Research progress of neuronal injury mediated by microglial activation and depression / 中国药理学通报

Depression is a common neurological disorder with high incidence, high recurrence and high disability, but its pathogenesis is unclear. In recent years, the protective and attacking effects of glial cells on neurons have become the frontier of neurological disease research. Neuronal injury caused by abnormal activation of microglia (MG) plays an important role in the pathogenesis of depression. In this paper, through literature retrieval by GeenMedical and CNKI, the relevant pathways and key targets of MG activation in depression are summarized so as to provide a theoretical basis for further clinical research.

Construction of hiPSC-derived Excitatory Neural Network-like Tissue / 中山大学学报(医学科学版)

ObjectiveTo construct a neural network-like tissue with the potential of synaptic formation in vitro by seeding human induced pluripotent stem cell-derived neural precursor cells （hiPSC-NPCs） on decellularized optic nerve （DON）， so as to provide a promising approach for repair of nerve tissue injury. MethodsThrough directional induction and tissue engineering technology， human induced pluripotent stem cells （hiPSCs） and 3D DON scaffolds were combined to construct neural network-like tissues. Then the hiPSCs were directionally induced into human neural precursor cells （hNPCs） and neurons. Immunofluorescence staining was used to identify cell differentiation efficiency. 3D DON scaffolds were prepared. Morphology and cytocompatibility of scaffolds were identified by scanning electron microscopy and Tunnel staining. Induced hiPSC-NPCs were seeded on DON scaffolds. Immunofluorescence staining， scanning electron microscopy， transmission electron microscopy and patch clamp were used to observe the morphology and functional identification of constructed neural network tissues. Results①The results of immunofluorescence staining suggested that most of hiPSC-NPCs differentiated into neurons in vitro. We had successfully constructed a neural network dominated by neurons. ② The results of scanning electron microscopy and immunohistochemistry suggested that a neural network-like tissue with predominating excitatory neurons in vitro was successfully constructed. ③The results of immunohistochemical staining， transmission electron microscopy and patch clamp indicated that the neural network-like tissue had synaptic transmission function. ConclusionA neural network-like tissue mainly composed of excitatory neurons has been constructed by the combination of natural uniform-channel DON scaffold and hiPSC-NPCs， which has the function of synaptic transmission. This neural network plays a significant role in stem cell derived replacement therapy， and offers a promising prospect for repair of spinal cord injury （SCI） and other neural tissue injuries.

Therapeutic effect and mechanism of Xiaoyao Kangai Jieyu Recipe on mice with breast cancer related depression through regulating COX pathway / 中国中药杂志

This study aimed to investigate the intervention effect and mechanism of Xiaoyao Kangai Jieyu Recipe(XKJR) on hip-pocampal microglia and neuronal damage in mice with breast cancer related depression. The mouse model of breast cancer related depression was established by inoculation of 4T1 breast cancer cells in axilla and subcutaneous injection of corticosterone(30 mg·kg~(-1)). The successfully modeled mice were randomly divided into a model group, a positive drug group(capecitabine 60 mg·kg~(-1)+fluoxetine 19.5 mg·kg~(-1)), and XKJR group(19.5 mg·kg~(-1) crude drug), with 6 in each group. Another 6 normal mice were taken as a normal group. The administration groups were given corresponding drugs by gavage, while the normal and model groups were given an equal volume of distilled water, once a day for 21 consecutive days. The depressive behavior of mice was assessed by glucose consumption test, open field test and novelty-suppressed feeding test. Hematoxylin and eosin(HE) staining and tumor suppression rate were used to evaluate the changes of axillary tumors. The mRNA expressions and the relative protein expressions of interleukin-1β(IL-1β), interleukin-18(IL-18), cyclooxyganese-2(COX-2) and glutamyl-prolyl-tRNA synthetase(EPRs) in the hippocampus of mice were determined by quantitative real-time polymerase chain reaction(qRT-PCR) and immunohistochemistry, respectively. Immunofluorescence was performed to detect the mean fluorescence intensity of CD11b, a marker of hippocampal microglia activation. Nissler staining and transmission electron microscopy were employed to observe the morphological changes and the ultramorphological changes of hippocampal neurons, respectively. The experimental results indicated that compared with the normal group, the model group had reduced glucose consumption and lowered number of total activities in open field test(P<0.05, P<0.01), prolonged first feeding latency in no-velty-suppressed feeding test(P<0.01), and significant depression-like behavior; the contents of IL-1β, IL-18, COX-2, and EPRs in hippocampus were increased(P<0.05, P<0.01), with hippocampal microglia activation and obvious neuronal damage. Compared with the model group, the positive drug group and the XKJR group presented an improvement in depressive behaviors, a decrease in the contents of IL-1β, IL-18, COX-2 and EPRs in hippocampus, and an alleviation in the activation of hippocampal microglia and neuronal damage; the tumor suppression rates of positive drug and XKJR were 40.32% and 48.83%, respectively, suggesting a lower tumor growth rate than that of the model group. In summary, XKJR may improve hippocampal microglia activation and neuronal damage in mice with breast cancer related depression through activating COX signaling pathway.

Construction of iPSC-derived Inhibitory Neural Network Tissue with Synaptic Transmission Potentials / 中山大学学报(医学科学版)

ObjectiveDirected differentiation of human induced pluripotent stem cells （hiPSCs） into spinal cord γ-aminobutyric acid （GABA）-ergic progenitor cells were implanted into an decellularized optical nerve （DON） bioscaffold to construct a hiPSC-derived inhibitory neural network tissue with synaptic activities. This study aimed to provide a novel stem cell-based tissue engineering product for the study and the repair of central nervous system injury. MethodsThe combination of stepwise directional induction and tissue engineering technology was applied in this study. After hiPSCs were directionally induced into human neural progenitor cells （hNPCs） in vitro， they were seeded into a DON for three-dimensional culture， allowing further differentiation into inhibitory GABAergic neurons under the specific neuronal induction environment. Transmission electron microscopy and whole cell patch clamp technique were used to detect whether the hiPSCs differentiated neurons could form synapse-like structures and whether these neurons had spontaneous inhibitory postsynaptic currents， respectively， in order to validate that the hiPSC-derived neurons would form neural networks with synaptic transmission potentials from a structural and functional perspective. ResultsThe inhibitory neurons of GABAergic phenotype were successfully induced from hiPSCs in vitro， and maintained good viability after 28 days of culture. With the transmission electron microscopy， it was observed that many cell junctions were formed between hiPSC-derived neural cells in the three-dimensional materials， some of which presented a synapse- like structure， manifested as the slight thickness of cell membrane and a small number of vesicles within one side of the cell junctions， the typical structure of a presynatic component， and focal thickness of the membrane of the other side of the cell junctions， a typical structure of a postsynaptic component. According to whole-cell patch-clamp recording， the hiPSC-derived neurons had the capability to generate action potentials and spontaneous inhibitory postsynaptic currents were recorded in this biotissue. ConclusionsThe results of this study indicated that hiPSCs can be induced to differentiate into GABAergic progenitor cells in vitro and can successfully construct iPSC-derived inhibitory neural network tissue with synaptic transmission after implanted into a DON for three-dimensional culture. This study would provide a novel neural network tissue for future research and treatment of central nervous system injury by stem cell tissue engineering technology.

Research progress on antidepressant effects of melatonin and its receptor agonists / 中国药理学通报

Depression, a chronic syndrome with significant and lasting depression and sleep disturbance, is the most common mental disorder.Recent studies have shown that melatonin plays an important role in the occurrence and development of depression.rI1iis review describes the antidepressant effects of melatonin from HPA axis, cytokines, neurosynaptic plasticity and monoamine neurotransmitters, and summarizes the melatonin receptor agonists agomelatine, ramelteon and piromelatine antidepressant effects.A theoretical basis is expected to provide a reference for the study of melatonin's antidepressant mechanism.

Antimicrobial resistance features and molecular typing of clinically isola-ted m ethicillin-resistant Staphylococcus aureus / 中国感染控制杂志

Objective To study antimicrobial resistance and genotyping of methicillin-resistant Staphylococcus au-reus(MRSA). Methods A total of 967 no-repetitive strains of Staphylococcus aureus(S.aureus)isolated from a hospital between January 2014 and November 2015 were collected,antimicrobial susceptibility testing,mecA gene,and Panton-Valentine leukocidin gene(PVL gene)were detected;staphylococcal cassette chromosome mec(SCCmec)typing,multilocus sequence typing(MLST),S.aureus protein A(spa)gene typing,and S.aureus ac-cessory gene regulator(agr)typing were performed with multiplex polymerase chain reaction. Results Of 967 strains of S.aureus,210(21.72%)were MRSA;detection rate of MRSA from sputum specimen was higher than that of skin and soft tissue specimen(68.09% vs 1 1.83% ,P<0.05);vancomycin- and linezolid-resistant S.aureus strains were not found,susceptibility rates of MRSA to gentamicin,tetracycline,erythromycin,clindamycin,levo-floxacin,ciprofloxacin,moxifloxacin,nitrofurantoin,and rifampicin were all lower than those of methicillin-sensi-tive Staphylococcus aureus(MSSA),differences were all statistically significant(all P<0.05);antimicrobial sus-ceptibility rate of MRSA to compound sulfamethoxazole was higher than MSSA,difference was significant(P<0.05). Susceptibility rates of MRSA isolated from skin and soft tissue to gentamicin,levofloxacin,ciprofloxacin,moxifloxacin,and rifampicin were 86.90% -95.24%,while MRSA isolated from sputum were only 1.56% -15.63%.Of 967 strains of S.aureus,210 harbored mecA gene,10 harbored PVL gene,8(3.81%)of 210 MRSA strains weren't typed. The main types of MLST,SCCmec,spa,and agr were ST 239(n= 177 strains),type Ⅲ(n= 177 strains),t 030(n= 177 strains),and typeⅠ(n= 196 strains)respectively.Conclusion The main epidemic clone of MRSA strain in this hospital is ST239-MRSA-SCCmec III-t030,antimicrobial resistance is serious,monitoring on drug-resistant strains in hospital should be strengthened.

Effects of Xiaoyao Kang'ai Jieyu Formula on Depressive Symptoms of Mice with Breast Cancer Related Depression / 中国中医药信息杂志

Objective To investigate the effects of Xiaoyao Kang'ai Jieyu Formula on mice with breast cancer related depression; To explore its mechanism. Methods BALB/c female mice were set as study objects. Subaxillary injection of inflammatory 4T1 cells and intraperitoneal injection of corticosterone were used to establish a model of breast cancer related depression. According to the consumption of sugar water, mice were randomly divided into blank group, model group, paclitaxel group, Xiaoyao Kang'ai Jieyu Formula group, chemotherapy+fluoxetine group, and chemotherapy + Xiaoyao Kang'ai Jieyu Formula group. After 21 days, sucrose preference test, open-field test, and novelty feeding test were performed to detect changes in the behavior of mice in each group. ELISA were used to detected the contents of corticotrophin releasing hormone (CRH), adrenocorticotropic hormone (ACTH), and corticosterone (CORT) in plasma, and the contents of 5-hydroxytryptamine (5-HT), dopamine (DA), norepinephrine (NE), tumor markers carbohydrate antigen CA153, CA125 and carcinoembryonic antigen (CEA) in serum. Results Compared with the blank group, the consumption of sugar, horizontal and vertical movements of mice in the model group significantly decreased (P<0.01, P<0.05); the latency of ingestion significantly increased (P<0.01, P<0.05); the levels of tumor markers CA153, CA125, CEA and some indexes of HPA axis significantly increased (P<0.01); the expressions of monoamine neurotransmitter NE, DA and 5-HT significantly decreased (P<0.01). Compared with the model group, sugar consumption and autonomic activity significantly increased in the chemotherapy + Xiaoyao Kang'ai Jieyu Formula group, and behavioral despair condition was improved (P<0.01, P<0.05); the content of tumor markers and some indexes related to HPA axis significantly decreased (P<0.01, P<0.05); the contents of 5-HT, DA and NE significantly increased (P<0.01, P<0.05). Conclusion The combination of Xiaoyao Kang'ai Jieyu Formula and paclitaxel can effectively relieve the depressive symptoms of breast cancer related depression.

Antimetastatic effects of cordycepin and its molecular mechanism in human hepatoma MHCC97H cells in vitro and in vivo / 药学学报

The objective of this study was to examine the antimetastatic effects of cordycepin and elucidate its molecular mechanism using MHCC97H cells in vitro and in vivo. Cellular proliferation was detected with MTT assay. The migration and metastatic potential were measured with scratch wound healing as well as transwell migration assays in vitro. Protein expression was detected by Western blotting. Antitumor and antimetastatic effects of cordycepin were evaluated by subcutaneous xenograft and lung metastatic model in vivo. The results demonstrated that cordycepin significantly inhibited MHCC97H cells proliferation and metastasis which was due to the down-regulation of AKT, p-AKT, p-GSK-3β, β-catenin, N-cadherin, MMP-7, MMP-9 and up-regulation the expression of E-cadherin. Furthermore, cordycepin inhibited tumor growth and metastasis in a dose-dependent manner in vivo. Cordycepin(40 and 20 mg·kg-1)and 5-fluorouracil group significantly inhibited the tumor weights to 0.38 ± 0.04, 0.61 ± 0.08 and 0.65 ± 0.07 g, respectively, comparing with the control group(1.52 ± 0.46 g)(P < 0.01), but not 10 mg·kg-1 cordycepin group(1.13 ± 0.36 g)(P > 0.05); the lung metastasis nodus numbers showed the same results, which in all group above(48.9 ± 7.2, 67.2 ± 9.4, 73.6 ± 8.6, respectively)were fewer than the control group(123.5 ± 14.5)(P < 0.01), except 10 mg·kg-1 cordycepin(106.4 ± 11.3)(P > 0.05). Collectively, cordycepin inhibited MHCC97H cell proliferation and metastasis in vivo and in vitro.

Efficacy and safety of onabotulinumtoxinA in treating neurogenic detrusor overactivity: a systematic review and meta-analysis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>OnabotulinumtoxinA is widely used in treating neurogenic detrusor overactivity (NDO). We carried out a systematic review and meta-analysis to assess the efficacy and safety of the drug for treating NDO.</p><p><b>METHODS</b>We searched the following databases: Medline, EMBASE, and the Cochrane Controlled Trials Register. All published randomized double-blind, placebo-controlled trials of onabotulinumtoxinA for the treatment of NDO were identified in the analysis. The reference lists of the retrieved studies were also investigated.</p><p><b>RESULTS</b>Four publications involving a total of 807 patients were identified in the analysis, which compared onabotulinumtoxinA with placebo. The changes of the mean number of urinary incontinence per week (the standardized mean difference [SMD] = -10.91, 95% confidence intervals [CIs] = -14.18--7.63, P < 0.0001); maximum cystometric capacity (SMD = 146.09, 95% CI = 126.19-165.99, P < 0.0001) and maximum detrusor pressure (SMD = -32.65, 95% CI = -37.83--27.48, P < 0.0001) indicated that onabotulinumtoxinA was more effective than the placebo, despite the doses of onabotulinumtoxinA. Safety assessments primarily localized to the urinary tract indicated onabotulinumtoxinA were often associated with more complications. Urinary tract infections (relative risk [RR] =1.48, 95% CI = 1.20-1.81, P = 0.0002); hematuria (RR = 1.81, 95% CI = 1.00-3.24, P = 0.05) and urinary retention (RR = 5.87, 95% CI = 3.61-9.56, P < 0.0001).</p><p><b>CONCLUSIONS</b>This meta-analysis indicates that onabotulinumtoxinA to be an effective treatment for NDO with side effects primarily localized to urinary tract.</p>

Effects of cytotoxin-associated gene A [CagA] positive Helicobacter pylori infection on anti-platelet glycoprotein antibody producing B cells in patients with primary idiopathic thrombocytopenic purpura [ITP]

To explore the effects of cytotoxin-associated gene A [CagA] positive Helicobacter pylori [H. pylori or HP] infection on circulating B cells producing specific platelet glycoprotein antibodies and the association between therapeutic outcomes in primary idiopathic thrombocytopenic purpura [ITP] patients. A total of 76 newly diagnosed primary ITP patients were included in the study which was conducted at the first affiliated hospital of Shantou University Medical college, in Shantou city China, between January 2013 and January 2014. These patients were tested for H. pylori infection by 13C urea breath test and for anti-CagA antibody in H. pylori positive cases by enzyme-linked immunosorbent assay [ELISA] method. Anti-GPIb and anti-GPIIb/IIIa antibody-producing B cells were measured using an enzyme-linked immunospot [ELISPOT] assay in all ITP patients and 30 controls. Anti-nuclear antibody [ANA] was also detected in ITP patients. The numbers of anti-GPIIb/IIIa antibody-producing B cells in HP+CagA+ patients were higher than in HP+CagA- or HP- patients. However, anti-GPIb antibody-producing B cells were found higher in HP- patients. Analysis of treatment outcomes showed that a therapeutic response was more likely in patients presenting anti-GPIIb/IIIa B cells, but the poor response was found to be associated with anti-GPIb B cells and ANA presences. CagA antigen of H. pylori may induce anti-GPIIb/IIIa antibodies production by a molecular mimicry mechanism. Anti-GPIIb/IIIa and anti-GPIb antibody producing B Cells detection is useful for predicting treatment effects of primary ITP

Modified sural neurocutaneous vascular flap based on single dominant perforator arising from peroneal artery for coverage of defects over Achilles tendon / 中华整形外科杂志

<p><b>OBJECTIVE</b>To report the operative techniques and clinical results of specially designed sural neurocutaneous vascular flap pedicled on a dominant perforator (the diameter > or = 0.8 mm) of the peroneal artery for coverage of soft tissue defects overlying the Achilles tendon.</p><p><b>METHODS</b>An approximately rectangular sural neurocutaneous vascular flap pedicled on the lowest dominant perforator arising from the peroneal artery was designed and harvested to repair defects over the Achilles tendon. The pedicle was located at a certain part of the flap, which divided the flap into the distal and the proximal parts. After the tendon was repaired, the flap was rotated 180 degrees based on the perforator and the position of the distal and proximal parts of the flap was changed to cover the defects and part of the donor site respectively. In most cases, skin graft was not needed.</p><p><b>RESULTS</b>The modified flaps were applied in 15 cases. All flaps (ranged from 13 cm x 15 cm - 18 cm x 9 cm ) were transplanted successfully without necrosis, and no vascular problems occurred. Following up for 10-17 months showed both satisfactory functional and cosmetic results.</p><p><b>CONCLUSIONS</b>The modified flap has reliable blood supply and the special design provides nearly normal outline of the ankle which favorites shoe wearing. It' s an excellent option for covering defects overlying the Achilles tendon.</p>

Prevalence of abnormal glycometabolism in patients with chronic hepatitis C and related risk factors in China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>An epidemiologic link between hepatitis C virus (HCV) and abnormal glycometabolism had been established. This study was designed to investigate the prevalence of type 2 diabetes mellitus and insulin resistance, and to explore the relation between insulin resistance and hepatitis C virus genotype, serum hepatitis C virus-RNA level in chronic hepatitis C (CHC) patients.</p><p><b>METHODS</b>Three hundred and fifty-nine consecutive patients (CHC, n = 296; chronic hepatitis B (CHB), n = 63) were evaluated. HCV genotyping was performed by restriction fragment method and serum hepatitis C virus-RNA quantified PCR for all CHC patients in the baseline serum. Fasting levels of insulin and glucose were measured in all patients and the homeostatic assessment of insulin resistance was calculated in the baseline serum.</p><p><b>RESULTS</b>Type 2 diabetes mellitus was diagnosed in 15.5% of 296 CHC patients. Insulin resistance was present in 23.8% of the 235 nondiabetic CHC patients, in 23.1% of the 182 nondiabetic and noncirrhotic CHC patients, and associated with high serum HCV RNA level (OR: 1.754; 95%CI: 1.207 - 2.548, P = 0.003) and age > 40 years (OR: 3.542; 95%CI: 1.257 - 9.978, P = 0.017). Insulin resistance was less frequent in CHB than in matched CHC (7.9% vs. 21.4% respectively, P < 0.0001).</p><p><b>CONCLUSION</b>The incidence of insulin resistance in CHC was significantly higher than that in CHB patients, associated with high serum HCV RNA level and age > 40 years.</p>

The cause analysis of low rate for dementia diagnosis in outpatient clinic / 中华老年医学杂志

Objective To investigate the cause of low rate for dementia diagnosiss in out-patient clinic.Methods All outpatients between September 15,2009 and December 25,2009 were screened by IQCODE,MMSE and neuropsychological examination.Diagnosis of dementia and its subtype were confirmed according to DSM-IV-TR,NINCDS-ADRDA,and NINDS-AIREN criteria.The caregivers of dementia patients were interviewed with questionnaire.Results There were 8,042 outpatients in the period and 1716 patients completed IQCODE,317 completed MMSE,72 completed a set of neuropsychological test.41 patients were diagnosed as dementia which composed of 23 cases of AD (56.1％),12 cases of vascular dementia(29.3％),2 cases of mixed dementia(4.9％),4 cases of other types of dementia(9.7％),and the prevalence of dementia at age of over 55 years was 1.8％ in out-patient clinics.Among the patients,18 cases were mild dementia (43.9％),19 moderate dementia (46.3 ％ ) and 4 severe dementia (9.8 ％).Four patients(9.8 ％ ) were diagnosed as dementia by case history,15 patients(36.5％) were diagnosed as dementia by clinic doctors,while 22 patients (53.7％) were diagnosed as dementia in the survey.35 caregivers finished questionaire,and 10 caregivers(28.6％) had no knowledge about dementia,22(62.8％) caregivers had a few knowledge and 3(8.6％) caregivers had lots of knowledge.19 (46.3％) dementia patients went to see a doctor with cognitive impairment and 22 (53.7 ％) with other symptoms.The reasons for delay in seeing a doctor included that caregivers considered the impairment of cognition as a result of normal aging (54.3％),patients rejected to see a doctor(14.3％),caregivers considered no treatment for dementia (5.7 ％),and there was economic reason ( 2.9％),inconvenient (8.5 ％) and others ( 14.3 ％).Conclusions The visiting rate of dementia patients in china is very low and many demented patients do not receive early diagnosis and treatment.Patients' delay may contribute to the lack of knowledge of caregivers,and to doctor's ignore of the cognitive impairment.

The effect of cryoglobulinemia on the antiviral therapy in patients with chronic hepatitis C / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the possible influence of cryoglobulinemia on the antiviral effect in chronic hepatitis C patients, who were treated with combination therapy of pegylated interferon alpha-2a and ribavirin.</p><p><b>METHODS</b>Forty consecutive patients with chronic hepatitis C (CHC) were enrolled in the study. They received pegylated interferon alfa-2a (40kD, 180mug/w) along with ribavirin. Baseline cryoglobulins were detected in the sera by cryoprecipitation. Hepatitis C virus (HCV) genotyping was performed and HCV viral load was detected at baseline, and at 4, 12 weeks during treatment, 24 weeks after cessation of treatment.</p><p><b>RESULTS</b>Eighteen (45.0%) patients infected with HCV were cryoglobulins positive at baseline. Mean serum HCV RNA level in cryoglobulins positive patients was higher than that in cryoglobulins negative patients (6.36+/-0.63 vs. 5.70+/-1.20, P = 0.032). The rapid virological response (RVR) rate was statically different between cryoglobulins positive patients and cryoglobulins negative ones (6/18, 33.3% vs. 15/22, 68.2%, P = 0.028). In contrast, no difference was found in early virological response (EVR) rate between the cryoglobulins positive patients and cryoglobulins negative ones (14/17, 82.4% vs. 18/21, 85.7%, P = 1.0). Sustained virological response (SVR) rate in cryoglobulins positive and cryoglobulins negative was different (0/3, 0 vs 6/6, 100%, P = 0.012). The rate of patients achieved RVR was different between the patients infected with HCV genotype 1 b of two groups (cryoglobulins positive: 2/13, 15.4% vs cryoglobulins negative 14/21; 66.7%, P = 0.005). However, the rate of EVR in patients infected HCV genotype 1 b was not statistically different (cryoglobulins positive: 9/12, 75.0% vs. cryoglobulins negative 17/20; 81.2%, P = 0.647).</p><p><b>CONCLUSION</b>The rates of RVR and SVR achievement in cryoglobulinemia positive CHC patients are lower than those in cryoglobulinemia negative CHC patients.</p>

Modified superficial peroneal neurocutaneous flap pedicled with lateral supramalleolar artery arising from peroneal artery for forefoot defect / 中华整形外科杂志

<p><b>OBJECTIVE</b>To report the operative techniques and clinical results of modified distally based superficial peroneal neurocutaneous flap for skin defect of the forefoot.</p><p><b>METHODS</b>A reversed superficial peroneal neurocutaneous flap pedicled with the lateral superamalleolar perforating artery or its descending branch, which vascularized the flap through the nutrient vessel chain of the nerve, which linked vascular territories of superamalleolar perforating artery, cutaneous branches of the anterior tibial artery and superficial peroneal artery, was designed to repair skin defects in the forefoot.</p><p><b>RESULTS</b>The modified flaps were applied in 17 cases. All flaps were survived successfully with no complication. The largest size of the flap was 20 cm x 8 cm. The flap could reach as far as the proximal end of the second and third toes or weight-bearing areas under the fifth metatarsal caput.</p><p><b>CONCLUSIONS</b>The modified flap has reliable blood supply with a relatively large size and long rotation arc. It is a simple and safe for covering medium to large defects in the forefoot.</p>

Study of distribution of dominant perforators arising from peroneal artery with color Doppler flow imaging and its clinical significance for sural neurocutaneous flap / 中华整形外科杂志

<p><b>OBJECTIVE</b>To study the distribution of the dominant perforators (the diameter > or = 0.8 mm) of the peroneal artery with color Doppler flow imaging (CDFI) for the purpose of anatomical preparations for the perforator sural neurocutaneous flap.</p><p><b>METHODS</b>The dominant perforators of the peroneal artery (DPPA) were studied with CDFI on bilateral legs of 20 healthy volunteers. The numbers, diameters and locations of the perforators were recorded for a statistical analysis. From Jan. 2005 to Jan. 2009, 51 free or pedicled sural neurocutaneous flaps supplied by a single DPPA were designed and harvested to repair the defects near the ankle (n=22), at the leg (n=15) and the forefoot or hand dorsum (n=14). The perforators were located preoperatively with CDFI and accuracy of CDFI was evaluated intraoperatively. The causes of false results were analysed to improve examining techniques.</p><p><b>RESULTS</b>The average number of DPPA was 4.2 with the average diameter of (1.13 +/- 0.24) mm (0.80-1.90 mm). They were located in the second to ninth segment of the line from the fibular caput to the tip of lateral malleolus which was equally divided into nine segments. The largest DPPA was (1.43 +/- 0.29) mm (1.00-1.90 mm) in diameter and most of them were located in the third to fifth segment (80.4%). The average diameter of the lowest DPPA was (1.02 +/- 0.16) mm( 0.80-1.30 mm) and they were located between the sixth to ninth segment. The total 169 DPPA as well as the largest ones mostly appeared in the middle third of the leg. All of the 51 flaps were transplanted successfully without necrosis, and no vascular problems occurred. Preoperative CDFI examination had a 93.6% true-positive rate and an 88.0% positive predictive value. What should be demonstrated was that if just considered the cases after Dec. 2007, the true-positive rate was 97%, and the positive predictive value was 93.9%.</p><p><b>CONCLUSIONS</b>According to the distribution characteristics of DPPA, a sural neurocutaneous flap pedicled with one of this relatively large perforator can be designed and harvested to repair skin defects of leg and around ankle, but can not be utilized for that of forefoot. With anastomosis of the perforator, the flap based on the largest DPPA can be used as a free flap to cover defect anywhere. CDFI is reliable in preoperative location of DPPA, which makes the surgical procedures easier.</p>

Free peroneal artery perforator sural neurocutaneous flap for hand and foot defects / 中华整形外科杂志

<p><b>OBJECTIVE</b>To report the operative techniques and clinical results of the free peroneal artery perforator sural neurocutaneous flaps.</p><p><b>METHODS</b>Free sural neurocutaneous flap with a single unit of perforating veins and artery arising from the peroneal artery was designed to repair skin defects of hand or from the ankle to distal end of the foot. After the flap was transposed to the defect, the perforating artery was anastomosed with a branch of a nearby artery, and the small saphenous vein was anastomosed with the cephalic vein or the great saphenous vein to establish the flap's circulation. An alternative way was to anastomose the perforating vessels only. The sural nerve was anastomosed to innervate the flap.</p><p><b>RESULTS</b>From Jan 2005 to Dec 2007, 12 cases were treated with the flaps with no flap necrosis. The size of the flaps ranged from 12 cm x 7 cm to 18 cm x 11 cm. The follow-up period was 7 to 27 months. Both the cosmetic and functional results were satisfactory. Two point discrimination was 7 to approximately 12 mm.</p><p><b>CONCLUSIONS</b>The flap has all the advantages of the free flap, the perforator flap and the neurocutaneous flap. It is easily performed with reliable blood supply. It's a good choice for repairing the skin defects of hands and feet.</p>

Prenatal genetic study of fetuses with congenital heart diseases / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the genetic abnormalities of fetuses with congenital heart diseases (CHD), and to provide guidance for the management of pregnancy and genetic counseling.</p><p><b>METHODS</b>Eighty-one fetuses with CHD detected by fetal echocardiography were analyzed by karyotyping after amniocentesis, cordocentesis or chorionic sampling. Then 22q11.2 deletion/duplication was detected by a competitive fluorescent multiplex short tandem repeat assay in 47 CHD fetuses without chromosomal abnormalities. With fluorescence in situ hybridization (FISH) using LSI dual color DNA probe, the deletion/duplication status was confirmed.</p><p><b>RESULTS</b>Thirty-four of 81 CHD fetuses had chromosomal anomalies, and 1 of the 47 CHD fetuses without chromosomal anomalies had duplication at chromosome 22q11. The incidence of aneuploidy associated CHD was 43.2%. The rate of chromosomal anomalies is higher in the cases associated with extra-cardiac anomalies than in that with isolated CHD (64.5% versus 28.0%). In the 35 fetuses with chromosomal abnormalities, 19 (54.3%) were trisomy 18.</p><p><b>CONCLUSION</b>Chromosomal abnormalities occurred in 43.2% of CHD cases and trisomy 18 is the most common aneuploidy. The likelihood of chromosomal anomaly increases when there is extracardiac involvement. Testing for the 22q11.2 microdeletion/duplication is recommended in all CHD fetuses without chromosomal anomalies. It is important for the further management of pregnancy and genetic counseling.</p>

Pretreatment with Rhodiola rosea extract reduces cognitive impairment induced by intracerebroventricular streptozotocin in rats: implication of anti-oxidative and neuroprotective effects / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To investigate the pretreatment effects of Rhodiola rosea (R. rosea) extract on cognitive dysfunction, oxidative stress in hippocampus and hippocampal neuron injury in a rat model of Alzheimer's disease (AD).</p><p><b>METHODS</b>Male Sprague-Dawley rats were pretreated with R. rosea extract at doses of 1.5, 3.0, and 6.0 g/kg for 3 weeks, followed by bilateral intracerebroventricular injection with streptozotocin (1.5 mg/kg) on days 1 and 3. Behavioral alterations were monitored after 2 weeks from the lesion using Morris water maze task. Three weeks after the lesion, the rats were sacrificed for measuring the malondialdehyde (MDA), glutathione reductase (GR) and reduced glutathione (GSH) levels in hippocampus and histopathology of hippocampal neurons.</p><p><b>RESULTS</b>The MDA level was significantly increased while the GR and GSH levels were significantly decreased with striking impairments in spatial learning and memory and severe damage to hippocampal neurons in the model rat induced by intracerebroventricular injection of streptozotocin. These abnormalities were significantly improved by pretreatment with R. rosea extract (3.0 g/kg).</p><p><b>CONCLUSION</b>R. rosea extract can protect rats against cognitive deficits, neuronal injury and oxidative stress induced by intracerebroventricular injection of streptozotocin, and may be used as a potential agent in treatment of neurodegenerative diseases such as AD.</p>

Effects of Rhodiola rosea on level of 5-hydroxytryptamine, cell proliferation and differentiation, and number of neuron in cerebral hippocampus of rats with depression induced by chronic mild stress / 中国中药杂志

<p><b>OBJECTIVE</b>To explore the effects of Rhodiola rosea on the level of 5-hydroxytryptamine (5-HT), cell proliferation and differentiation, and number of neuron in cerebral hippocampus of rats with depression induced by chronic mild stress.</p><p><b>METHOD</b>Fifty rats were divided into 5 groups: normal control, untreated, negative control, positive control and Rhodiola rosea-treated groups. There were 10 rats in each group. Except for normal control group, depression was induced in rats by chronic mild stress. The depressive rats in the other four groups were intragastrically administered with 0.5% sodium carboxymethycellulose, fluoxetine and Rhodiola rosea for 3 weeks. After the treatment, the content of 5-HT in the hippocampus was detected by high-performance liquid chromatography. The proliferating cells and differentiated cells in the hippocampus were labeled by bromodeoxyuridine (BrdU) or/and beta-tubulin III immunohistochemistry, and the number of hippocampal neurons was counted by morphometry.</p><p><b>RESULT</b>Compared with the normal control group, the content of 5-HT, number of BrdU positive cells, percentage of BrdU and beta-tubulin III double labeled cells and number of neurons in cerebral hippocampus in the Rhodiola rosea-treated group were increased and recovered to normal level.</p><p><b>CONCLUSION</b>Rhodiola rosea may enhance the level of 5-HT and promote the proliferation and differentiation of neural stem cells in the hippocampus of the depressive rats, and may play a role in saving injured neurons of the hippocampus.</p>