Thoughts on the Formulation of"2023 Guidelines for Diagnosis and Treatment of Depression with Integrative Chinese and Western Medicine" / 世界科学技术-中医药现代化

The integration of Chinese and Western Medicine(ICWM)in the diagnosis and treatment of depression has been a long-standing issue in the field of mental health.In order to maximize the benefits of this combined approach,the"2023 Guidelines for Diagnosis and Treatment of Depression with Integrative Chinese and Western Medicine"(GDTD-ICWM)has been developed based on organizing evidence-based and standardized workflows for ICWM.This article aims to discuss the background,highlights,summary and outlook of the"Guidelines",as well as offer operational suggestions to guide clinical practices in order to strengthen the implementation,practice and promotion of the"Guidelines".

Comparative Study on the Topological Attributes of Deficiency and Excess Pattern of Cerebral Small Vessel Disease Mild Cognitive Impairment Based on fMRI Graph Theory Network / 世界科学技术-中医药现代化

Objective This study aimed to explore the differences in global and local brain network topological properties between deficient pattern(DP)and excess pattern(EP)of mild vascular cognitive impairment caused by subcortical small vessel disease based on graph theory network.Methods Patients were recruited prospectively and were classified with DP and EP subtype.The global small-world topological attributes and local nodes were calculated for the comparison of DP,EP,and healthy controls(CN)using the GRETNA platform.Results The three groups all had small-world attributes,but only the patients in EP had a significantly lower small world attribute δ in the range of 0.05-0.26 than the control group(P<0.05).The node efficiency and node strength indicators of multiple brain region were able to significantly distinguish the DP group from the EP group.However,there was no positive brain region in the node efficiency of the DP patients(P>0.05),and only a few brain regions showed increased node strength efficiency(P<0.05).Conclusion The results indicate that the syndrome of DP and EP have significantly different neuroimaging phenotypes,providing a basis for further research of biological classification based on Chinese Medicine syndromes.

RAS-selective lethal small molecule 3 inhibits the fibrosis of pathological scar fibroblasts / 中国组织工程研究

BACKGROUND:Abnormal extracellular matrix accumulation and excessive proliferation of fibroblasts are the main manifestations of pathological scars.Excessive proliferation of fibroblasts leads to the production of large amounts of collagen-based extracellular matrix.Therefore,to investigate the role of fibroblast fibrosis in the formation of pathological scar will provide a new idea for revealing the mechanism of pathological scar and biological therapy. OBJECTIVE:To investigate the effect of RAS-selective lethal small molecule 3(RSL3)on the fibrosis of human pathological scar fibroblasts. METHODS:Then cases of pathological scar tissue and normal skin tissue samples from the same individuals,provided by the Department of Burn Plastic Surgery,General Hospital of Ningxia Medical University,were collected.Fibroblasts of human pathological scar and human normal skin were extracted and used in the following experiments.The general condition of the pathological scar tissue and the normal skin tissue was detected by hematoxylin-eosin staining.The appearance of fibroblasts from pathological scar and normal skin were observed by inverted microscope.The fibroblasts were verified by immunofluorescence assay.The cells were treated with different concentrations of RSL3(1,3,5,7,9,11,13 μmol/L).The inhibitory concentration of RSL3 on fibroblasts was detected by cell counting kit-8.Control group(without treatment)and RSL3 intervention group(treated with 7 μmol/L RSL3 for 24 hours)were set up.The mRNA and protein expressions of glutathione peroxidase 4,type Ⅰ collagen,type Ⅲ collagen and α-smooth muscle actin were detected by Qrt-PCR and western blot,respectively.Level of malondialdehyde in cells was detected.The residual scratch area was measured by cell scratch test after 24 hours to calculate the percentage of residual scratch area. RESULTS AND CONCLUSION:The expression of glutathione peroxidase 4 in the pathological scar group was higher than that in the normal skin group(Mrna:t=3.252,P<0.01;protein:t=5.075,P<0.01).The expression of glutathione peroxidase 4 in the pathological scar fibroblast group was higher than that in the normal skin fibroblast group(Mrna:t=10.32,P<0.01;protein:t=26.22,P<0.01).Compared with the control group,the expression of glutathione peroxidase 4 was decreased(Mrna:t=2.798,P<0.05;protein:t=4.643,P<0.01),the content of malondialdehyde was increased(t=2.917,P<0.05),the expression of type Ⅰ collagen(Mrna:t=15.84,P<0.01;protein:t=4.610,P<0.01),type Ⅲ collagen(Mrna:t=28.86,P<0.01;protein:t=7.713,P<0.01)and α-smooth muscle actin(Mrna:t=2.671,P<0.05;protein:t=7.417,P<0.01)were decreased in the RSL3 intervention group.Compared with the control group,the migration ability was weakened in the RSL3 intervention group(t=14.06,P<0.01).To conclude,RSL3 can inhibit the expression of glutathione peroxidase 4 and then inhibit the ability of fibrosis and migration of pathological scar fibroblasts.

Expression and pathological diagnostic value of extracellular matrix metalloproteinase inducer,ma-trix metalloproteinase-9 and lysine demethylase 6B in invasive breast cancer / 新乡医学院学报

Objective To investigate the expressions of extracellular matrix metalloproteinase inducer(EMMPRIN),matrix metalloproteinase-9(MMP-9),lysine demethylase 6B(KDM6B)proteins and their correlation with clinicopathologic features in invasive breast cancer,and analyze the correlation among the three proteins and their value in pathological diagnosis of invasive breast cancer.Methods The surgical biopsy specimens of 124 patients with invasive breast cancer who were admitted to the Department of Pathology,the Fifth Clinical Medical College of Henan University of Chinese Medicine/People's Hospital of Zhengzhou from January 2014 to December 2017 were selected as research subjects,and 20 low-grade intraductal carcinoma tissue specimens,27 high-grade intraductal carcinoma tissue specimens,and 22 adjacent tissue specimens＞1 cm away from the invasive breast cancer were selected as controls.The expressions of EMMPRIN,MMP-9 and KDM6B proteins in cancer-adjacent tissues,low-grade intraductal carcinoma tissues,high-grade intraductal carcinoma tissues and invasive breast cancer tissues were detected by immunohistochemistry.The relationship between the relative expressions of EMMPRIN,MMP-9 and KDM6B proteins and clinicopathologic features of invasive breast cancer was analyzed,Spearman correlation analysis was used to evaluate the correlation of EMMPRIN,MMP-9 and KDM6B proteins in breast cancer tissues,and receiver operating characteristic(ROC)curve was adopted to evaluate the diagnostic value of EMMPRIN,MMP-9 and KDM6B for invasive breast cancer.Results The relative expressions of EMMPRIN and MMP-9 proteins in high-grade intraductal carcinoma and invasive breast cancer tissues were significantly higher those in cancer-adjacent tissues and low-grade intraductal carcinoma tissues,and the relative expression of KDM6B protein was significantly lower than those in cancer-adjacent tissues and low-grade intraductal carcinoma tissues(P＜0.05);the relative expressions of EMMPRIN and MMP-9 proteins in invasive breast cancer tissues were significantly higher those in high-grade intraductal carcinoma tissues,and the relative expression of KDM6B protein was significantly lower than that in high-grade intraductal carcinoma tissues(P＜0.05);there was no statistically significant difference in the relative expressions of EMMPRIN,MMP-9 and KDM6B proteins between cancer-adjacent tissues and low-grade intraductal carcinoma tissues(P＞0.05).The relative expressions of EMMPRIN and KDM6B proteins were not related to the age,tumor location and tumor diameter of patients with invasive breast cancer(P＞0.05),and the relative expression of MMP-9 protein was not related to the age and tumor location of patients with invasive breast cancer(P＞0.05).Relative expressions of EMMPRIN,MMP-9 and KDM6B proteins were correlated with WHO grading,lymph node metastasis,and tumor,node and metastasis(TNM)staging of invasive breast cancer(P＜0.05),and the relative expression of MMP-9 protein was correlated with the tumor diameter(P＜0.05).In the WHO grades Ⅰ,Ⅱ,and Ⅲ of invasive breast cancer,the relative expressions of EMMPRIN and MMP-9 proteins increased sequentially,while the relative expression of KDM6B protein decreased sequentially(P＜0.05);the relative expressions of EMMPRIN and MMP-9 proteins in the lymph node metastasis group were significantly higher than those in the non-lymph node metastasis group,and the relative expression of KDM6B protein was significantly lower than that in the non-lymph node metastasis group(P＜0.05);the relative expressions of EMMPRIN and MMP-9 proteins in TNM stages Ⅲ-Ⅳ were significantly higher than those in stages Ⅰ-Ⅱ(P＜0.05),while the relative expression of KDM6B protein was significantly lower than that in stages Ⅰ-Ⅱ(P＜0.05).In the group of invasive breast cancer with diameter≤2 cm,2 to 5 cm,and＞5 cm,the relative expression of MMP-9 protein increased sequentially(P＜0.05).Spearman correlation analysis showed that the expression of EMMPRIN was positively correlated with MMP-9 protein in invasive breast cancer tissues(r=0.990,P=0.000),the expression of EMMPRIN was negatively correlated with KDM6B protein(r=-0.606,P=0.000),and the expression of MMP-9 was negatively correlated with KDM6B protein(r=-0.612,P=0.000).ROC curve analysis showed that the area under the curve(AUC)of EMMPRIN protein for diagnosing invasive breast cancer was 0.875[95％confidence interval(CI):0.823-0.926,P＜0.05],with an optimal threshold of 10.043,sensitivity of 79.0％,and specificity of 76.8％;the AUC of MMP-9 protein in diagnosing invasive breast cancer was 0.863(95％CI:0.808-0.917,P＜0.05),with an optimal threshold of 10.070,sensitivity of 74.2％,and specificity of 76.8％;the AUC of KDM6B protein in diagnosing invasive breast cancer was 0.267(95％CI:0.196-0.338,P＜0.05),with an optimal threshold of 11.003,sensitivity of 71.0％,and specificity of 98.6％.Conclusion EMMPRIN,MMP-9 and KDM6B are related to the occurrence and development of invasive breast cancer.Detection of the expressions of EMMPRIN,MMP-9 and KDM6B is helpful to the pathological diagnosis of invasive breast cancer and clinical judgment of invasion and metastasis of breast cancer.

Efficacy and safety profile of repetitive transcranial magnetic stimulation versus modified electroconvulsive therapy in combination with antidepressants in patients with major depressive disorder / 四川精神卫生

BackgroundMajor depressive disorder is one of the most disabling mental diseases. Currently， medication in combination with physiotherapy and psychotherapy remains the most commonly used treatment modality for the disease， whereas only a few randomized controlled studies have been conducted on physiotherapy， and even fewer studies have focused on medication combined with physiotherapy. ObjectiveTo explore the efficacy and safety profile of repetitive transcranial magnetic stimulation （rTMS） versus modified electroconvulsive therapy （MECT） in combination with antidepressants in the treatment of major depressive disorder， so as to provide an optimized treatment plan for patients with major depressive disorder. MethodsPatients with major depressive disorder （n=335） hospitalized in Shandong Daizhuang Hospital from January 1， 2019 to April 30， 2023 were included， all of whom met the diagnostic criteria of the International Classification of Diseases， tenth edition （ICD-10）. Depending on their disease condition， patients were subjected to either MECT in combination with drugs （n=141） or rTMS in combination with drugs （n=194） after admission. Depressive symptoms were assessed using Hamilton Depression Scale-24 item （HAMD-24） at the baseline and the end of the 1st， 2nd， 3rd and 4th week of treatment， and the adverse reactions were documented in patient's medical records. ResultsAnalysis of variance on HAMD-24 revealed a significant effect of time （F=3.081， P=0.042）， but no effect of group （F=1.023， P=0.313）， and the interaction effect between the time and the groups was not statistically significant （F=1.642， P=0.191）. No statistical difference was reported between two groups in response rate and full remission rate （P>0.05）. Throughout the course of treatment， 58 cases （41.13%） of recent memory impairment and 74 cases （52.48%） of headache or neck muscle pain occurred in MECT combined with drugs group， and 27 cases （13.92%） in rTMS combined with drugs group experienced headache or head skin discomfort. ConclusionAntidepressants in combination with rTMS or MECT show equivalent efficacy in the treatment of major depressive disorder， while rTMS combined with antidepressants demonstrates a superior safety profile compared to MECT.

Analysis of variant of GLI3 gene in a child featuring autosomal dominant Pallister-Hall syndrome / 中华医学遗传学杂志

OBJECTIVE@#To explore the clinical and genetic characteristics of a child with Pallister-Hall syndrome (PHS).@*METHODS@#DNA was extracted from peripheral blood sample from the child and subjected to whole exome sequencing. Suspected variants were verified by Sanger sequencing of his family members.@*RESULTS@#Genetic testing revealed that the child has harbored a heterozygous c.3320_3330delGGTACGAGCAG (p.G1107Afs×18) variant of the GLI3 gene. Neither parent was found to carry the same variant.@*CONCLUSION@#The c.3320_3330delGGTACGAGCAG (p.G1107Afs×18) frameshift variant of the GLI3 gene probably underlay the pathogenesis of PHS in this child. Genetic testing should be considered for patients featuring hypothalamic hamartoma and central polydactyly.

Analysis of clinical characteristics and ATP7A gene variants in a Chinese pedigree affected with Menkes disease / 中华医学遗传学杂志

OBJECTIVE@#To explore the clinical characteristics and variants of ATP7A gene in a child with Menkes disease.@*METHODS@#A child with Menkes disease diagnosed at the West China Second Hospital of Sichuan University and its family members in March 2022 was selected as the study subjects. Clinical manifestations and results of laboratory tests and genetic testing were summarized.@*RESULTS@#The main manifestations of the child included seizures, global development delay, facial dysmorphism, sparse and curly hair, increased lactate and pyruvate, and significantly decreased cuprin. EEG showed frequent issuance of multifocal spikes, spines, polyspines (slow) and polymorphic slow waves. Multiple tortuous vascular shadows were observed on cranial MRI. Whole exome sequencing revealed that the child has harbored a hemizygous c.3076delA (p.ile1026*) variant of the ATP7A gene, which was inherited from his mother. The variant may lead to premature termination of protein translation. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the variant was predicted as pathogenic (PVS1+PM2+PP4).@*CONCLUSION@#The c.3076delA (p.Ile1026*) variant of the ATP7A gene probably underlay the Menkes disease in this child. Above finding has provided evidence for clinical diagnosis. The significantly increased lactic acid and pyruvate can be used as a reference for the diagnosis and management of Menkes disease. Microscopic abnormalities in the hair of the carriers may also facilitate their diagnosis.

Mechanism of health behavior in relieving anxiety mood / 四川精神卫生

Taking the intervention of healthy behaviors in anxiety mood as the entry point， this paper aims to review the mechanism of healthy exercise behaviors， healthy eating behaviors， healthy leisure and entertainment behaviors in regulating anxiety mood based on recent national and international research findings， and to summary the alleviation of anxiety mood from the following three aspects： choice of exercise， diet control and participation in leisure and entertainment activities， thus providing a practical basis for the scale application of health behavior treatment for anxiety mood.

Chinese expert consensus on clinical treatment of adult patients with severe traumatic brain injury complicated by corona virus disease 2019 (version 2023) / 中华创伤杂志

The condition of patients with severe traumatic brain injury (sTBI) complicated by corona virus 2019 disease (COVID-19) is complex. sTBI can significantly increase the probability of COVID-19 developing into severe or critical stage, while COVID-19 can also increase the surgical risk of sTBI and the severity of postoperative lung lesions. There are many contradictions in the treatment process, which brings difficulties to the clinical treatment of such patients. Up to now, there are few clinical studies and therapeutic norms relevant to sTBI complicated by COVID-19. In order to standardize the clinical treatment of such patients, Critical Care Medicine Branch of China International Exchange and Promotive Association for Medical and Healthcare and Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Chinese expert consensus on clinical treatment of adult patients with severe traumatic brain injury complicated by corona virus infection 2019 ( version 2023) based on the joint prevention and control mechanism scheme of the State Council and domestic and foreign literatures on sTBI and COVID-19 in the past 3 years of the international epidemic. Fifteen recommendations focused on emergency treatment, emergency surgery and comprehensive management were put forward to provide a guidance for the diagnosis and treatment of sTBI complicated by COVID-19.

A systematic review and meta-analysis of severe risk in patients with common chronic diseases and coronavirus disease 2019 / 中华传染病杂志

Objective:To systematically review the severe risk in common chronic diseases and coronavirus disease 2019 (COVID-19) cases.Methods:PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, China Biology Medicine disc, medRxiv, SSRN and ChinaXiv were searched for clinical and epidemiological studies that reported chronic diseases in patients with COVID-19. Only studies of severe COVID-19 in comparison with non-severe controls were included. The prevalence rates of chronic diseases including chronic obstructive pulmonary disease (COPD), diabetes mellitus, hypertension, malignant tumor, cardiovascular diseases, cerebrovascular disease, chronic kidney disease, and chronic liver disease were estimated. Pooled odds ratio ( OR) with 95% confidence interval ( CI) between patients with severe COVID-19 and non-severe groups were calculated. R 3.6.3 software was used for meta-analysis. Results:The search yielded 2 455 articles. A total of 19 eligible comparative studies with 4 792 patients were included in a quantitative analysis. Meta-analysis showed that there was a proportion of 55.0% (95% CI 40.0%-80.0%) male among patients with COVID-19, and the overall pooled prevalence of any chronic diseases in COVID-19 cases was 30.4% (95% CI 24.0%-37.0%). The most prevalent comorbidity was hypertension (16.9%(95% CI 14.0%-20.0%)), followed by diabetes mellitus (8.3%(95% CI 8.0%-9.0%)). The proportion of male patients with severe COVID-19 was higher than that of male patients with non-severe COVID-19 (64.4% vs 52.8%, OR=1.49, 95% CI 1.08-2.05, Z=4.63, P<0.01). The prevalence rates of COPD, cerebrovascular disease, diabetes mellitus, chronic kidney disease, hypertension, cardiovascular diseases and malignant tumor in severe COVID-19 patients were higher than those of non-severe patients ( OR=5.77, 95% CI 3.80-8.74; OR=4.47, 95% CI 2.71-7.38; OR=3.55, 95% CI 2.86-4.40; OR=3.05, 95% CI=1.76-5.28; OR=2.82, 95% CI=1.96-3.97; OR=2.39, 95% CI=1.77-3.23; OR=2.15, 95% CI 1.27-3.66, respectively, Z=8.37, 6.01, 11.60, 4.20, 5.46, 5.71, 3.12, all P<0.01). There was no significant difference in the prevalence of chronic liver disease between severe and non-severe patients ( OR=1.35, 95% CI 0.84-2.17, P=0.11). Conclusion:COVID-19 patients with chronic diseases have higher risk of developing severe disease, and the ORs from high to low are COPD, cerebrovascular disease, diabetes mellitus, chronic kidney disease, hypertension, cardiovascular diseases and malignant tumor.

Research progress in downstaging treatment of hepatocellular carcinoma before liver transplantation / 中华肝胆外科杂志

Liver transplantation is an effective curative treatment for hepatocellular carcinoma patients. However, most patients lost the change of surgery when diagnosed as hepatocellular carcinoma. Through local or systemic treatment, hepatocellular carcinoma can be treated in a downstaging manner to reduce tumor burden, so that patients who are beyond the transplantation criteria can still be up to the transplantation criteria after treatment, and finally receive liver transplantation. At present, pre-transplant downstaging treatment has been widely accepted. In this review, we summarized the indications, treatment options, treatment endpoints, and treatment outcomes of pre-transplant downstaging treatment.

The correlation between the timed up and go test and fall risks in elderly frail patients / 中华老年医学杂志

Objective:To evaluate the correlation between the timed up and go(TUG)test and fall risks in elderly frail patients.Methods:From July to September 2019, elderly frail patients who were treated at the cardiovascular department of our hospital were enrolled.Basic clinical data and fall-related information of patients were collected.Patients were divided into the fall group and the non-fall group.Results on the body mass index(BMI), TUG, 4-meter maximum walking speed(4 m MWS)and Barthel index were compared between the two groups.The correlation between TUG and each indicator was examined.Multivariate Logistic regression analysis was used to analyze the correlation between the TUG and falls in elderly patients.Results:A total of 96 eligible patients were enrolled, including 35 in the fall group and 61 in the non-fall group.The average TUG time was longer in the fall group than in the non-fall group(16.45±6.44 s vs.10.17±2.91 s, t=-6.556, P<0.001). The correlation analysis results showed that the TUG was correlated with falls and 4 m MWS( r=0.582 and 0.875, both P<0.001). Multivariate Logistic regression analysis showed that the TUG( OR=1.201, 95% CI: 1.111-1.470, P=0.004)and 4 m MWS( OR=1.146, 95% CI: 1.063-1.244, P=0.015)were risk factors for falls. Conclusions:The TUG is correlated with fall risks in elderly frail patients and should be recommended as a routine test in clinical practice.

Effect of auditory integration training on core symptoms in children with autism spectrum disorders whose auditory conduction dysfunction repaired / 中华行为医学与脑科学杂志

Objective:To explore the improvement of core symptoms in children with autism whose auditory pathway dysfunction were repaired after accepting auditory integration training(AIT).Methods:The ASD children with abnormal auditory evoked potentials were divided into AIT group (the ones whose BAEP return to normal after AIT training into test group), control group A (blank control group) and control group B (ABA training group). The ASD children were assessed by Portage Development Checklist, Child Autism Rating Scale (CARS) and Autism Therapy Assessment Scale (ATEC) at the time of admission, one month after admission, three months after admission.The curative effect with the change value of each factor fraction was evaluated.Results:At the time of enrollment, there were no significant differences among the scores of CARS((36.31±4.08), (36.33±3.76), (36.33±5.14)) as well as ATEC language ((19.08±6.43), (16.40±6.42), (18.48±5.96)), social ((15.63±7.13), (16.05±7.57), (16.19±7.19)), and perception ((16.78±5.39) (16.92±6.75), (17.12±6.73)) and self-care ((15.98±8.71), (17.93±8.22), (17.26±8.93), respectively)) in the AIT group, control group B and control group A. After one month and three months from enrollment, the scores of CARS were ((33.96±3.79), (35.09±4.38) and (34.30±3.98), respectively after one month; (32.95±3.15), (36.86±3.86) and (33.95±3.90), respectively) after three months in the AIT group, control group B and control group A. The repeated measurement analysis of variance showed that the main effect of time was significant ( F=22.308, P<0.01), the main effect of group was not significant ( F=2.647, P>0.05), and there was interaction between time and group ( F= 8.626, P<0.01). For the scores of ATEC language (one month: (16.18±7.10), (18.62±6.63), (13.40±5.44); three months: (14.13±6.13), (18.40±6.35), (10.75±5.17)), social(one month: (12.31±6.68), (17.76±6.82), (15.08±6.75); three months: (10.71±5.42), (16.31±6.30), (12.15±7.30)), perception (one month: (14.37±5.86), (17.43±7.22), (18.58±6.92); three months: (10.35±5.43), (16.44±7.05), (16.68±7.37)) in AIT group, control group B and control group A. The main effect of time was significant ( F=35.534, 40.729, 40.401, all P<0.01), the main effect of group was also significant ( F=7.600, 6.193, 7.675, all P<0.01), and there was interaction between time and group ( F=7.602, 3.355, 7.649, all P<0.05). Multiple comparisons showed that there were statistically significant differences between the AIT group and the control group B, the control group A and the control group B in the scores of ATEC language scale after intervention (I1-J1=-1.69, P1<0.05; I2-J2=-4.98, P2<0.01) between the AIT group and the control group A in the scores of ATEC social scale after intervention (I-J=-4.54, P<0.01) .There were significant differences between the AIT group and the control group A, the AIT group and the control group B in the scores of ATEC perception scale after intervention (I1-J1=-3.16, P1<0.05; I2-J2=-4.89, P2<0.01); for the scores of ATEC self-care ability subscale the main effect of time was significant ( F=22.876, P<0.01), the main effect of group was also significant ( F=3.427, P<0.05), and time and group had no interaction ( F=1.885, P>0.05). Multiple comparisons showed that the scores of ATEC self-care ability scale between the AIT group and the control group A were statistically significant (I-J=-4.46, P<0.05). Conclusion:The results of this study show that AIT training can improve the core symptoms of the ASD children whose BAEP returns to normal.

Protective effect of diminazene on kidney injury of limb ischemiareperfusion model mice and its mechanism / 吉林大学学报(医学版)

Objective: To detect the levels of angioteinsin II (Ang II) and angioteinsin (1-7) [Ang (1-7)] and the expression levels of angiotensin II type-1 receptor (AT1R) and Mas receptor (MasR) proteins in kidney tissue of the limb ischemia-reperfusion (LIR) mice pre-treated with the angiotensin coverting enzyme 2 (ACE2) activator diminazene (DIZE), and to explore the protective effect of DIZE on the kidney injury of the LIR mice. Methods: Eighteen male ICR mice aged 8 weeks were divided into control group, LIR group and LIR+DIZE group. The mice in model group and LIR+DIZE group were subjected to 2 h of ischemia and 4 h of reperfusion to establish the LIR models. The mice in LIR + DIZE group were pre-treated with 10 mg · kg-1 · d-1 DIZE for 14 d by subcutaneous injection before LIR. The histological technique was used to observe the morphology of kidney tissue of the mice and the pathological injury was evaluated. Chemical colorimetry was performed to determine the levels of serum urea and serum creatinine (Scr) of the mice. Enzyme linked immunosorbent assay (ELISA) was used to determine the Ang II and Ang (1-7) levels in kidney tissue of the mice. Western blotting method was used to measure the expression levels of AT1R and MasR proteins in kidney tissue of the mice. Results: Compared with control group, the pathological changes such as inflammatory cell infiltration and epithelial cell degeneration were found in kidney tissue of the mice in LIR group, and the kindey injury score was obviously increased (P<0. 05); compared with LIR group, the kidney injury performance in the kidey tissue of the mice in LIR + DIZE group was alleviated and the kidney injury score was decreased significantly (P<0. 05). Compared with control group, the levels of serum urea and Scr of the mice in LIR group were significantly increased (P<0. 05); compared with LIR group, the levels of serum urea and Scr of the mice in LIR + DIZE group were significantly decreased (P<0. 05). Compared with control group, the Ang II, Ang (1-7) levels and the ratio of Ang II/Ang (1-7) of the mice in LIR group were significantly increased (P<0. 05); compared with LIR group, the Ang II level of the mice in LIR+DIZE group was markedly decreased (P<0. 05), the Ang (1-7) level was significantly increased (P<0. 05)), and the ratio of Ang II/Ang (1-7) was decreased (P<0.05). Compared with control group, the expression level of AT1R protein in kidney tissue of the mice in LIR group was significantly decreased (P<0.05), the expression of MasR protein was significantly increased (P<0. 05), and the ATlR/MasR ratio was decreased (P<0.05). Compared with LIR group, the AT1R and MasR protein expression levels in kidney tissue of the mice in LIR + DIZE group were significantly increased (P < 0.05), and the ATlR/MasR ratio was also increased (P < 0.05). Conclusion: The imbalance of Ang II/Ang (1-7) and AT1R/Mas expressions in kidney tissue of the mice may be involved in kidney injury after LIR of the mice. ACE2 activitor DIZE may play a protective role in the kidney by improving the imbalance of Ang II/Ang (1-7) and ATlR/MasR expressions.

Association of JMJD3, MMP-2 and VEGF expressions with clinicopathological features of invasive ductal breast carcinoma / 南方医科大学学报

OBJECTIVE@#To examine the expressions of JMJD3, matrix metalloproteinase-2 (MMP-2) and vascular endothelial growth factor (VEGF) in invasive ductal breast carcinoma, their association with the clinicopathological features of the patients and the effect of JMJD3 overexpression on proliferation and MMP-2 and VEGF expressions in breast cancer cells.@*METHODS@#The protein and mRNA expressions of JMJD3, MMP-2, and VEGF in invasive ductal breast carcinoma and paired adjacent tissues were detected by immunohistochemistry and RT-PCR, respectively, and their correlation with the clinicopathological characteristics of the patients was analyzed. Kaplan-Meier survival analysis was used to evaluate the correlation of JMJD3, MMP-2 and VEGF expression levels with the survival of the patients. In breast cancer MDA-MB-231 cells transfected with a JMJD3-expression plasmid, the expression of Ki67 was examined immunohistochemically, the cell proliferation was assessed with CCK8 assay, and the mRNA expressions of MMP-2 and VEGF were detected with RT-PCR.@*RESULTS@#Breast cancer tissues had significantly lower JMJD3 expression and higher MMP-2 and VEGF expressions at both the mRNA and protein levels than the adjacent tissue (@*CONCLUSIONS@#The expressions of JMJD3, MMP-2 and VEGF in invasive ductal breast carcinoma are closely correlated to tumor proliferation, invasion, metastasis and prognosis and can be used for prognostic evaluation of breast cancer.

Study of peripheral blood T lymphocyte subsets CD45RA+ and CD45RO+ in children withHenoch-Schonlein purpura / 中国基层医药

Objective@#To observe the change and clinical significance of the peripheral blood T-lymphocytes CD45RA+ and CD45RO+ in children with Henoch-Schonlein purpura (HSP) under different clinical classification.@*Methods@#From October 2015 to July 2017, the clinical data of 80 children with HSP in the Affiliated Hospital of North Sichuan Medical College were retrospectively analyzed.According to the clinical classification, they were divided into three groups: skin involvement group (35 cases), abdominal type group (36 cases), and renal type group (9 cases). Another 80 healthy children were selected as the control group.The changes and clinical significance of peripheral blood T-lymphocytes CD45RA+ , CD45RO+ and CD45RA+ /CD45RO+ ratio were analyzed.@*Results@#Among the 80 children, 40 cases were male and 40 cases were female, with age of (7.2±2.3)years old.The CD45RA+ and CD45RO+ rates in the HSP group were (13.19±7.09)%, (12.07±3.46)%, respectively, which were significantly lower than those in the control group [(23.26±6.01)%, (21.74±3.46)%], the differences were statistically significant (t=9.69, 16.42, all P<0.05). The CD45RA+ ratio, CD45RA+ count and CD45RA+ /CD45RO+ ratio of the kidney type group were (8.02±3.63)%, (2.19±0.33)/μL, (-0.28±0.19), respectively, which were significantly lower than those of the skin group [(15.74±7.71)%, (2.55±0.33)/μL, (0.27±0.12)], the differences were statistically significant(t=3.085, 2.709, 4.013, all P<0.05). The ratio of CD45RA+ /CD45RO+ in the abdominal group was significantly lower than that in the skin group[(-0.07±0.27)vs.(0.27±0.12), t=2.989, P<0.05].@*Conclusion@#Peripheral blood T lymphocyte subsets CD45RA+ and CD45RO+ may play a role in the generation and development of immune function changes in children with HSP, and the decrease of CD45RA+ T cells may be related to the risk of HSP nephritis.

The study of AAV9 expression in cochleae of mice at different ages / 中华耳鼻咽喉头颈外科杂志

Objective@#To determine the extent of transfection and expression of adeno-associated virus (AAV) serotype 9 (AAV9) in the cochleae of mice at different ages.@*Methods@#AAV9-green fluorescent protein (GFP) was inoculated into the cochlea of mice via the round window membrane (RWM) or through cochleostomy at different ages. Four groups were divided according to ages and injection sites: P1SM group, AAV9-GFP was delivered to the scala media by cochleostomy at postnatal day 1; P1RW group, AAV9-GFP was delivered to the scala tympani via RWM at postnatal day 1; P9RW group: AAV9-GFP was injected through RWM at postnatal day 9; and P30RW group, adult mice (P30) were injected through RWM. GFP expression in cochlear whole mount was analyzed and auditory brainstem response (ABR) tests were conducted one month after virus injection (for each animal, only left cochlea was injected and the right side was used as a control). GraphPad Prism 5 statistical software was used for data analysis.@*Results@#All of inner hair cells (IHCs) and most of outer hair cells (OHCs) were transfected via two approaches at P1 injection. There was no significant difference in ABR threshold between injected ears and untreated ears (P>0.05). All of the IHCs and parts of OHCs (69% in apical turn) were transfected via RWM at P9. The strongest GFP expression was observed near the apical turn. Cochlear inoculation via RWM at P30 led to transgene expression in only IHCs. The ABR threshold of injected ears in P9RW group and P30RW group was significantly higher than that of contralateral ears (P<0.01).@*Conclusions@#AAV9 can be highly expressed in the inner and outer hair cells of the cochlea and hearing sensitivity can be preserved if virus injections are performed in neonatal mice. After AAV9 is transfected into the inner ear of adult mice, it is only expressed in the inner hair cells, which leads to the increase of the ABR response threshold of mice. Transfection efficiency is significant higher in neonate mice than in P9 and adult mice.

Dual-source CT diagnosis of single atrium / 中国医学影像技术

Objective To investigate the value of ECG-gated dual-source computed tomography angiography (DSCTA) in the diagnosis of single atrium (SA).Methods DSCTA was performed in 29 patients with SA.The classification diagnosis was made,and the complicated deformities were observed.Results Among 29 patients,atrial situs solitus was found in 14 (14/29,48.28％),atrial situs inversus was found in 6 (6/29,20.69％) and atrial situs ambiguous was found in 9 (9/29,31.03％,including right atrial isomerism in 8 and left atrial isomerism in 1 patient).The patients complicated with 39 kinds,totally 228 deformities.The bronchi and lung structures were found in the same position as atrium in 23 patients (23/29,79.31％),including atrial situs solitus in 13,right atrial isomerism in 7 and atrial situs inversus in 3 patients.Conclusion DSCTA can accurately diagnose SA and associated abnormalities.The features of bronchus and lung structures are helpful to identifying left and right atrial appendage.

Protective mechanisms of hydrogen rich saline on renal ischemia-reperfusion injury / 重庆医学

Objective To explore the protective mechanisms of hydrogen-rich saline on renal ischemiareperfusion injury.Methods Mice were divided in to 3 groups:control (sham operation),ischemia-reperfusion (IR) and ischemia-reperfusion+ hydrogen-rich saline (HRS).Mice in IR+ HRS group were administrated HRS by intravenous injection 3days and 1min before operation and 4 times in the following 2hours after operation.Mice in control and IR group were administrated normal saline as the same volume and frequency with IR + HRS group.Mice were sacrificed 24 hours after operation,creatinine and urea nitrogen in serum were detected by biochemical analyzer,MDA and SOD level were detected by spectrophotometer,expression of Bcl-xl,Bcl2,Bak,Bax,Cleaved Caspase-3 proteins level were detected by western blot.Results Compared to IR group,creatinine,urea nitrogen,MDA level decreased significantly after HRS consumption.SOD enzyme activity increased significantly after HRS consumption.HRS treatment down-regulates expression of Bak,Bax and Cleaved Caspase-3 protein level,and up-regulates expression of Bcl2,and Bcl-xl protein level.Conclusion HRS eliminates ROS and elevates antioxidant activity in renal after IR,besides,HRS also regulate apoptosis signal pathway to protect IR injury in renal.

Discussion on traditional Chinese medicine treatment models of depression named "three phases, five internal organs and ten syndromes" / 国际中医中药杂志

Based on the inheritance, the research group summarized the transmissive pathogenesis of depression in three typical stages, formulating the stepward treatment units which included Chinese medicine, acupuncture and TCM characterized psychotherapy, and formed a sequential treatment plan that balanced the principle of strengthening healthy Qi to eliminate pathogens, active and passive treatment, physical therapy and psychotherapy. Based on the retrospective analyses, ten typical clinical syndromes have been formed, constituting the pattern differentiation of "Three Phases, Five internal organs and Ten syndromes" for depression, which sysmatically showed the TCM syndrome differentiation. This work promoted the experiences and methods of treating depression by Chinese medicine.