Association between hypertension and the risk of gallstone disease / 临床肝胆病杂志

ObjectiveThis article aims to investigate the association between hypertension and the risk of GSD by conducting a national multicenter study， a systematic review， and a meta-analysis. MethodsThe study was conducted in three stages. In the first stage， subjects were recruited for health examination in four hospitals in Chengdu， Tianjin， Beijing， and Chongqing， China， from 2015 to 2020， and the multivariate logistic regression analysis was used to investigate the association between hypertension and the risk of GSD in each center. In the second stage， Embase， PubMed， Wanfang Data， VIP， and CNKI databases were searched for related studies published up to May 2021， and a meta-analysis was conducted to further verify such association. In the third stage， the random effects model was used for pooled analysis of the results of the multicenter cross-sectional study and the findings of previous literature. ResultsA total of 633 948 participants were enrolled in the cross-sectional study， and the prevalence rate of GSD was 7.844%. The multivariate logistic regression analysis showed that hypertension was positively associated with the risk of GSD（P<0.05）. Subgroup analysis showed that there was no significant difference in the association between hypertension and GSD between individuals with different sexes， ages， and subtypes of GSD. A total of 80 articles were included in the systematic review and the meta-analysis， and the results showed that the risk of GSD was increased by 1.022 times for every 10 mmHg increase in diastolic pressure and 1.014 times for every 10 mmHg increase in systolic pressure. ConclusionHypertension significantly increases the risk of GSD， and the findings of this study will provide a basis for the etiology of GSD and the identification of high-risk groups.

Exosome and Its Function in Central Nervous System / 生物化学与生物物理进展

Exosome is a kind of extracellular vesicles secreted by cells to the outside. Biogenesis mainly involves two invaginations of the cytoplasmic membrane, the formation of multivesicular bodies, and the release of exosomes. Exosomes have abundant and diverse inclusions—including landmark membrane proteins, soluble proteins, various RNA molecules and DNA fragments, etc. Cells can achieve intercellular signal communication by secreting and receiving exosomes. Through interaction of ligand molecules on the exosome membrane with receptors on the surface of other cytoplasmic membranes, exosomes can activate cell signal transduction or fuse with the cell membrane to release its contents into the cytoplasm to exert regulatory functions. In the central nervous system, exosomes secreted by neurons and various glial cells can mediate wired synaptic signal transmission, but mainly play a role similar to neuromodulator by way of volume transmission. In this paper, the biogenesis of exosomes and important functional components are described in detail, and the characteristics of neural exosomes in the biogenesis, content sorting and controlled release are compared with those of synaptic vesicles. We further review the research progress on the physiological functions of neural exosomes on the central nervous system and their roles in the occurrence and development of neurodegenerative diseases and major depressive disorder. We also prospect the application of exosomes in the early diagnosis and targeted therapy of nervous system diseases.

Clinical features of thalamic infarction caused by non-thalamogeniculate artery occlusion / 中风与神经疾病杂志

@#Objective To explore the clinical and etiological features of rare and special thalamic artery(thalamotuberal artery,thalamoperforating artery,and posterior choroidal artery) occlusion. Methods We included 48 patients with thalamogeniculate artery occlusion and 19 patients with non-thalamogeniculate artery occlusion to compare their clinical manifestations and etiological classifications. Results Compared with the thalamogeniculate artery occlusion group,the non-thalamogeniculate artery occlusion group showed a significantly higher percentage of decline in advanced cognition(0.00% vs 21.1%, χ2=10.747,P=0.001),a significantly lower percentage of unilateral sensory disturbance(75% vs 21.1%, χ2=16.466,P<0.001),a significantly higher percentage of large artery atherosclerosis in etiology classification(29.17% vs 84.2%, χ2=16.679,P<0.001),and a significantly larger infarct volume(t=10.86,P<0.001). Conclusion Patients with thalamic stroke caused by non-thalamogeniculate artery occlusion are more likely to have decline in advanced cognition and large artery atherosclerosis. More attention should be paid to large vessel disease screening for such patients.

To explore the correlation analysis between the changes of cognitive function and the expression levels of serum ICAM-1 and 8-iso-PGF2α in patients with acute ischemic stroke / 中风与神经疾病杂志

@#To explore the correlation analysis between the changes of cognitive function and the expression levels of serum ICAM-1 and 8-iso-PGF2α in patients with acute ischemic stroke. Method A total of 100 patients with Acute ischemic stroke admitted to our hospital from August 2017 to October 2019 were divided into group A （60 cases，MoCA score<26 points） and group B （40 cases，MoCA） according to the MoCA score Score ≥26 points）. Enzyme-linked immunosorbent assay was used to determine the expression levels of ICAM-1 and 8-iso-PGF2α in the two groups. Spearman was used to analyze the correlation between serum ICAM-1 and 8-iso-PGF2α and MoCA scores. Logistic regression was used to analyze Acute ischemic stroke. Influencing factors of patients’ cognitive function changes. ROC curve analysis of serum ICAM-1，8-iso-PGF2α expression for the diagnostic value of cognitive function in patients with Acute ischemic stroke. Results The expression of serum ICAM-1 and 8-iso-PGF2α in group A was significantly higher than that in group B （P<0.05）；Serum ICAM-1 and 8-iso-PGF2α expression levels were significantly correlated with the location of infarct，carotid atherosclerosis，carotid stenosis，NIHSS score，MoCA，and age （P<0.05），but not related to education level （P> 0.05）. The infarcts were located in the thalamus，temporal lobe and frontal lobe. NIHSS score，diabetes and hypertension were independent risk factors for cognitive dysfunction in patients with Acute ischemic stroke （P<0.05）. The sensitivity and specificity of ICAM-1 and 8-iso-PGF2α in diagnosing the changes of cognitive function in patients with Acute ischemic stroke were 93.00% and 90.00% （P<0.05）. Conclusion The expression of serum ICAM-1 and 8-iso-PGF2α is closely related to the changes of cognitive function in patients with Acute ischemic stroke.

Recent research on the mechanism of mesenchymal stem cells in the treatment of bronchopulmonary dysplasia / 中国当代儿科杂志

Bronchopulmonary dysplasia (BPD) is a chronic lung disease due to impaired pulmonary development and is one of the main causes of respiratory failure in preterm infants. Preterm infants with BPD have significantly higher complication and mortality rates than those without BPD. At present, comprehensive management is the main intervention method for BPD, including reasonable respiratory and circulatory support, appropriate enteral nutrition and parenteral nutrition, application of caffeine/glucocorticoids/surfactants, and out-of-hospital management after discharge. The continuous advances in stem cell medicine in recent years provide new ideas for the treatment of BPD. Various pre-clinical trials have confirmed that stem cell therapy can effectively prevent lung injury and promote lung growth and damage repair. This article performs a comprehensive analysis of the mechanism of mesenchymal stem cells in the treatment of BPD, so as to provide a basis for clinical applications.

Effect of zoladronate on the proliferation and osteogenic differentiation of rat bone mesenchymal stem cells / 华西口腔医学杂志

OBJECTIVE@#To evaluate the effect of zoledronate acid (ZA) on the proliferation and osteogenic differentiation of rat mesenchymal stem cells (BMSCs).@*METHODS@#The BMSCs isolated from the SD rats were cultured with different concentrations of ZA (1, 5, 10, and 20 μmol·L), and the contro1 group received the same volume of culture medium but without ZA. Cell counting kit-8 was used to detect proliferation activity in each group. Alkaline phosphatase (ALP) staining and alizarin red staining were used to detect the osteogenic differentiation ability in each group. The gene expression levels of ALP, bone morphogenetic protein-2 (BMP-2), typeⅠcollagenase (COL-Ⅰ), runt-related transcription factor-2 (Runx-2), zinc finger structure transcription factor (Osx), osteocalcin (OCN), and osteopontin (OPN) were evaluated by real-time quantitative polymerase chain reaction (qRT-PCR).@*RESULTS@#Zoledronate at 1 μmol·L⁻¹ concentration had no effect on the proliferation and osteogenic differentiation of BMSCs. No significant difference was observed between this group and the control group (P>0.05). When the ZA concentration was more than 1 μmol·L⁻¹, ZA inhibited the proliferation and osteogenic differentiation of BMSCs, and the effect was concentration dependent. The difference between each group and the control group was statistically significant (P<0.05). At ZA concentration of 5 μmol·L⁻¹, ZA enhanced the expression of ALP, BMP-2, COL-Ⅰ, Runx-2, Osx, OCN, and OPN (P<0.05). However, at ZA concentration of more than 5 μmol·L⁻¹, the expression levels of osteogenicrelated genes in each group was lower than those of the control group (P<0.05).@*CONCLUSIONS@#Low ZA concentration has no effect on the proliferation and osteogenic differentiation of BMSCs. ZA at 5 μmol·L⁻¹ concentration inhibits the proliferation but promotes the osteogenic differentiation of BMSCs. High ZA concentration inhibits the proliferation and osteogenic differentiation of BMSCs.

The effect of intranasal instillation of insulin on cognitive function in patients with Alzheimer disease / 中国医师进修杂志

Objective To investigate the effect of intranasal instillation of insulin with different doses on cognitive function in patients with Alzheimer disease (AD).Methods Sixty-three AD patients were collectcd.According to the order of doctor's office visiting,they were divided into insulin 1 group (21 cases,intranasal instillation of insulin 20 U,2 times per day),insulin 2 group (21 cases,intranasal instillation of insulin 40 U,2 times per day) and placebo group (21 cases,intranasal instillation of physiological saline,2 times per day).Mini-mental state examination scale (MMSE) and Rivermead behavioural memory test second edition (RBMT Ⅱ) were used to evaluate the improvement of cognitive function after 3 months and 6 months.Results Before treatment,the scores of MMSE and RBMT Ⅱ in insulin 1 group were (20.2 ± 2.3) and (17.2 ± 1.9) scores,in insulin 2 group were (20.7 ± 2.8) and (16.5 ± 1.9) scores.After treatment for 3 months,the scores of MMSE and RBMT Ⅱ in insulin 1 group were (21.8 ± 3.2) and (19.2 ± 2.0) scores,in insulin 2 group were (21.6 ± 3.5) and (18.1 ± 2.0) scores.The scores of MMSE and RBMT Ⅱ in insulin 1 group and insulin 2 group significantly improved compared with those before treatment (P ＜ 0.05 or ＜ 0.01).But the scores of MMSE and RBMT Ⅱ in placebo group were significantly aggravated,(18.9 ± 3.8) scores vs.(20.9 ± 2.5) scores,(15.2 ± 2.1) scores vs.(16.1 ± 2.0) scores,P ＜ 0.05.After treatment for 6 months,the scores of MMSE and RBMT Ⅱ in insulin 1 group were (22.5 ± 3.3) and (20.5 ± 2.0) scores,in insulin 2 group were (22.7 ± 3.1) and(19.8 ± 1.9) scores,and in placebo group were (17.9 ± 4.5) and(14.7 ± 2.0) scores.The scores of MMSE and RBMT Ⅱ in insulin 1 group and insulin 2 group were significantly better than those in placebo group (P ＜ 0.01).Conclusion Intranasal instillation of insulin can improve cognitive disorders in patients with AD.

A novel "box lesion" minimally invasive totally thoracoscopic surgical ablation for atrial fibrillation

<p><b>INTRODUCTION</b>Minimally invasive surgical ablation is an emerging alternative method to catheter ablation and the full surgical maze procedure for nonpharmacologic treatment of atrial fibrillation (AF). We present a totally thoracoscopic "box lesion" radiofrequency ablation procedure in patients with paroxysmal or persistent AF.</p><p><b>MATERIALS AND METHODS</b>From June 2011 to October 2012, 14 patients with lone paroxysmal (n = 7) or persistent AF (n = 7) were enrolled in this study. Procedures were performed through 3 5-12 mm holes on each side of the chest wall. A bipolar ablation device was used to create a box lesion in the posterior wall of the left atrium that encircled the 4 pulmonary veins (achieving bilateral pulmonary vein/posterior left atrial wall isolation). Perioperative complications were recorded for all patients. Freedom from AF was assessed by 24-hour Holter monitoring every 3 months or during symptoms of arrhythmia.</p><p><b>RESULTS</b>The ablation was successfully performed in all patients, with median operation time of 128 minutes (range, 45 to 180 minutes). No operative mortality or morbidity were noted during the study period. Freedom from AF was achieved in 12 patients (85.7%) during follow-up (median follow-up 9 months). One patient with persistent AF was shifted to paroxysmal AF. No atrial flutter or atrial tachycardia was noted during the follow-up.</p><p><b>CONCLUSION</b>These early results show that totally thoracoscopic surgical ablation using a unique "box lesion" procedure for persistent or paroxysmal AF is a feasible and effective method with good short-term results. Further study is necessary to validate this result.</p>

Clinical and imaging analysis of corpus callosum infarction / 国际脑血管病杂志

Objective To investigate the clinical and imaging characteristics in patients with corpus callosum infarction.Methods The clinical data of 416 patients meetingthe diagnosis of cerebral infarction Were collected,in which,8 patients Were confirmed as corpus callosum infarction by MRI.Results Corpus callosum infarction accounted for 1.9% of all patients with cerebral infarction.CT scan did not show the corpus callosum infaretiom in 7 patients.The nonenhanced MRI revealed the lesions.The enhanced MRI revealed the lesion in another patient.The infarction foci were not only involved in the corpus callosum(knee,body or splenium),but also cornplicated with frontal lobe,occipital lobe and thalamus infractions.The clinical manifesta tions of the corpus callosum infarction were different due to the specific lesion sites.The simple infarction in the body of the corpus callosum mainly presented as contralateral paraparesis.atria,and left limb apra.xia;the infarction in the knee of the corpus callosum mainly presented as lower limb paralysis or contralateral paraparesis;the infarction in the splenium of the corpus callosum presented as limb paralysis and dizziness;the lacunar infarct in the corpus callosum had no obvious clinical manifestations.The patients who complicated with frontal lobe and thalamus infarction had behavioral and psychological syrnptonm,including mental retardation,language abnormalities.and incontinence.Conelusions Corpus callosum infarction is not common.MRI is the basis of diagaosis.The clinical manifestation is lack of specificity.and it is agsociated with the location of corpus callosum infarction and whether it comolicates with the infarction on other part.