of the treatment plan of the control group,the observation group was also treated with CPAP therapy. They were all the patients with cerebral infarction who were treated for 14 d. The oxygen desaturation index (ODI),lowest oxygen saturation (LS a O2 ),oxidized low-density lipoprotein (ox-LDL),and superoxide dismutase (SOD)concentration,National Institute of Health Stroke Scale (NIHSS)scores and Barthel index (BI)scores,and the modified Rankin scale (mRS)scores after 3 months before and after the therapy in the patients of both groups were documented. The total effective rate was assessed. Results (1)The ODI and LS a O2 in the observation group and the control group after treatment were better than those before treatment. There were significant differences between the 2 groups (ODI:16 ± 6% vs. 35 ± 21%,26 ± 15% vs. 36 ± 21 %;LS a O2:88 ± 6% vs. 75 ± 11%,80 ± 8% vs. 75 ± 11%;all P < 0. 05). (2)After treatment,ox-LDL of the observation group was lower than that of the control group. There was significant differences between the 2 groups (ox-LDL:487 ± 90 μg/ L vs. 548 ± 77 μg/ L,SOD:111 ± 10 kU/ L vs. 94 ± 15 kU/ L,all P < 0. 01). (3)After treatment,the NIHSS and BI scores of the observation group and the control group were better than those before treatment. There were significant differences (the NHISS scores:5. 2 ± 2. 2 vs. 12. 9 ± 3. 9;7. 6 ± 3. 1 vs. 12. 5 ± 4. 2;the BI scores:88 ± 10 vs. 52 ± 30;81 ± 4 vs. 58 ± 30;all P < 0. 01). The NIHSS and BI scores of observation group were better than those of the control group. There were significant differences (all P < 0. 01). They were followed up for 3 months,the mRS score (1. 3 ± 0. 4)of the observation group was lower than that of the control group (2. 0 ± 1. 1). There was significant difference between the 2 groups (t = 3. 362,P <0. 01). (4)The total effective rate of the observation group and control group was 74. 2% (23 / 31)and 48. 6% (18 / 37)respectively. There was significant difference between the 2 groups (χ2 = 4. 598,P <0. 05). Conclusion The CPAP therapy can alleviate the oxidative stress levels in patients with acute cerebral infarction combined with OSAS in short term and improve the neurological function of patients.

Relationship between carotid atherosclerosis progression and chronic Helicobacter pylori infection in patients with high risk of stroke / 中华神经科杂志

Objective To investigate the relationship between Helicobacter pylori (Hp) infection and carotid atherosclerosis (CAS) progression in patients with high risk of stroke,and to provide clinical evidence for the primary prevention of stroke.Methods Three hundred and thirty-two patients with high risk of stroke were screened from 2 800 people who were consecutively selected and had health examination from June to December 2014 in the Department of Medical Center,General Hospital of Wanbei Coal and Electricity Group.Their clinical information was collected.A total of 267 patients whose carotid ultrasound examinations showed plaques and stenosis were selected for the study.Two hundred and three of the 267 patients who met the screening conditions and completed the follow-up were selected as study subjects.The Hp infection status was detected by the 14C urea breath test and the dynamic progression of CAS was observed.The risk factors of CAS progression were also analyzed.Results Hp infection was found in 170 of 332 patients with high risk of stroke.Among the 267 patients who prompted plaques and stenosis in carotid ultrasound in 2014,203 patients were followed up for 1 year,and 133 patients (65.5％,133/203) were found infected by Hp.Forty-six patients had suggestive carotid stenosis and stenosis aggravating in 2015,31 (67.4％,31/46) of which were found infected by Hp.Logistic regression analysis showed that smoking (OR =1.632,95％ CI 1.275-1.940,P =0.011),systolic blood pressure (OR =1.343,95％ CI 1.105-1.632,P =0.019),low density lipoprotein (OR =1.590,95％ CI 1.188-2.005,P =0.005),oxidative low density lipoprotein (OR =1.732,95％ CI 1.325-2.170,P =0.000) and Hp infection (OR =1.672,95％ CI 1.180-2.154,P =0.016) were independent risk factors for carotid atheroslerosis progression.Conclusions Hp infection was found closely related to CAS progression in patients at high risk of stroke.Positive and effective prevention of Hp infection,advocating smoking cessation and controlling blood pressure and blood fat can effectively reduce the incidence of stroke.

Surgical treatment of multiple intracranial aneurysms / 中华外科杂志

<p><b>OBJECTIVE</b>To discuss the surgical strategies and analyze the clinical outcomes of multiple intracranial aneurysms (MIA).</p><p><b>METHODS</b>The clinical data of 49 MIA patients surgically treated between January 2009 and December 2013 was analyzed retrospectively. Among the 49 patients, 12 patients were male and 37 were female, mean age (49 ± 11) years. Thirty-five patients had ruptured aneurysms, and 14 had unruptured aneurysms. Treatment strategies included one-stage operation (MIA were treated in one-stage with an unilateral approach), two-stage treatment (MIA were treated stage by stage) and partial treatment (only ruptured aneurysm was treated). Postoperative CT angiograms (CTA) or digital subtraction angiograms (DSA) were reviewed and the Glasgow Outcome Scale (GOS) scores were evaluated during follow-up period.</p><p><b>RESULTS</b>Thirty-two patients (65.3%) underwent one-stage operation, 9 patients (18.4%) underwent two-stage treatment, and 8 patients (16.3%) underwent partial treatment. Forty-seven patients were followed up 4-49 months, mean (22 ± 7) months. Postoperative CTA or DSA showed no aneurysm recurrence. According to the GOS scores, 41 patients (83.7%) with good outcomes (GOS 4, 5), 6 patients (12.2%) were disabled (GOS 2, 3) and 2 patients (4.1%) were dead (GOS 1).</p><p><b>CONCLUSION</b>Selecting the right patients for surgery and making personalized surgical strategies based on the characteristics of patients and aneurysms could improve the surgical outcomes of MIA.</p>

The surgery of giant symptomatic cavernous sinus aneurysms / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the management and outcomes in patients with giant symptomatic cavernous sinus aneurysms who underwent aneurysms trapping with bypass, proximal carotid occlusion and aneurysms trapping.</p><p><b>METHODS</b>Twenty-three patients with giant symptomatic cavernous sinus aneurysms underwent surgery between February 2007 and March 2013, 3 cases were male and 20 cases were female patients, the age of the patients ranged between 24 and 68 years, mean age was 54.7 years. The pre-operative digital subtraction angiography (DSA) and ballon occlusion test (BOT) were performed to confirm the diagnosis and identify hemodynamic reserve with carotid occlusion, and the aneurysms trapping with bypass, aneurysms trapping and proximal occlusion of the internal carotid artery were performed according to BOT results. During the surgery, the neurophysiological monitoring and the intraoperative CT perfusion were used. The follow-up by DSA or CT angiography were made.</p><p><b>RESULTS</b>Seventeen patients underwent aneurysms trapping with bypass, 1 underwent aneurysms trapping and 5 underwent proximal occlusion of the internal carotid artery. After surgery, symptom improved in 4 cases, did not change in 10 cases, and new neural function deficit developed in 9 cases. The follow-up period were 3 months to 75 months. Two patients were lost. The Glasgow Outcome Scale of last follow-up were 5 in 19 patients, 3 in 1 patient and 1 in 1 patient.</p><p><b>CONCLUSIONS</b>The aneurysms trapping with bypass and proximal occlusion of the internal carotid artery are effective and reliable procedure for treatment of giant symptomatic cavernous sinus aneurysms in selected patients after evaluation of the pre-operative BOT, intra-operative neurophysiological monitoring and the intraoperative CT perfusion.</p>

Individualized surgical treatment of complex middle cerebral artery aneurysms / 中华外科杂志

<p><b>OBJECTIVE</b>To summarize individualized surgical treatment strategies for complex middle cerebral artery (MCA) aneurysms.</p><p><b>METHODS</b>Twenty patients with complex MCA aneurysms treated by microsurgery in Chinese People's Liberation Army General Hospital between December 2009 and November 2012 were retrospectively analyzed. There were 12 male and 8 female patients, with a mean age of 43 years (range: 14-58 years). Giant aneurysms (size > 2.5 cm) were found in 6 cases, wide-neck aneurysms in 7 cases and serpentine ones in 3 patients. Important perforators were involved in aneurysm neck in 2 cases. Important branches originated from aneurysms in 6 patients. Two patients harbored recurrent aneurysms after coiling. Individualized surgical strategies were planned according to preoperative imaging. A frontotemporal approach was routinely used. Intraoperative somatosensory evoked potential monitoring, indocyanine green videoangiography and microvascular Doppler ultrasonography were regularly used. A postoperative digital subtraction angiography (DSA) or computed tomography angiography (CTA) was performed to verify the efficacy of treatment and patency of bypass vessels.</p><p><b>RESULTS</b>Of the 20 cases, 7 aneurysms were clipped with clipping and reconstruction of parent artery with multiple clips, 3 M1 segment aneurysms were proximally occluded with extra-intracranial high-flow revascularization, 2 aneurysms were treated with aneurysmectomy with superficial temporal artery to middle cerebral artery low-flow revascularization, 1 aneurysm was treated with aneurysmectomy with superficial temporal artery to middle cerebral artery low-flow revascularization and branch side-to-side anastomosis, 2 aneurysms were treated with aneurysmectomy and re-anastomosis of parent artery, 1 aneurysm was treated with aneurysmectomy and re-anastomosis of parent artery and reinplantation of lenticulostriate artery, 3 bilateral MCA aneurysms were clipped by unilateral approach, and 1 was trapped. Nineteen patients were favorable with Glasgow Outcome Scale score 4-5 at discharge, and 1 patient died of cardiac infarction one week after surgery. The mean clinical follow-up was 20 months (range: 6-39 months). During follow-up, no bleeding occurred. DSA or CTA confirmed absence of aneurysm in 14 cases and residual neck in 2 patients. The other 3 patients were lost to follow-up.</p><p><b>CONCLUSIONS</b>Individualized, multi-modality surgical treatment strategies are effective and safe solution for treatment of complex MCA aneurysms. Revascularization remains imperative surgical technique.</p>

Outcome of Endoscopic Transsphenoidal Surgery in Combination with Somatostatin Analogues in Patients with Growth Hormone Producing Pituitary Adenoma

OBJECTIVE: To determine the efficacy of endoscopic surgery in combination with long-acting somatostatin analogues (SSAs) in treating patients with growth hormone (GH)-secreting pituitary tumor. METHODS: We performed retrospective analysis of 133 patients with GH producing pituitary adenoma who underwent pure endoscopic transsphenoidal surgery in our center from January 2007 to July 2012. Patients were followed up for a range of 3-48 months. The radiological remission, biochemical remission and complication were evaluated. RESULTS: A total of 110 (82.7%) patients achieved radiological complete resection, 11 (8.2%) subtotal resection, and 12 (9.0%) partial resection. Eighty-eight (66.2%) patients showed nadir GH level less than 1 ng/mL after oral glucose administration. No mortality or severe disability was observed during follow up. Preoperative long-acting SSA successfully improved left ventricle ejection fraction (LVEF) and blood glucose in three patients who subsequently underwent success operation. Long-acting SSA (20 mg every 30 days) achieved biochemical remission in 19 out 23 (82.6%) patients who showed persistent high GH level after surgery. CONCLUSION: Endoscopic transsphenoidal surgery can biochemically cure the majority of GH producing pituitary adenoma. Post-operative use of SSA can improve biochemical remission.

Individualized fluid-solid coupled model of intracranial aneurysms based on computed tomography angiography data / 南方医科大学学报

<p><b>OBJECTIVE</b>To establish an individualized fluid-solid coupled model of intracranial aneurysms based on computed tomography angiography (CTA) image data.</p><p><b>METHODS</b>The original Dicom format image data from a patient with an intracranial aneurysm were imported into Mimics software to construct the 3D model. The fluid-solid coupled model was simulated with ANSYS and CFX software, and the sensitivity of the model was analyzed. The difference between the rigid model and fluid-solid coupled model was also compared.</p><p><b>RESULTS</b>The fluid-solid coupled model of intracranial aneurysm was established successfully, which allowed direct simulation of the blood flow of the intracranial aneurysm and the deformation of the solid wall. The pressure field, stress field, and distribution of Von Mises stress and deformation of the aneurysm could be exported from the model. A small Young's modulus led to an obvious deformation of the vascular wall, and the walls with greater thicknesses had smaller deformations. The rigid model and the fluid-solid coupled model showed more differences in the wall shear stress and blood flow velocity than in pressure.</p><p><b>CONCLUSION</b>The fluid-solid coupled model more accurately represents the actual condition of the intracranial aneurysm than the rigid model. The results of numerical simulation with the model are reliable to study the origin, growth and rupture of the aneurysms.</p>

Effect of hydroxyethyl starch on tissue perfusion and serum TNF-α、IL-6、IL-8 levels in patients with severe acute pancreatitis / 中国基层医药

Objective To observe effects of hydroxyethyl starch(130/0.4,voluven)on tissue perfusion and serum TNF-α,IL-6,IL-8 levels in patients with severe acute pancreatitis(SAP).Methods 60 SAP patients with non-operative treatment were randomly divided into voluven group and Ringer's solution group(n =30 per group).In addition to conventional drugs and treatment,of which voluven group daily 15ml/kg intravenously for 5 d;Ringer's solution group daily 20ml/kg intravenously for 5d.Hemodynamic parameters and tissue perfusion indicators were monitored,TN F-α,IL-6,IL-8 levels were examined after treatment 0,12,24,48,96 hours.Results Compared with Ringer solution group,Voluven group therapy high efficiency,faster raise MAP,ScvO2,Phi value,lower HR,Hct(t =2.785,3.126,4.132,3.168,2.218,all P ＜ 0.05).TNFα,IL-6 after 48h treatment,IL-8 after 96h treatment,both groups were significantly decreased,but the voluven group was significantly lower than Ringer's solution group(P ＜ 0.05).Conclusion Voluven could effectively and quickly maintain hemodynamic stability,improve the hemorheological and tissue perfusion,could be more conducive to improving the pancreatic microcirculation,thus inhibiting inflammatory cytokines TNF-α,IL-6,IL-8 release,and had favorable treatment effect on patients with SAP.

Efficiency of Ozone in Inactivation of f_2 Phage in Water / 环境与健康杂志

Objective To observe the efficacy of ozone in the inactivation of f2 phage in water. Methods The concentration of ozone in water was measured by iodometry. During the experiment,the suspension of f2 phage was added in the ozonized water, at 5,15,30 min, the f2 phage inactivation rate was calculated. Results Under the same condition of ventilation,in the range of pH regulated in the drinking water sanitary standard,the effect of pH on the inactivation of f2 phage was not obvious, while the chromaticity of water could remarkably influence the inactivation of f2 phage. Conclusion The higher chromaticity of water can interfere the inactivation of f2 phage in water by ozone.

TiO_2 Photocatalyst and Its Application in Water Treatment / 环境与健康杂志

The paper reviews the basic mechanism of photocatalytic oxidation, the kinds of photocatalyst, the characteristics of TiO2 and the commonly used carriers of TiO 2 photocatalytic oxidation in water treatment, the degradation of organic pollutants in water by photocatalytic oxidation and the applications of this new technique in tap water purification. The photocatalytic oxidation as a new technique of environmental protection is being much con-cerned widely.