Techniques and classification of intersphincteric resection for ultra-low rectal cancer / 中华胃肠外科杂志

ISR is the most widely used anal-preserving operation for ultra-low rectal cancer. It can be divided into total ISR, subtotal ISR and partial ISR according to the resection range of internal sphincter. The advantage of ISR is that it can preserve the sphincter while ensuring the safety of oncology for ultra-low rectal cancer, representing the state of the art. However, it still needs to face the problem that the quality of life will decline due to poor postoperative anal function. The conformal sphincter-preserving operation (CSPO) is a functional anal-preserving surgery improved on the basis of ISR. It is superior to ISR in the postoperative anal function and patients' quality of life. So it can be a new choice for ultra-low rectal cancer.

The impact of extended waiting time on tumor regression after neoadjuvant chemoradiotherapy for locally advanced rectal cancer / 中华外科杂志

Objective: To investigate the influence of extending the waiting time on tumor regression after neoadjuvant chemoradiology (nCRT) in patients with locally advanced rectal cancer (LARC). Methods: Clinicopathological data from 728 LARC patients who completed nCRT treatment at the First Affiliated Hospital, Naval Medical University from January 2012 to December 2021 were collected for retrospective analysis. The primary research endpoint was the sustained complete response (SCR). There were 498 males and 230 females, with an age (M(IQR)) of 58 (15) years (range: 22 to 89 years). Logistic regression models were used to explore whether waiting time was an independent factor affecting SCR. Curve fitting was used to represent the relationship between the cumulative occurrence rate of SCR and the waiting time. The patients were divided into a conventional waiting time group (4 to <12 weeks, n=581) and an extended waiting time group (12 to<20 weeks, n=147). Comparisons regarding tumor regression, organ preservation, and surgical conditions between the two groups were made using the t test, Wilcoxon rank sum test, or χ2 test as appropriate. The Log-rank test was used to elucidate the survival discrepancies between the two groups. Results: The SCR rate of all patients was 21.6% (157/728). The waiting time was an independent influencing factor for SCR, with each additional day corresponding to an OR value of 1.010 (95%CI: 1.001 to 1.020, P=0.031). The cumulative rate of SCR occurrence gradually increased with the extension of waiting time, with the fastest increase between the 9th to <10th week. The SCR rate in the extended waiting time group was higher (27.9%(41/147) vs. 20.0%(116/581), χ2=3.901, P=0.048), and the organ preservation rate during the follow-up period was higher (21.1%(31/147) vs. 10.7%(62/581), χ2=10.510, P=0.001). The 3-year local recurrence/regrowth-free survival rates were 94.0% and 91.1%, the 3-year disease-free survival rates were 76.6% and 75.4%, and the 3-year overall survival rates were 95.6% and 92.2% for the conventional and extended waiting time groups, respectively, with no statistical differences in local recurrence/regrowth-free survival, disease-free survival and overall survival between the two groups (χ2=1.878, P=0.171; χ2=0.078, P=0.780; χ2=1.265, P=0.261). Conclusions: An extended waiting time is conducive to tumor regression, and extending the waiting time to 12 to <20 weeks after nCRT can improve the SCR rate and organ preservation rate, without increasing the difficulty of surgery or altering the oncological outcomes of patients.

Reappraisal of the lateral mesorectum and its clinical importance / 中华外科杂志

The mesentery has been defined as a double fold of the peritoneum connecting some regions of the intestine to the posterior abdominal wall. It emerges from the superior mesenteric root region and fans out to span the intestine from the duodenum to the rectum. The mesorectal is a continuation of the intraperitoneal mesentery in the pelvic cavity. The lateral structure of the rectum is complex and the traditional view calls it the lateral ligament of the rectal. However, this structure could be called the lateral mesorectum from the perspective of embryonic development and membrane anatomy. The lateral mesorectum is the bridge of the vessels, lymphatic, and nerves between the rectum and the pelvic wall. It anchors the rectum to the lateral pelvic wall and is the anatomical basis of lateral lymph node metastasis in low rectal cancer. Meanwhile, it is important to identify the lateral mesorectum and its surrounding structure to radically resect the tumor and protect the pelvic autonomic nerve during the total mesorectal excision procedure.

Effect of a novel radio-frequency atmospheric-pressure glow discharge plasma jet treatment on crosslinking of dentin collagen / 北京大学学报(医学版)

OBJECTIVE@#To investigate the effect of a noval radio-frequency atmospheric-pressure glow discharge (RF-APGD) plasma jet on crosslinking of dentin collagen.@*METHODS@#(1) Twenty intact third molars were collected. The middle dentin discs were prepared for each tooth by low-speed water-cooled Isomet saw, and then immersed in 10% (mass fraction) H3PO4 solution for 16 h to obtain fully demine-ralized dentin collagen. The twenty dentin discs were then randomly divided into five groups. The control group was untreated while the four experimental groups were treated by plasma jet with gas temperature of 4 ℃ for different times (20 s, 30 s, 40 s, and 50 s). The structure and crosslinking degree of dentin collagen were characterized by attenuated total reflection-Fourier transform infrared spectroscopy. The surface morphology of demineralized dentin was observed by scanning electron microscope, and the microstructure was observed by transmission electron microscope. (2) Fourty non-caries third molars were collected to prepare 5 g fine dentin powder, then completely demineralized with 10% H3PO4 solution. The control group was untreated, while the four experimental groups were treated by plasma jet for 20 s, 30 s, 40 s and 50 s. The crosslinking degree of each group was determined by ninhydrin colorimetric method. (3) Forty intact third molars were collected to obtain dentin strips. Only two central symmetrical dentin strips (nasty 80) were taken from each tooth and immersed in 10% H3PO4 solution for 16 h to obtain fully demineralized dentin collagen. Eighty dentine collagen fiber strips were randomly divided into five groups. The control group was untreated and the axial surfaces of dentin collagen fiber strips in the expe-rimental groups were treated with the plasma jet for 20 s, 30 s, 40 s and 50 s. The ultimate tensile strength of dentin was measured by universal mechanical machine.@*RESULTS@#(1) The surface morphology of demineralized dentin observed by scanning electron microscope showed that the network structure of collagen fibers on the surface of demineralized dentin treated with the plasma jet for 20 s, 30 s and 40 s could maintain the uncollapsed three-dimensional structure, and part of the microstructure was destroyed after plasma jet treated for 50 s. After being treated by plasma jet for 20 s, 30 s and 40 s, the three-dimensional structure was uncollapsed, and the typical periodic transverse pattern of natural type Ⅰ collagen fiber could be seen. The results of infrared spectra showed that the secondary conformation of dentin collagen fibers was the same as that of the control group after being treated with the plasma jet, and the intensity of amide band was significantly increased after being treated for 30 s and 40 s. (2) The results of ninhydrin crosslinking test showed that the crosslinking ratio of dentin collagen treated by plasma jet for 30 s and 40 s was the highest, and the difference was statistically significant (P < 0.05). (3) The results of dentin ultimate tensile strength showed that the control group was (1.67±0.24) MPa, and the plasma jet treated 20 s, 30 s, 40 s and 50 s groups were (4.21±0.15) MPa, (7.06±0.30) MPa, (7.32±0.27) MPa, and (6.87±0.17) MPa, which were significantly different from that of the control group (P < 0.05).@*CONCLUSION@#The novel RF-APGD plasma jet treatment can promote the crosslinking degree of demineralized dentin collagen and improve their ultimate tensile strength.

A prospective cohort study on the clinical value of pelvic peritoneal reconstruction in laparoscopic anterior resection for middle and low rectal cancer / 中华胃肠外科杂志

Objective: To investigate the safety and efficacy of pelvic peritoneal reconstruction and its effect on anal function in laparoscopy-assisted anterior resection of low and middle rectal cancer. Methods: A prospective cohort study was conducted. Consecutive patients with low and middle rectal cancer who underwent laparoscopy-assisted transabdominal anterior resection at Naval Military Medical University Changhai Hospital from February 2020 to February 2021 were enrolled. Inclusion criteria: (1) the distance from tumor to the anal verge ≤10 cm; (2) laparoscopy-assisted transabdominal anterior resection of rectal cancer; (3) complete clinical data; (4) rectal adenocarcinoma diagnosed by postoperative pathology. Exclusion criteria: (1) emergency surgery; (2) patients with a history of anal dysfunction or anal surgery; (3) preoperative diagnosis of distant (liver, lung) metastasis; (4) intestinal obstruction; (5) conversion to open surgery for various reasons. The pelvic floor was reconstructed using SXMD1B405 (Stratafix helical PGA-PCL, Ethicon). The first needle was sutured from the left anterior wall of the neorectum to the right. Insertion of the needle was continued to suture the root of the sigmoid mesentery while the Hemo-lok was used to fix the suture. The second needle was started from the beginning of the first needle, after 3-4 needles, a drainage tube was inserted through the left lower abdominal trocar to the presacral space. Then, the left peritoneal incision of the descending colon was sutured, after which Hemo-lok fixation was performed. The operative time, perioperative complications, postoperative Wexner anal function score and low anterior resection syndrome (LARS) score were compared between the study group and the control group. Three to six months after the operation, pelvic MRI was performed to observe and compare the pelvic floor anatomical structure of the two groups. Results: A total of 230 patients were enrolled, including 58 who underwent pelvic floor peritoneum reconstruction as the study group and 172 who did not undergo pelvic floor peritoneum reconstruction as the control group. There were no significant differences in general data between the two groups (all P>0.05). The operation time of the study group was longer than that of control group [(177.5±33.0) minutes vs. (148.7±45.5) minutes, P<0.001]. There was no significant difference in the incidence of perioperative complications (including anastomotic leakage, anastomotic bleeding, postoperative pneumonia, urinary tract infection, deep vein thrombosis, and intestinal obstruction) between the two groups (all P>0.05). Eight cases had anastomotic leakage, of whom 2 cases (3.4%) in the study group were discharged after conservative treatment, 5 cases (2.9%) of other 6 cases (3.5%) in the control group were discharged after the secondary surgical treatment. The Wexner score and LARS score were 3.1±2.8 and 23.0 (16.0-28.0) in the study group, which were lower than those in the control group [4.7±3.4 and 27.0 (18.0-32.0)], and the differences were statistically significant (t=-3.018, P=0.003 and Z=-2.257, P=0.024). Severe LARS was 16.5% (7/45) in study group and 35.5% (50/141) in control group, and the difference was no significant differences (Z=4.373, P=0.373). Pelvic MRI examination 3 to 6 months after surgery showed that the incidence of intestinal accumulation in the pelvic floor was 9.1% (3/33) in study group and 46.4% (64/138) in control group (χ(2)=15.537, P<0.001). Conclusion: Pelvic peritoneal reconstruction using stratafix in laparoscopic anterior resection of middle and low rectal cancer is safe and feasible, which may reduce the probability of the secondary operation in patients with anastomotic leakage and significantly improve postoperative anal function.

Hollow-structured nanoparticles as an anticancer drug carrier / 中国药理学与毒理学杂志

Many drug candidates identified from natural products are poorly water-soluble. The surfactants used to disperse the hydrophobic anticancer drugs in water may cause a serious of acute hypersensitivity reactions. Nanotech?nology provides an alternative strategy for delivery of anticancer drugs. Drugs can be encapsulated or attached to the nanomaterials such as lipids, polymers and solid-core nanoparticles. In the present study, porous inorganic nanoparti?cles have been utilized for delivery of water-insoluble anticancer drugs. The synthesized nanoparticles were functional?ized with different organic polymers. The porous nanoparticles were readily internalized by human glioblastoma U-87 MG cells, and didn't display cytotoxicity. The internalized nanoparticles were mainly localized in endosomes/lysosomes in cells. With the hydrophobic curcumin and carfilzomib as model drugs, intracellular delivery of hydrophobic anticancer drugs by the porous inorganic nanoparticles was studied. The porous nanoparticle-based encapsulation of hydrophobic drug provides the aqueous dispersion of the drugs. In endosomes/lysosomes mimicking buffers with a pH of 4.5-5.5, pH-dependent drug release was observed from drug loaded nanoparticles. The intracellular drug content and cytotoxicity were significantly higher for drug loaded nanoparticles than free drug. These results suggested porous inorganic nanoparticles might be a promising intracellular carrier for hydrophobic anticancer drugs.

Effect of a novel cold atmospheric plasma jet treatment with different temperatures on resin-dentin bonding / 北京大学学报(医学版)

OBJECTIVE@#To investigate the effect of different treatment temperatures of a novel cold atmospheric plasma jet treatment on the resin-dentin bonding.@*METHODS@#(1) Fifty-two freshly extracted, non-carious and intact third molars were collected. The occlusal one-third of the crown was removed by means of a water-cooled low-speed Isomet saw. One dentin disc [(900 ±100) μm] was prepared for each tooth. The fifty-two dentin discs were randomly divided into control group and experimental groups, of which four were in control group, and forty-eight were divided into four experimental groups according to the different treatment temperatures (4 °C, 10 °C, 20 °C and 30 °C) of the novel radio-frequency atmospheric-pressure glow discharge (RF-APGD) plasma jet, twelve in each group. Each experimental group was divided into three subgroups according to different treatment time (10 s, 20 s and 30 s), with four in each subgroup. The occlusal one-third of the crown was removed by means of a water-cooled low-speed Isomet saw. The morphology of demineralized dentin surfaces was analyzed using field emission scanning electron microscopy. (2) Twenty unerupted, non-carious and intact third molars were randomly divided into five groups, four in each group: control group, untreated; 4 °C, 10 °C, 20 °C and 30 °C experimental groups, each group was treated with the RF-APGD plasma jet for 20 s. The micro-tensile resin dentin bond strength was tested after 20 s RF-APGD plasma jet treatment with different temperatures, using a universal mechanical machine.@*RESULTS@#(1) The field emission scanning electron microscopy results indicated that when compared with the control group, a 10 s RF-APGD plasma jet treatment with 30 °C and 20 °C collapsed the collagen scaffold. Collagen fibrils maintained an uncollapsed three-dimensional structure after the 4 °C RF-APGD plasma jet treatment for even 30 s treatment. (2) The microtensile resin dentin bond strength results of the 4 °C RF-APGD plasma jet treatment group (57.8±0.7) MPa were significantly higher than that of the control group [(47.4±0.5) MPa] and 10 s, 20 s and 30 s RF-APGD plasma treatment group [(51.9±0.7) MPa,(29.7±1.0) MPa and (22.2±1.5) MPa] with statistically significant difference (P<0.05). Compared with the control group, the micro-tensile bond strength increased about 21.9% and 9.5% after 4 °C and 10 °C RF-APGD plasma jet treatment, respectively.@*CONCLUSION@#Compared with other treatment temperatures, this novel RF-APGD plasma jet treatment with the temperature of 4 °C can preserve the three-dimensional morphology of demineralized dentin better, and can improve the resin-dentin bonding.

Clinical manifestations and genetic diagnosis of paroxysmal kinesigenic dyskinesia / 中国当代儿科杂志

The clinical manifestations of five children with paroxysmal kinesigenic dyskinesia (PKD) were retrospectively analyzed and their gene mutations were analyzed by high-throughput sequencing and chromosome microarray. The 5 patients consisted of 4 males and 1 female and the age of onset was 6-9 years. Dyskinesia was induced by sudden turn movement, scare, mental stress, or other factors. These patients were conscious and had abnormal posture of unilateral or bilateral extremities, athetosis, facial muscle twitching, and abnormal body posture. The frequency of onset ranged from 3-5 times a month to 2-7 times a day, with a duration of <30 seconds every time. Electroencephalography showed no abnormality in these patients. Three patients had a family history of similar disease. The high-throughput sequencing results showed that a heterozygous mutation in the PRRT2 gene, c.649_650insC (p.R217PfsX8), was found in two patients; the mutation c.436C>T (p.P146S) was found in one patient; a splice site mutation, IVS2-1G>A, was found in one patient. The two mutations c.436C>T and IVS2-1G>A had not been reported previously. The chromosome microarray analysis was performed in one patient with negative results of gene detection, and the chromosome 16p11.2 deletion (0.55 Mb) was observed. Low-dose carbamazepine was effective for treatment of the 5 patients. PKD is a rare neurological disease. The detection of the PRRT2 gene by multiple genetic analysis can help the early diagnosis of PKD.

Effects of aluminum on serum, bone and urinary fluoride content of rats with fluorosis / 中国地方病学杂志

ObjectiveTo observe the changes of fluoride content in serum,bone and urine after rats were exposed to single fluoride,single aluminum or fluoride combined with aluminum and to investigate the effects of different doses of aluminum on fluoride accumulation and excretion in rats.Methods Male Wistar rats were randomly divided into 9 groups based on 3 × 3 factorial design.Different doses of fluoride(NaF,0,50,200 mg/L)and(or) aluminum(AlCl3,0,100,200 mg/L) were administered to rats in each group by drinking water.The rats took food and water ad libitum during the experimental period.After feeding for 18 weeks,rats with obvious dental fluorosis were determined as successful establishment of animal model.The fluoride content in the serum,bones and urine were measured.Results Fluoride affected the fluoride content in serum,bones and urine(F=166.74,577.81,160.96,all P ＜ 0.01 ).The interaction of fluoride and aluminum on serum,bone and urinary fluoride were statistically significant (F =7.95,5.13,6.94,all P ＜ 0.01 ).When the fluoride level was 50 mg/L,the serum fluoride contents were [ (0.08 ± 0.03) and (0.08 ± 0.02) mg/L] in the aluminum levels of 0 and 100 mg/L groups,which was higher than that of the aluminum level of 200 mg/L group[ (0.04 ± 0.01)mg/L,F=7.14,5.78.all P＜ 0.05].The bone fluoride content in the 0 mg/L aluminum level group[ (1996.53 ± 383.73) mg/kg] was higher than that of the 100 and 200 mg/L groups[(1252.51 ± 189.08),( 1160.63 ± 129.63) mg/kg,F=20.54,24.56,all P ＜ 0.01 ].When the fluoride level was 200 mg/L,the bone fluoride contents were decreased with the increasing doses of aluminum[ (4668.70 ± 887.67),(3920.30 ± 528.31 ),(3297.64 ± 396.04) mg/kg].Between any two groups,the differences were statistically significant (F =15.59,52.31,14.38,all P ＜ 0.01 ).When the fluoride level was 50 mg/L,the urinary fluoride content in the 0 mg/L aluminum level group[ (34.054 ± 9.30)mg/L] was higher than that of the 100,200 mg/L groups[( 14.81 ± 6.32),(14.67 ± 3.42) mg/L,F =25.30,24.32,all P ＜ 0.01 ].When the fluoride level was 200 mg/L,the urinary fluoride contents in the 0,100 mg/L aluminum level groups[ (57.14 ± 21.38),(51.75 ± 8.39)mg/L] were higher than that of the 200 mg/L group[(34.839 ± 9.30) mg/L,F=30.04,20.31,all P ＜ 0.01 ].ConclusionsAluminum is an antagonist of fluoride.The antagonism could be enhanced as the dose of aluminum increased.In this study,aluminum could effectively counteract the absorption of fluoride in rat model when the ratio of fluoride to aluminum is 1 ∶ 2.

High-throughput screening for hamster chymase 2 inhibitors / 药学学报

To screen potential hamster chymase 2 inhibitors, a high-throughput screening (HTS) model was established. Recombinant hamster chymase 2 with active form was cloned and expressed in E. coli. The HTS model with total volume of 50 microL in 384-well microplate was based on fluorescence analysis and was proved sensitive as well as specific (Z' = 0.84). A total of 40 080 samples (including 28 060 compounds and 12 020 natural products) were screened, and 613 samples with inhibition greater than 90% were selected for further rescreening. Finally, compounds J16647 and J16648 were identified with high inhibitory activity on chymase 2, and whose IC50 values were 0.823 and 0.690 micromol x L(-1), respectively.

Application of circular staplers in cervical esophagogastric anastomosis after esophageal cancer resection / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate safety and feasibility of circular staplers in cervical esophagogastrostomy after esophageal cancer resection.</p><p><b>METHODS</b>The clinical data of patients with esophageal carcinoma were analyzed retrospectively. These patients underwent esophagectomy and cervical esophagogastrostomy with mechanical staplers from August 2009 to April 2011 in the Henan Provincial People's Hospital.</p><p><b>RESULTS</b>A total of 202 patients had the anastomosis performed successfully except for one case who had esophageal tear during anastomosis and required hand-sewn repair. There was no operative mortality. Six patients developed cervical anastomotic leakage after operation, and all were treated conservatively. There was no thoracic anastomotic leakage and other complications related to anastomosis. Two patients had obvious gastroesophageal reflux. After a median of 10.2 months of follow-up, there was no anastomotic stricture.</p><p><b>CONCLUSION</b>Circular mechanical stapling in cervical esophagogastric anastomosis is a safe and feasible operative procedure.</p>

Qingli shengjing pills decrease apoptosis of germ cells and expressions of fas and fasL in male mice infected with Escherichia coli / 中华男科学杂志

<p><b>OBJECTIVE</b>To study the effects of Qingli Shengjing Pills (QSP) on the apoptosis of germ cells and expressions of Fas and FasL in male mice infected with Escherichia coli (E. coli), and to clarify the molecular mechanism of QSP in the treatment of male infertility induced by E. coli infection.</p><p><b>METHODS</b>Fifty male mice were injected with E. coli via the bladder to make infection models, and at 15 dpi equally randomized into five groups: an untreated, a high-dose QSP (22.5 g/ml), a medium-dose QSP (13.5 g/ml), a low-dose QSP (4.50 g/ml) and a Furadantin treatment group, which were coded as MN, MTa, MTb, MTc and MTd, respectively. Another 10 mice were injected with saline and included in the control group coded as CT. After 10 days of oral medication, the apoptosis of germ cells in the testis of the mice was detected by flow cytometry, the expressions of Fas and FasL determined by immunohistochemistry and the histopathological changes observed simultaneously.</p><p><b>RESULTS</b>After the treatment, the apoptosis of germ cells was observed in all the infected groups, and the apoptosis level in MN (57.44%) was significantly higher than that in CT (28.54%), MTb (28.59%) or MTa (30.11%) (P < 0.01) but had no significant difference from that in MTc (46.54%) or MTd (43.41%) (P > 0.05). The expressions of Fas and FasL proteins were significantly higher in MN than in CT, MTa, MTb, MTc and MTd (P < 0.01). Histopathological changes of the testis tissue were observed in MN, but not in other groups.</p><p><b>CONCLUSION</b>E. coli infection could increase the apoptosis rate of germ cells and the expressions of Fas and FasL proteins. Qingli Shengjing Pills, capable of enhancing reproductivity by reducing the expressions of Fas and FasL and apoptosis of germ cells, can be used as one of the effective drugs for infertility induced by E. coli infection.</p>

Mechanism involving blm gene underlies repair of DNA damage of Jurkat cells induced by mitomycin C / 中国实验血液学杂志

The defect or block of apoptosis is an important factor involved in the drug resistance of tumor cells. Blm gene plays a great role in DNA damage and repair. This study was aimed to explore the relationship of blm gene expression with cell cycle and apoptosis after Jurkat DNA damage. The apoptosis rate and change of cell cycle were detected by flow cytometry, the expression level of blm mRNA in Jurkat cells was determined by semi-quantitative RT-PCR. The results indicated that after induction with 0.4 g/L of mitomycin C (MMC) for 24 hours the apoptosis rate of Jurkat cells were (11.42±0.013)%, and (66.08±1.60)% Jurkat cells were arrested in G2/M phase. After induction for 48 hours, the apoptosis rate of Jurkat cells declined from (11.42±0.013)% to (8.08±0.27)%, and cell count of Jurkat cells arrested in G2/M phase decreased from (66.08±1.60)% to (33.96±1.05)%. When induced with 0.4 g/L of MMC for 24 hours, the apoptosis rate of fibroblasts and the percentage of fibroblasts in G2/M, G0-G1 and S phase all showed no significant change until 48 hours. The range of apoptosis rate and the change of cell percentage in three phases were significantly different between Jurkat cells and fibroblasts (p<0.01). Expression level of blm mRNA in Jurkat cells was remarkably higher than that in normal fibroblasts (p<0.01), at 48 hours expression level of blm mRNA was remarkably higher than that at 24 hours. The 2 groups showed clear difference of blm mRNA expression after treated by MMC (p<0.01). It is concluded that the blm gene may play a significant role in repair of DNA damage of Jurkat cells after MMC induction. Abnormal expression of blm is correlated to the drug resistance of leukemia cells.

Protective effect of effective composite of Chinese medicine prescription naodesheng against focal cerebral ischemia in rats / 中国结合医学杂志

<p><b>OBJECTIVE</b>To study the effects and possible mechanisms of effective composite of Naodesheng (NDS) on permanent cerebral ischemia-induced injury in rats.</p><p><b>METHODS</b>Male Sprague-Dawley rats: with middle cerebral artery occlusion (MCAO) were established with the modified suture method, and they were randomly divided into the following groups: the sham-operated group, the model group, the Nimodipine group (0.012 g/kg), the NDS group (1.075 g/kg), the total extracts group (0.23 g/kg), the high-dose NEC group (0.07 g/kg), the middle-dose NEC group (0.02 g/kg), and the low-dose NEC group (0.007 g/kg). The aforesaid medicines were administered at the 2nd, 4th, and 24th h after focal cerebral ischemia, and the infarction size and water content in the brain were evaluated at the 26th h after MCAO. Then, after oral administration once daily for 7 successive days, the changes in the degree of neurological deficit, oxidative stress, and apoptosis were measured on the 7th day.</p><p><b>RESULTS</b>NEC could significantly reduce the infarction size after focal cerebral ischemia, and slightly relieve water content in the brain, significantly alleviate neurological function impairment, increase the levels of superoxide dismutase (SOD) and adenosine triphosphate enzyme (ATPase) activity, and decrease the content of malondialdehyde (MDA). NEC could also extenuate Bax and caspase-3 expression in the hippocampus tissue of the ischemic region. As compared with the three NEC treated groups, the high-dose NEC showed better efficacy.</p><p><b>CONCLUSIONS</b>NEC could significantly reduce brain injury induced by ischemia;: its mechanism was closely associated with hindering oxidative stress and apoptosis. The effective composite-guided methodology is a feasible tool to improve the neuro-protective properties of the Chinese medicine guided prescription NDS against focal cerebral ischemia in rats.</p>

Differences in serum retinol level between the breastfed and non-breastfed children aged 0 to 23 months / 中华流行病学杂志

<p><b>OBJECTIVE</b>Some recent studies found that high prevalence of vitamin A deficiency in the breastfed children. This study aimed to understand the differences in serum retinol level between breastfed and bottle-fed children aged 0 to 23 months and the possible causes of low level of serum retinol for the breastfed children.</p><p><b>METHODS</b>Data for children aged 0 to 23 months were extracted from a population-based cross sectional study for vitamin A nutrition status. Fluorescence method was used to measure the serum retinol. Mothers or caregivers were asked to answer a pre-designed questionnaire and socioeconomic status, peri-natal care, breastfeeding status, morbidity histories and other related factors were collected. Semi-quantitative food frequency questionnaire was used to investigate the child's dietary intake one week prior to the survey. Data were analyzed using SAS 8.1.</p><p><b>RESULTS</b>Of 401 children aged 0 to 23 months, the breastfeeding rate was 50.37%. The means of the serum retinol level between bottle-fed (30.67 +/- 0.57) microg/dl and the breastfed children (27.60 +/- 0.56) microg/dl was significantly different (P < 0.01). The corresponding figures were (31.82 +/- 0.98) microg/dl and (29.46 +/- 0.96) microg/dl after adjustment for confounders, which also showed significant difference (P < 0.01). After stratified by age groups, the breastfeeding rates in the 0-, 6-, 12- and 18-months groups were 92.1%, 70.1%, 32.0% and 17.1%, respectively. We calculated the difference in means of the serum retinol level between the bottle-fed and breastfed children for each of four age groups, and the 95% confidence limits of the differences. The differences in means and the 95% confidence limits for 0-, 6-, 12- and 18-months group were 4.70 microg/dl (-2.52-1.92), 0.82 microg/dl (-2.32-3.95), 2.95 microg/dl (-0.68-6.58) and 6.05 microg/dl (2.34-9.77), respectively. After adjustment for confounders and covariates, the adjusted figures were 0.00 microg/dl (-7.18-7.19), 1.35 microg/dl (-1.76-4.45), 2.92 microg/dl (-0.82-6.65) and 4.26 microg/dl (0.71-7.81), respectively. The significant difference in means of serum retinol level was only found in the 18-months group before or after adjustments (P < 0.01 for both). The Cochrane-Atmitage chi square trend test showed that the breastfed children tended to have lower frequencies of complementary dietary intakes than that of the bottle-fed aged 12 months and above.</p><p><b>CONCLUSIONS</b>The breastfed children aged 0 to 23 months had relative low serum retinol level while compared with the bottle-fed. However, the significant differences seemed to be only confined to those aged 18 months and above. Low level of vitamin A in breast milk and low frequent complimentary food supplements might have served as the potential for the differences.</p>