An Unusual Anatomical Variation of Accessory Left Gastric Artery Arising from Left Hepatic Artery / Una Variación Anatómica Inusual de la Arteria Gástrica Izquierda Accesoria que se Origina de la Arteria Hepática Izquierda

SUMMARY: The stomach receives a rich blood supply from five sets of arteries, all of which originate from the celiac trunk. During the dissection of a female cadaver that had been fixed with formalin, an atypical branching pattern was observed. An accessory left gastric artery was found to originate from the left hepatic artery and send small branches to the esophagus, cardia, and fundus of the stomach. However, there was no anastomosis between the lower accessory left gastric artery and the left gastric artery. This is a rare variant of the gastric artery that has not been previously described in detail. It is important to recognize this variation for safe and effective interventional diagnosis and treatment techniques if dealing with the liver or gastric arteries.

El estómago recibe un rico suministro de sangre de cinco conjuntos de arterias, todas las cuales se originan en el tronco celíaco. Durante la disección de un cadáver femenino que había sido fijado con formalina, se observó un patrón de ramificación atípico. Se encontró una arteria gástrica izquierda accesoria que se originaba en la arteria hepática izquierda y enviaba pequeñas ramas al esófago, el cardias y el fondo del estómago. Sin embargo, no hubo anastomosis entre la arteria gástrica izquierda accesoria inferior y la arteria gástrica izquierda. Se trata de una variante rara de la arteria gástrica que no se ha descrito previamente en detalles. Es importante reconocer esta variación para la aplicación de técnicas de diagnóstico y tratamiento intervencionistas seguras y efectivas a nivel del hígado o las arterias gástricas.

A rare variation of radial nerve coexisting with the intercalated ectopic muscle from latissimus dorsi muscle / Una rara variación del nervio radial que coexiste con el músculo ectópico intercalado del músculo latísimo del dorso

SUMMARY: The axilla is the main communication channel connecting the upper limbs, the neck and chest. Stabilization of the internal structure is essential for upper limb and shoulder mobility. In this case, we observed and recorded the characteristics of the variation of the radial nerve as well as the intercalated ectopic muscle from latissimus dorsi muscle. The position relationship between both, was also particularly noted by us. In view of the presence of the variation we reported, related clinical research, surgery and disease diagnosis are expected to take this case into account.

La axila es el principal canal de comunicación que conecta los miembros superiores, el cuello y el tórax. La estabilización de la estructura interna es fundamental para la movilidad del miembro superior y del hombro. En este caso observamos y registramos las características de la variación del nervio radial así como del músculo ectópico intercalado del músculo latísimo del dorso. La relación de posición entre ambas también fue significativa en este estudio. En vista de la presencia de la variación que informamos, se espera que la investigación clínica relacionada con la cirugía y el diagnóstico de la enfermedad tengan en cuenta este caso.

Curcumin alleviates nuclear factor-κB/NOD-like receptor protein 3 mediated renal injury caused by acute respiratory distress syndrome through reducing mitochondrial oxidative stress / 中华危重病急救医学

OBJECTIVE@#To evaluate the effect of curcumin on renal mitochondrial oxidative stress, nuclear factor-κB/NOD-like receptor protein 3 (NF-κB/NLRP3) inflammatory body signaling pathway and tissue cell injury in rats with acute respiratory distress syndrome (ARDS).@*METHODS@#A total of 24 specific pathogen free (SPF)-grade healthy male Sprague-Dawley (SD) rats were randomly divided into control group, ARDS model group, and low-dose and high-dose curcumin groups, with 6 rats in each group. The ARDS rat model was reproduced by intratracheal administration of lipopolysaccharide (LPS) at 4 mg/kg via aerosol inhalation. The control group was given 2 mL/kg of normal saline. The low-dose and high-dose curcumin groups were administered 100 mg/kg or 200 mg/kg curcumin by gavage 24 hours after model reproduction, once a day. The control group and ARDS model group were given an equivalent amount of normal saline. After 7 days, blood samples were collected from the inferior vena cava, and the levels of neutrophil gelatinase-associated lipocalin (NGAL) in serum were determined by enzyme-linked immunosorbent assay (ELISA). The rats were sacrificed, and kidney tissues were collected. Reactive oxygen species (ROS) levels were determined by ELISA, superoxide dismutase (SOD) activity was detected using the xanthine oxidase method, and malondialdehyde (MDA) levels were determined by colorimetric method. The protein expressions of hypoxia-inducible factor-1α (HIF-1α), caspase-3, NF-κB p65, and Toll-like receptor 4 (TLR4) were detected by Western blotting. The mRNA expressions of HIF-1α, NLRP3, and interleukin-1β (IL-1β) were detected by reverse transcription-polymerase chain reaction (RT-PCR). Renal cell apoptosis was detected by TdT-mediated dUTP nick end labeling (TUNEL). The morphological changes in renal tubular epithelial cells and mitochondria were observed under a transmission electron microscope.@*RESULTS@#Compared with the control group, the ARDS model group exhibited kidney oxidative stress and inflammatory response, significantly elevated serum levels of kidney injury biomarker NGAL, activated NF-κB/NLRP3 inflammasome signaling pathway, increased kidney tissue cell apoptosis rate, and renal tubular epithelial cell damage and mitochondrial integrity destruction under transmission electron microscopy, indicating successful induction of kidney injury. Following curcumin intervention, the injury to renal tubular epithelial cells and mitochondria in the rats was significantly mitigated, along with a noticeable reduction in oxidative stress, inhibition of the NF-κB/NLRP3 inflammasome signaling pathway, and a significant decrease in kidney tissue cell apoptosis rate, demonstrating a certain dose-dependency. Compared with the ARDS model group, the high-dose curcumin group exhibited significantly reduced serum NGAL levels and kidney tissue MDA and ROS levels [NGAL (μg/L): 13.8±1.7 vs. 29.6±2.7, MDA (nmol/g): 115±18 vs. 300±47, ROS (kU/L): 75±19 vs. 260±15, all P < 0.05], significantly down-regulated protein expressions of HIF-1α, caspase-3, NF-κB p65, and TLR4 in the kidney tissue [HIF-1α protein (HIF-1α/β-actin): 0.515±0.064 vs. 0.888±0.055, caspase-3 protein (caspase-3/β-actin): 0.549±0.105 vs. 0.958±0.054, NF-κB p65 protein (NF-κB p65/β-actin): 0.428±0.166 vs. 0.900±0.059, TLR4 protein (TLR4/β-actin): 0.683±0.048 vs. 1.093±0.097, all P < 0.05], and significantly down-regulated mRNA expressions of HIF-1α, NLRP3, and IL-1β [HIF-1α mRNA (2-ΔΔCt): 2.90±0.39 vs. 9.49±1.87, NLRP3 mRNA (2-ΔΔCt): 2.07±0.21 vs. 6.13±1.32, IL-1β mRNA (2-ΔΔCt): 1.43±0.24 vs. 3.95±0.51, all P < 0.05], and significantly decreased kidney tissue cell apoptosis rate [(4.36±0.92)% vs. (27.75±8.31)%, P < 0.05], and significantly increased SOD activity (kU/g: 648±34 vs. 430±47, P < 0.05).@*CONCLUSIONS@#Curcumin can alleviate kidney injury in ARDS rats, and its mechanism may be related to the increasing in SOD activity, reduction of oxidative stress, and inhibition of the activation of the NF-κB/NLRP3 inflammasome signaling pathway.

Proliferation Inhibitory Activity of Quinones from Blaps rynchopetera Defense Secretion on Colorectal Tumor Cells / 中国结合医学杂志

OBJECTIVE@#To explore the proliferation inhibitory effect of quinones from Blaps rynchopetera defense secretion on colorectal tumor cell lines.@*METHODS@#Human colorectal cancer cell HT-29, human colorectal adenocarcinoma cell Caco-2 and normal human colon epithelial cell CCD841 were chosen for the evaluation of inhibitory activity of the main quinones of B. rynchopetera defense secretion, including methyl p-benzoquinone (MBQ), ethyl p-benzoquinone (EBQ), and methyl hydroquinone (MHQ), through methyl thiazolyl tetrazolium assay. The tumor-related factors, cell cycles, related gene expressions and protein levels were detected by enzyme-linked immunosorbent assy, flow cytometry, RT-polymerase chain reaction and Western blot, respectively.@*RESULTS@#MBQ, EBQ, and MHQ could significantly inhibit the proliferation of Caco-2, with half maximal inhibitory concentration (IC50) values of 7.04 ± 0.88, 10.92 ± 0.32, 9.35 ± 0.83, HT-29, with IC50 values of 14.90 ± 2.71, 20.50 ± 6.37, 13.90 ± 1.30, and CCD841, with IC50 values of 11.40 ± 0.68, 7.02 ± 0.44 and 7.83 ± 0.05 µg/mL, respectively. Tested quinones can reduce the expression of tumor-related factors tumor necrosis factor α, interleukin (IL)-10, and IL-6 in HT-29 cells, selectively promote apoptosis, and regulate the cell cycle which can reduce the proportion of cells in the G1 phase and increase the proportion of the S phase. Meanwhile, tested quinones could up-regulate mRNA and protein expression of GSK-3β and APC, while down-regulate that of β-catenin, Frizzled1, c-Myc, and CyclinD1 in the Wnt/β-catenin pathway of HT-29 cells.@*CONCLUSION@#Quinones from B. rynchopetera defense secretion could inhibit the proliferation of colorectal tumor cells and reduce the expression of related factors, which would be functioned by regulating cell cycle, selectively promoting apoptosis, and affecting Wnt/β-catenin pathway-related mRNA and protein expressions.

Regulation of myocardial ischemia reperfusion injury signal pathway by flavonoid monomer / 中国中药杂志

Acute myocardial infarction seriously endangers the health of people due to its high morbidity and high mortality. Reperfusion strategy is the preferred treatment strategy for acute myocardial infarction. However, reperfusion may lead to additional heart damage, namely myocardial ischemia reperfusion injury(MIRI). Therefore, how to reduce myocardial ischemia reperfusion injury has become one of the urgent problems to be solved in cardiovascular disease. Traditional Chinese medicine(TCM) has the multi-component, multi-channel, and multi-target advantages in the treatment of MIRI, which offers new ideas in this aspect. TCM containing flavonoids has a variety of biological activities and plays a significant role in the treatment of MIRI, which has great research and development application value. TCM containing flavonoids can regulate multiple signaling pathways of MIRI, such as phosphatidylinositol 3 kinase/kinase B(PI3K/Akt) signaling pathway, Janus kinase/signal transducer and activator of transcriptions(JAK/STAT) signaling pathway, adenosine 5'-monophosphate(AMP)-activated protein kinase(AMPK) signaling pathway, mitogen-activated protein kinase(MAPK) signaling pathway, nuclear factor-erythroid 2-related factor 2/antioxidant response element(Nrf2/ARE) signaling pathway, nuclear factor kappa-B(NF-κB) signaling pathway, silent information regulator 1(Sirt1) signaling pathway, and Notch signaling pathway. It reduces MIRI by inhibiting calcium overload, improving energy metabolism, regulating autophagy, and inhibiting ferroptosis and apoptosis. Therefore, a review has been made based on the regulation of relative signaling pathways against MIRI by TCM containing flavonoids, thus providing theoretical support and potential therapeutic strategies for TCM to alleviate MIRI.

Research advances in chest tightness variant asthma / 中华预防医学杂志

Chest tightness variant asthma (CTVA) is a special type of asthma with chest tightness as the only or main symptom. Due to the lack of typical asthma symptoms such as coughing, wheezing, shortness of breath, and positive signs in chest, it is easy to be missed or misdiagnosed in clinical practice. The onset of chest tightness variant asthma is insidious, and there is few research and attention both domestic and international, so there is no unified diagnosis and treatment standard especially in childhood asthma. This article expounds the related research advances in chest tightness variant asthma, in order to increase clinical attention and provide reference and basis for the prevention of the disease as well as the formulation of diagnosis and treatment strategies.

Research progress on the diagnosis and treatment of demodex blepharitis / 国际眼科杂志(Guoji Yanke Zazhi)

Demodex is one of the most common parasites in the human body. It can be classified into demodex folliculorum and demodex brevis based on the parasitic sites. It is an opportunistic pathogenic microorganism, and clinical symptoms may not appear in part of infected people, but the parasite can cause multiple common ocular diseases represented by blepharitis. Its typical symptoms include dry eyes, foreign body sensation in eyes, secretion attached to eyelashes, and ocular surface irritation. The diagnosis of demodex blepharitis should be based on the clinical manifestations and the results of etiological tests. The treatment is related to many kinds of drugs including plant essential oil and physical therapy. At present, diagnosing and treating demodex blepharitis is increasingly sophisticated, but the relationship between demodex infection and its pathogenicity remains unclear. This paper summarizes the current characteristics of demodex and the clinical manifestation, diagnosis, treatment, and existing issues of demodex blepharitis, hoping to provide a reference for future studies in demodex.

Clinical characteristics of IgE-mediated cow's milk protein allergy in children / 中华儿科杂志

Objective: To analyze the clinical features of IgE-mediated cow's milk protein allergy (CMPA) in children aged 0-5 years. Methods: This cross-sectional study collected the data on children diagnosed with CMPA in the Department of Allergy at the Children's Hospital of the Capital Institute of Pediatrics from October 2019 to November 2020 and improved peripheral blood routine,total IgE defection, milk specific IgE (sIgE) defection,SPT and milk component defection,diagnosis of severe anaphylaxis based on clinical manifestations. Rank-sum test and chi-square test are used for statistical analysis of clinical characteristics between groups. Results: A total of 106 children (67 boys and 39 girls) were enrolled with the age of 15 (8, 34) months, including 42 cases (≤ 1 year of age), 39 cases (>1-<3 years of age) and 25 cases(≥3 years of age), the onset age of 6 (5, 8) months. Among them, 95 cases (89.6%) were reacted after consuming milk or its products, 42 cases (39.6%) had reaction due to skin contact and 11 cases (10.4%) reacted after exclusive breastfeeding. The onset time of milk product consumption was 45 (1, 120) min, skin contact pathway was 10 (5, 30) min and symptoms in breastfeeding pathway was 121 (61, 180) min. There was statistical difference among the time of symptoms (χ2=77.01, P<0.001).The cutaneous reaction was most common (100 cases, 94.3%), followed by digestive (20 cases, 18.9%) and respiratory (16 cases, 15.1%), and the nervous symptoms (1 case, 0.9%) were uncommon and 24 cases (22.6%) had at least one episode of anaphylaxis. There were 87 cases (82.1%) also diagnosed with other food allergies, 94 cases (88.7%) with previous eczema, 57 cases (53.8%) with history of rhinitis, and 23 cases (21.7%) with history of wheezing. The total IgE level was 191.01 (64.71, 506.80) kU/L, and the cow's milk sIgE level was 3.03 (1.11, 15.24) kU/L. The maximum diameter of the wheal in SPT was 8.2 (4.0, 12.0) mm. Component resolved diagnosis showed that 77 cases (81.9%) were sensitized to at least one out of 4 main components, including casein, α lactalbumin, β lactoglobulin and bovine serum albumin.The possibility of anaphylaxis in children with milk sIgE grade Ⅳ-Ⅵ was higher than that in children with grade 0-Ⅲ (57.7% (15/26) vs. 12.5% (10/80), OR=9.545, 95%CI 3.435-26.523). Children with milk SPT ≥+++ had a higher probability of anaphylaxis than those with milk SPT ≤++ (34.4% (11/32) vs. 11.5% (3/26), OR=4.016, 95%CI 0.983-16.400). Anaphylaxis were more common in α lactalbumin positive children than in negative children (34.3% (13/38) vs. 14.2% (8/56), χ2=1.23，P=0.042). Conclusions: CMPA in children has early onset and diversified clinical manifestations, which are mainly cutaneous symptoms. Most children are sensitized to at least one allergen component. Serum sIgE level, SPT reaction and allergen components play important roles in the diagnosis and evaluation of CMPA, and higher milk sIgE level may predict a higher risk of anaphylaxis.

Ultrasonic differential diagnosis analysis of female urethral diverticulum and vaginal wall cyst / 中华超声影像学杂志

Objective:To explore the clinical and ultrasound image characteristics and differential diagnosis of female urethral diverticulum(UD) and vaginal wall cysts.Methods:A retrospective analysis of the clinical and ultrasound image features of 12 female patients with UD were collected as UD group and 30 patients with vaginal wall cysts confirmed by surgical pathology and clinical follow-up were collected as vaginal wall cysts group in Peking Union Medical College Hospital from January 2017 to May 2021. Ultrasound image characteristics, and the main points of the differential diagnosis of the two were analyzed and summarized.Results:There were no significant differences in the age of the patients and the maximum diameter of the lesions between UD group and vaginal wall cysts group(all P>0.05). Eight cases (66.7%) of female patients with UD had urinary system symptoms, 5 cases (16.7%) of vaginal wall cysts had urinary system symptoms, the difference was statistically significant ( P<0.05); In 10 cases (83.3%) the UD lesions were located in the upper middle and upper pelvic floor, and vaginal wall cyst lesions in 23 cases (76.7%) were located in the lower middle and lower pelvic floor, the difference was statistically significant ( P<0.05). In terms of ultrasound image characteristics, UD lesions were often irregular in shape, surrounding the urethra, with unclear borders, cyst wall thickness >0.1 cm, internal wall not smooth along with calcification, internal visible separation, partly visible to the urethra, and peripheral blood flow signals were abundant. Vaginal wall cysts were mostly round-shaped, not surrounding the urethra, clear borders, thin and smooth walls, less internal partitions, not communication with the urethra, and the peripheral blood flow signals were not abundant. The differences between the two group were statistically significant (all P<0.05). Whether the sound transmission inside the lesion was not statistically significant ( P>0.05). Conclusions:Combined with urinary system symptoms, lesion location, ultrasound characteristics (morphology, whether surrounding the urethra, boundary, cyst wall thickness, inner wall calcification, internal separation, whether it is connected to the urethra, blood flow distribution) can be used to distinguish between UD and vaginal wall cysts, whether the sound transmission inside the lesion cannot be used as the basis for the differential diagnosis of the two.

The effect of dexmedetomidine combined with thoracic paravertebral block on sleep quality, serum interleukin -6 and high mobility group protein-1 in patients undergoing thoracoscopic pulmonary surgery / 中国医师进修杂志

Objective:To analyze the effect of dexmedetomidine combined with thoracic paravertebral block (TPVB) on sleep quality, serum interleukin-6 (IL-6) and high mobility group protein (HMGB-1) levels in patients undergoing thoracoscopic pulmonary surgery.Methods:The clinical data of 90 patients who received thoracoscopic pulmonary surgery from January 2020 to January 2021 in Affiliated Hospital of Xuzhou Medical University were retrospectively analyzed. Among them, 45 patients were given dexmedetomidine combined with TPVB before operation (experiment group), and 45 patients were given TPVB before operation (control group). The indexes of sleep quality were recorded, including Pittsburgh sleep quality index (PSQI) and total sleep time 24 and 48 h after operation. The visual analogue score (VAS) during quiet and cough 1, 6, 12, 24 and 48 h after operation were recorded. The serum substance P (SP), 5-hydroxytryptamine (5-HT), C-reactive protein (CRP), IL-6 and HMGB-1 before operation and 1 d after operation were detected. The adverse reactions were compared between 2 groups.Results:The PSQI 24 and 48 h after operation in experiment group was significantly lower than that in control group: (11.38±4.61) scores vs. (13.65±2.72) scores and (8.78±3.79) scores vs. (10.95±2.81) scores, the total sleep time was significantly longer than that in control group: (7.71±2.64) h vs. (5.49±2.10) h and (9.75±3.14) h vs. (7.82±2.67) h, and there were statistical differences ( P<0.01). The VAS during quiet and cough 1, 6 and 12 h after operation in experiment group was significantly lower than that in control group, and there was statistical difference ( P<0.01); there was no statistical difference in the VAS during quiet and cough 24 and 48 h after operation between 2 groups ( P>0.05). There were no statistical differences in serum SP, 5-HT, CRP, IL-6 and HMGB-1 before operation between 2 groups ( P>0.05); the SP, 5-HT, CRP, IL-6 and HMGB-1 1 d after operation in experiment group were significantly lower than those in control group: (132.59±10.34) ng/L vs. (141.57±12.26) ng/L, (0.73±0.11) μmol/L vs. (0.95±0.09) μmol/L, (32.46±3.54) mg/L vs. (38.53±4.12) mg/L, (145.67±24.68) ng/L vs. (162.79±23.51) ng/L and (70.35±6.81) ng/L vs. (92.36±7.08) ng/L, and there were statistical differences ( P<0.01). The incidence of adverse reactions in experiment group was significantly lower than that in control group: 20.00% (9/45) vs. 48.89% (22/45), and there was statistical difference ( χ2 = 8.32, P = 0.004). Conclusions:Dexmedetomidine combined with TPVB can effectively improve postoperative sleep quality of patients undergoing thoracoscopic pulmonary surgery, relieve pain, and reduce postoperative serum pain mediators and inflammatory factors, with fewer adverse reactions.

The Anesthesiology Milestones 2.0 an competency-based assessment for residency training in the United States: an interpretation / 中华麻醉学杂志

From a time-based to a competency-based medical education, the evolution of residency training began nearly 30 years ago, the development of valid and reproducible assessment tools faces challenges.Medical educators across specialties remain motivated to develop a relevant, generalizable, and measurable system.The Accreditation Council for Graduate Medical Education (ACGME) in the United States commits to the responsibility by assuring that the process and outcome of graduate medical education (GME) in the national residency programs produce competent, safe, and compassionate doctors.The Milestones Project is the ACGME′s evolution to a competency-based system, which allows each specialty to develop its own subcompetencies and 5-level progression of Milestones, along a continuum of novice to expert.Milestones 1.0 provided important foundational information and insights for the education community, that has had nearly 5 years of experience for residency training in Anesthesiology, needs to be improved.Milestones 1.0 highlighted challenges with assessment and evaluation of residents, some mismatch between subcompetencies and current and future clinical practices in Anesthesiology, and the need for faculty development tools.The ACGME assembled representatives from stakeholder groups using an iterative process within the Anesthesiology community to develop the second generation of Milestones in 2021.This article describes Milestones 2.0 for residency training in Anesthesiology in the United States, emphasizing the rationality and practicability, to provide evidence for residency training in Anesthesiology in China.There is a lack of systematic, cooperative and continuous research on medical education in Anesthesiology in China, and a lack of competency-based and milestone-based residency training in Anesthesiology.It is urgent to narrow the gap between developed countries and China to improve medical education and training in Anesthesiology.

A new type of extreme insulin resistance—type C insulin resistance syndrome and its clinical characteristics / 中华内分泌代谢杂志

We report on two cases of type C insulin resistance syndrome(TCIRS) admitted to the Department of Endocrinology, Peking Union Medical College Hospital from January 2000 to December 2020. Both patients presented with persistent hyperglycemia, low immunoreactive insulin, extreme insulin resistance, high insulin autoantibodies, high total insulin, and large insulin antibody pool. TCIRS is marked by extreme insulin resistance with ketoacidosis and respond to medium to high doses glucocorticoids rather than plasmapheresis.

Initial establishment of digital reference standardized crown models of the primary teeth / 北京大学学报(医学版)

OBJECTIVE@#To explore the construction process of the digital reference crown models, and to initially establish the digital reference crown models of the primary teeth to lay the foundation for the establishment of the standardized crown models and the future related applications of computer-aided design/computer-aided manufacture (CAD/CAM) technology to pediatric dentistry.@*METHODS@#This study randomly selected children who were caries free, aged from 4 to 5 years in several kindergartens of Haidian District of Beijing.Plaster dental models were made for the children after taking complete impressions.The digital dental models were reconstructed by using the three-dimensional (3D) dental model scanner.And then, Geomagic Studio, a 3D reverse engineering software, was employed to extract the single dental crown data, the mesiodistal and buccolingual diameters and the height of the crowns were measured.The object was reduced or enlarged by a numerical factor, and then the size of each dental crown was standardized.A total of 3-5 points features on the crown were created, and all the objects were aligned through the functions of feature-based alignment.Finally, through average-based object creation and smoothing, the digital models of reference crowns of the primary teeth were established.@*RESULTS@#A total of 40 plaster dental models from 16 boys and 26 girls were selected out for our further study.The digital dental models were reconstructed, and the mesiodistal and buccolingual diameters and the height of the crowns were measured by using reverse engineering technology.Comparing the results of using mesiodistal diameter, buccolingual diameter and height as the standards, we chose the mesiodistal diameters of crowns to do the standardization, and successfully established the digital reference models of 20 primary teeth crowns with detailed surface characteristics.@*CONCLUSION@#In this study, the digital reference crown models of the primary teeth were established by reverse engineering technology, providing reference value for the standardized crown models and application for clinical practice, scientific research and teaching.Furthermore, this study also contributes to the extensive application of CAD/CAM technology in pediatric dentistry and the development of CAD/CAM dental systems with independent intellectual property rights.

KCNQ Channels in the Mesolimbic Reward Circuit Regulate Nociception in Chronic Pain in Mice / 神经科学通报·英文版

Mesocorticolimbic dopaminergic (DA) neurons have been implicated in regulating nociception in chronic pain, yet the mechanisms are barely understood. Here, we found that chronic constructive injury (CCI) in mice increased the firing activity and decreased the KCNQ channel-mediated M-currents in ventral tegmental area (VTA) DA neurons projecting to the nucleus accumbens (NAc). Chemogenetic inhibition of the VTA-to-NAc DA neurons alleviated CCI-induced thermal nociception. Opposite changes in the firing activity and M-currents were recorded in VTA DA neurons projecting to the medial prefrontal cortex (mPFC) but did not affect nociception. In addition, intra-VTA injection of retigabine, a KCNQ opener, while reversing the changes of the VTA-to-NAc DA neurons, alleviated CCI-induced nociception, and this was abolished by injecting exogenous BDNF into the NAc. Taken together, these findings highlight a vital role of KCNQ channel-mediated modulation of mesolimbic DA activity in regulating thermal nociception in the chronic pain state.

Demethylzeylasteral (T-96) initiates extrinsic apoptosis against prostate cancer cells by inducing ROS-mediated ER stress and suppressing autophagic flux

BACKGROUND: Demethylzeylasteral (T-96) is a pharmacologically active triterpenoid monomer extracted from Tripterygium wilfordii Hook F (TWHF) that has been reported to exhibit anti-neoplastic effects against several types of cancer cells. However, the potential anti-tumour effects of T-96 against human Prostate cancer (CaP) cells and the possible underlying mechanisms have not been well studied. RESULTS: In the current study, T-96 exerted significant cytotoxicity to CaP cells in vitro and induced cell cycle arrest at S-phase in a dose-dependent manner. Mechanistically, T-96 promoted the initiation of autophagy but inhibited autophagic flux by inducing ROS-mediated endoplasmic reticulum (ER) stress which subsequently activated the extrinsic apoptosis pathway in CaP cells. These findings implied that T-96-induced ER stress activated the caspase-dependent apoptosis pathway to inhibit proliferation of CaP cells. Moreover, we observed that T-96 enhances the sensitivity of CaP cells to the chemotherapeutic drug, cisplatin. CONCLUSIONS: Taken together, our data demonstrated that T-96 is a novel modulator of ER stress and autophagy, and has potential therapeutic applications against CaP in the clinic.

Establishment and validation of prediction model for postoperative sleep disturbance in patients undergoing non-cardiac surgery / 中华麻醉学杂志

Objective:To establish and validate the prediction model for postoperative sleep disturbance (PSD) in patients undergoing non-cardiac surgery.Methods:A total of 454 patients of both sexes, aged≥18 yr, of American Society of Anesthesiologists physical statusⅠ-Ⅲ, underwent non-cardiac surgery under general anesthesia from November 2019 to September 2020 were selected.The perioperative data were collected.The patients were divided into training set and validation set with a ratio of 7∶3 by using a simple random sampling method.The characteristic variables of PSD were selected using LASSO regression analysis and the independent risk factors were identified using multivariate logistic regression analysis in training set.Akaike′s information criterion was used to evaluate the quality of fit of the model.The nomogram of PSD in non-cardiac surgery patients was constructed based on the identified factors.The discrimination of the model was evaluated using receiver operating characteristic (ROC) curve, and the agreement of the model was evaluated using Hosmer-Lemeshow goodness-of-fit test and Brier score.Results:Seven risk factors (gender, preoperative anxiety, satisfaction with the ward environment, anesthesia time, the intraoperative consumption of midazolam and sufentanil and numerical rating scale (NRS) score at 3 days after operation) and two related factors (preoperative NRS score and general anesthesia combined with nerve block) were used to establish and verify the PSD nomogram.The area under the ROC curve was 0.805 (95% confidence interval [CI] 0.721-0.848) in training set.The area under the ROC curve was 0.773 (95% CI 0.684-0.876) in validation set.In training and validation sets, the calibration curves were tested by Hosmer-Lemeshow good of fit test, the P values were 0.590 and 0.950, respectively, and the Brier scores were 0.154 and 0.156, respectively.The nomogram predicated that the sensitivity (95% CI) and specificity (95%CI) were 81.83% (60.32%-95.14%) and 78.15% (71.83%-83.25%), respectively, in training set, and the sensitivity (95% CI) and specificity (95%CI) were 77.86% (39.84%-97.25%) and 78.15% 77.86% (68.74%-85.48%), respectively, in validation set.The optimal cut-off value of nomogram score was 113. Conclusion:In this study, the nomogram prediction model for PSD in patients undergoing non-cardiac surgery has been successfully established, which can visually and individually predict the risk of PSD.

Analysis of the association between health-related quality of life with social support and negative emotions among ethnic Korean children and adolescents / 中国学校卫生

Objective@#To understand the health-related quality of life status of ethnic Korean children and adolescents and its relationship with social support and negative emotions, and to provide assistance to the healthy development of ethnic Korean children and adolescents.@*Methods@#From April to June 2018 in Jilin Province, 4 024 ethnic Korean children and adolescents were selected for the survey of quality of life, social support, and negative emotion, and multiple linear regression analysis was used to understand the relationships between them.@*Results@#The average score of the quality of life of ethnic Korean children and adolescents was (81.01±12.64)points. The average scores for school function, emotional function, social function and physiological function were (80.16±15.36) points, (73.07±19.85) points, (88.52±14.03) points and (82.65±14.17) points, respectively. Multiple linear regression analysis showed that the negative emotions of ethnic Korean primary and middle school students had a negative association with effect on quality of life (β=-0.24, P<0.01), social support had a positive predictive effect on quality of life (β=0.17, P<0.01), and the interaction between negative emotions and social support played a negative role in quality of life of ethnic Korean primary and middle school students (β =-0.19, P<0.01).@*Conclusion@#The health-related quality of life of ethnic Korean children and adolescents is acceptable. Social support can alleviate negative emotions to reduce the impact of negative emotions on quality of life.

Effect of Nrf2/HO-1 signaling pathway in intestinal protection by Sishen Pills against ulcerative colitis in mice / 中国中药杂志

The present study aimed to explore the effect of nuclear factor erythroid 2 related factor 2(Nrf2)/heme oxygenase-1(HO-1) signaling pathway in intestinal protection by Sishen Pills against ulcerative colitis(UC). After the UC model was induced by 3% dextran sodium sulfate(DSS), experimental animals were randomly divided into control group, model group, salazosulfapyridine(SASP) group, and low-and high-dose Sishen Pills groups. Drug intervention(ig) was performed for seven consecutive days during modeling. On the 7 th day, the mice were euthanized. The body weight and colon length were recorded, and the histopathological changes of the colon were observed by HE staining. Serum interleukin-6(IL-6), tumor necrosis factor-α(TNF-α), total antioxidant capacity(T-AOC), malondialdehyde(MDA), and reactive oxygen species(ROS) were detected by ELISA. The protein and mRNA expression of Nrf2, HO-1, and NADPH quinine oxidoreductase-1(NQO-1) was determined by Western blot and reverse transcription-polymerase chain reaction(RT-PCR). Compared with the normal group, the model group exhibited reduced body weight, colon length, and T-AOC, increased IL-6, TNF-α, MDA, and ROS, and diminished protein and mRNA expression of Nrf2, HO-1, and NQO-1 in the colon tissues. Compared with the model group, the SASP group and high-dose Sishen Pills group showed elevated body weight, colon length, and T-AOC, lowered IL-6, TNF-α, MDA, and ROS levels, and increased protein and mRNA expression of Nrf2, HO-1, and NQO-1 in the colon tissues. As assessed by HE staining, Sishen Pills could improve the pathological changes of the colon. The findings suggested that Sishen Pills could protect the colon against UC induced by 3% DSS. The specific mechanism of action may be related to the anti-inflammatory and anti-oxidative stress effects by the activation of the Nrf2/HO-1 signaling pathway.

Development of a perioperative nursing quality evaluation indicator system for lobectomy patients with Da Vinci robotic under enhanced recovery after surgery / 中国实用护理杂志

Objective:To develop nursing quality evaluation indicator system for perioperative patients with Da Vinci robotic under enhanced recovery after surgery(ERAS), in order to provide references for clinical evaluation of nursing quality for lobectomy patients.Methods:Based on the theory of structure-process-outcome quality model and ERAS, literature review, semi-structured interviews were adopted to determine nursing quality indicator system for perioperative patients. Delphi method was used in two rounds of consultation among 21 experts.Results:The positive coefficient was 100%, authority coefficient was 0.839,0.901, and the coefficients of concordance were 0.317,0.335. The final indicator system consisted of 3 first-level indicators, 14 second-level indicators, and 52 third-level indicators.Conclusion:The nursing quality evaluation indicator system for lobectomy patients with Da Vinci robotic was scientific and reliable, which can provide scientific references for evaluating nursing quality for perioperative patients with Da Vinci robotic under ERAS.

Diagnostic value of 4-dimensional computed tomography in preoperative localization in patients with primary hyperparathyroidism / 中华内科杂志

Objective:To provide more options for preoperative localization diagnosis in patients with primary hyperparathyroidism (PHPT), the diagnostic efficacy of parathyroid 4-dimensional computed tomography (4D-CT) in patients with PHPT was evaluated.Methods:This was a single-center retrospective study including 57 patients with surgical proved PHPT. All of the patients underwent 4D-CT, 99Tc m -sestamibi parathyroid imaging (MIBI), and ultrasonography (US) preoperatively. The reference standard for correct localization was based on operation reports and pathology confirmation. The patients were grouped according to the preoperative serum calcium levels, tumor diameter, or ectopic lesions (yes/no), respectively. The sensitivity, specificity, positive predictive value, negative predictive value and area under the curve (AUC) of 4D-CT, MIBI and US, alone or in combination, were analyzed in total and each subgroup patients. Results:Fifty-seven patients (39 women, 18 men; mean age of 56.5 years) were evaluated, including four cases with multi-gland disease and thirteen cases with ectopic parathyroid lesions. In all the patients, similar diagnostic efficacy was found in 4D-CT (AUC: 0.943) and MIBI (AUC: 0.927), both of which were higher than that of US (AUC: 0.847) ( P = 0.01 for 4D-CT vs. US; P = 0.04 for MIBI vs. US). In a subset analysis for ectopic quadrants, the diagnostic efficacy of 4D-CT was significantly higher than that of MIBI ( P = 0.04) or US ( P = 0.01), with the sensitivity of 100%, 69.2%, and 61.5%, and AUC of 0.989, 0.846, and 0.808 for 4D-CT, MIBI and US, respectively. Conclusions:4D-CT has similar diagnostic efficacy for preoperative localization to MIBI in patients with PHPT, and it is superior to MIBI and US in identifying the ectopic parathyroid gland. 4D-CT can be recommended as an alternative preoperative localization method, especially when parathyroid lesions could not be precisely located by US and MIBI.