Age-related changes in liver functional reserve measured by the L-1- 13C-phenylalanine breath test / 中华老年医学杂志

Objective:To evaluate liver functional reserve in healthy subjects of different age groups using the L-[1- 13C]-phenylalanine breath test( 13C-pheBT)and to investigate the patterns of changes in liver functional reserve with aging in comparison with elderly cirrhosis patients. Methods:Thirty-seven healthy volunteers were divided into a young and middle-aged group(n=10), an early elderly group(n=9), an advanced elderly group(n=9)and a longevity group(n=9). Eight elderly patients with liver cirrhosis were selected as the control group.An oral dose of 100 mg 13C-phe was administered to each subject.Expired breath samples were collected at pre-dose and at 12 different time points within 150 minutes post-dose.Isotope ratio mass spectrometer was used to measure the abundance of 13C.The percentage of the 13C excretion rate( 13CO 2ERt), the percentage of 13C cumulative excretion( 13Ccumt)at different time points, and the percentage of the 13C peak excretion rate( 13CO 2ERmax)after drug administration were calculated.In addition, associations between 13C-pheBT and common liver function parameters were analyzed. Results:Compared with healthy volunteers, 13CO 2ER 30, 13CO 2ER 45, 13CO 2ER 60, 13Ccum 45, 13Ccum 60, 13Ccum 75, 13Ccum 90 and 13Ccum 105, 13Ccum 120, 13Ccum 135, 13Ccum 150 showed significant differences in the longevity group, the young and middle-aged group and the young elderly group.There were statistically significant differences between the elderly cirrhosis group and the healthy volunteers in each subgroup(all P<0.05); The mean values of 13CO 2ERmax, 13CO 2ER 30, 13Ccum 45, 13Ccum 60, 13Ccum 75, 13Ccum 90, 13Ccum 105, 13Ccum 120, 13Ccum 135, 13Ccum 150 decreased following the order of the young and middle-aged group, the early elderly group, the advanced elderly group, the longevity group, and the elderly cirrhosis group(all P<0.05). In healthy volunteers, the 13CO 2 exclusion rate curve and the cumulative exclusion rate curve showed that the curves of the young and middle-aged group and the early elderly group almost overlapped, while the curves of the advanced group and the longevity group decreased with age, and the difference between the longevity group and the young and middle-aged group and between the longevity group and the early elderly group was markedly prominent. Conclusions:13C-pheBT is a safe, sensitive and reliable test for quantitation of liver function.Our recommendations include collecting samples within an hour of drug administration and using 13CO 2ERmax, 13CO 2ER 30, 13Ccum 45 and 13Ccum 60 as the main parameters.Overall, the functional reserve and compensatory capability of the liver are robust.The decline in liver functional reserve in healthy individuals is a gradual and slow process, with a significant decrease after age 80 and more so after age 90.

Comparison of safety of total laparoscopic versus laparoscopic-assisted radical gastrectomy for distal gastric cancer in older patients / 中华胃肠外科杂志

Objective: To compare the effectiveness of total laparoscopic versus laparoscopic-assisted distal gastrectomy and investigate the safety and replicability of total laparoscopic distal gastrectomy in older patients. Methods: This was a retrospective cohort study. The inclusion criteria were as follows: (1) age ≥65 years; (2) malignant gastric tumor diagnosed pathologically preoperatively; (3) Eastern Cooperative Oncology Group performance status score 0-1; (4) Grade I-III American Society of Anesthesiologists physical status; (5) preoperative clinical tumor stage I-III; (6) total laparoscopic or laparoscopic-assisted distal gastrectomy performed; and (7) gastrointestinal tract reconstruction using uncut Roux-en-Y or Billroth-II+Braun procedure. Patients who had received neoadjuvant therapy, undergone conversion to open surgery, or had serious comorbidities or incomplete data were excluded. The clinical data of 129 patients who met the above criteria and had undergone laparoscopic surgery for gastric cancer from January 2012 to December 2021 in the Gastrointestinal Cancer Center in the Beijing Cancer Hospital were analyzed. According to the operation method, the patients were divided into total laparoscopic group and laparoscopic-assisted group. Variables studied comprised: (1) surgical procedure and postoperative recovery; (2) postoperative pathological findings; and (3) postoperative complications. Measurement data with skewed distribution are represented as mean(quartile 1, quartile 3). Comparisons between groups were evaluated using the Mann-Whitney U test. Results: After propensity score matching in a 1:1 ratio, there were 40 patients in the total laparoscopic distal gastrectomy group and 40 in the laparoscopic-assisted distal gastrectomy group. Baseline characteristics did not differ significantly between the two groups (all P>0.05).Compared with the laparoscopic-assisted group, the total laparoscopic group had shorter main incisions (4.1±1.0 cm vs. 8.5±2.8 cm, t=9.375, P<0.001), time to fluid intake [4.0 (3.0, 4.8) days vs. 5.0 (4.0, 6.0) days, Z=2.167, P=0.030], and duration of indwelling abdominal drainage catheter [6.0 (6.0, 7.0) days vs. 7.0 (6.0, 8.0) days, Z=2.323, P=0.020]. Numerical Rating Scale scores on postoperative days 1 and 2 were higher in the total laparoscopic than the laparoscopic-assisted group [2.5 (1.0, 3.0) vs. 1.5 (1.0, 2.0), Z=1.980, P=0.048; 2.0 (1.0, 3.0) vs. 1.0 (1.0, 2.0), Z=2.334, P=0.020, respectively]. However, there were no significant differences between the groups in operation time, intraoperative blood loss, white blood cell count, hemoglobin concentration, or albumin concentration on postoperative day 1, time to ambulation, mean time to bowel movement, postoperative admission to the intensive care unit, length of postoperative hospital stay, or Numerical Rating Scale scores on postoperative day 3 (all P>0.05). There were also no significant differences between the two groups in maximum tumor diameter, pathological tumor type, total number of lymph nodes dissected, or total number of positive lymph nodes (all P>0.05). The incidence of postoperative complications was 15.0% (6/40) in the total laparoscopic group and the laparoscopic-assisted group; these differences are not significant (χ2<0.001, P>0.999). Conclusions: Compared with laparoscopic-assisted radical gastrectomy for distal gastric cancer, total laparoscopic surgery has the advantages of shorter incision, shorter time to fluid intake, and shorter duration of indwelling abdominal drainage catheter in older patients (age ≥65 years). Total laparoscopic radical gastrectomy for distal gastric cancer does not increase the risk of postoperative complications and could therefore be performed more frequently.

Mechanosensitive Ion Channel TMEM63A Gangs Up with Local Macrophages to Modulate Chronic Post-amputation Pain / 神经科学通报·英文版

Post-amputation pain causes great suffering to amputees, but still no effective drugs are available due to its elusive mechanisms. Our previous clinical studies found that surgical removal or radiofrequency treatment of the neuroma at the axotomized nerve stump effectively relieves the phantom pain afflicting patients after amputation. This indicated an essential role of the residual nerve stump in the formation of chronic post-amputation pain (CPAP). However, the molecular mechanism by which the residual nerve stump or neuroma is involved and regulates CPAP is still a mystery. In this study, we found that nociceptors expressed the mechanosensitive ion channel TMEM63A and macrophages infiltrated into the dorsal root ganglion (DRG) neurons worked synergistically to promote CPAP. Histology and qRT-PCR showed that TMEM63A was mainly expressed in mechanical pain-producing non-peptidergic nociceptors in the DRG, and the expression of TMEM63A increased significantly both in the neuroma from amputated patients and the DRG in a mouse model of tibial nerve transfer (TNT). Behavioral tests showed that the mechanical, heat, and cold sensitivity were not affected in the Tmem63a-/- mice in the naïve state, suggesting the basal pain was not affected. In the inflammatory and post-amputation state, the mechanical allodynia but not the heat hyperalgesia or cold allodynia was significantly decreased in Tmem63a-/- mice. Further study showed that there was severe neuronal injury and macrophage infiltration in the DRG, tibial nerve, residual stump, and the neuroma-like structure of the TNT mouse model, Consistent with this, expression of the pro-inflammatory cytokines TNF-α, IL-6, and IL-1β all increased dramatically in the DRG. Interestingly, the deletion of Tmem63a significantly reduced the macrophage infiltration in the DRG but not in the tibial nerve stump. Furthermore, the ablation of macrophages significantly reduced both the expression of Tmem63a and the mechanical allodynia in the TNT mouse model, indicating an interaction between nociceptors and macrophages, and that these two factors gang up together to regulate the formation of CPAP. This provides a new insight into the mechanisms underlying CPAP and potential drug targets its treatment.

A summary on surveillance system of occupational disease under the framework of National Health Insurance Informatization Project / 中华劳动卫生职业病杂志

The surveillance of occupational disease has entered a new stage ofdevelopment, with the implementation of the national health informatization project. To improve the efficiency and quality of occupational disease monitoring information reporting in this paper, the system architecture and related management regulations, as long as the major changes and achievement of "surveillance system of occupational disease and health hazards information" under the framework of National Health Insurance Informatization Project were elaborated. The deficiencies existing in the system were analyzed, and expectation for the construction of the occupational disease surveillance system was addressed.

Generation of Mlk3 KO mice by CRISPR/Cas9 and its effect on blood pressure / 生物工程学报

To explore the effect of Mlk3 (mixed lineage kinase 3) deficiency on blood pressure, Mlk3 gene knockout (Mlk3KO) mice were generated. Activities of sgRNAs targeted Mlk3 gene were evaluated by T7 endonuclease I (T7E1) assay. CRISPR/Cas9 mRNA and sgRNA were obtained by in vitro transcription, microinjected into zygote, followed by transferring into a foster mother. Genotyping and DNA sequencing confirmed the deletion of Mlk3 gene. Real- time PCR (RT-PCR), Western blotting or immunofluorescence analysis showed that Mlk3KO mice had an undetectable expression of Mlk3 mRNA or Mlk3 protein. Mlk3KO mice exhibited an elevated systolic blood pressure compared with wild-type mice as measured by tail-cuff system. Immunohistochemistry and Western blotting analysis showed that the phosphorylation of MLC (myosin light chain) was significantly increased in aorta isolated from Mlk3KO mice. Together, Mlk3KO mice was successfully generated by CRISPR/Cas9 system. MLK3 functions in maintaining blood pressure homeostasis by regulating MLC phosphorylation. This study provides an animal model for exploring the mechanism by which Mlk3 protects against the development of hypertension and hypertensive cardiovascular remodeling.

Herbal Textual Research on Myrrha in Famous Classical Formulas / 中国实验方剂学杂志

In order to provide the basis for the development of famous classical formulas containing Myrrha， the name， origin， quality evaluation， harvest and processing of Myrrha were systematically researched by consulting the ancient herbal and medical books， combining with the modern related literature. According to textual research， the results showed that Commiphora myrrha was the main base in ancient times， which was produced in Somalia， Ethiopia and northern Kenya. In addition， raw and fried products of Myrrha were the commonly used specifications in ancient herbal medicine， which are still used today. Nowadays， Myrrha， fried Myrrha and vinegar-processed Myrrha were the commonly used specifications. Among the three specifications， Myrrha is the raw products after cleaning， fried Myrrha is a kind of processed products， which has relevant records in ancient materia medica and is still used today. Vinegar-processed Myrrha is a new processing specification in modern times. Based on the research results， it is suggested that Myrrha in Shentong Zhuyutang should be the purified raw Myrrha in accordance with the 2020 edition of Chinese Pharmacopoeia.

Study on the rules of traditional Chinese medicine to promote wound healing based on data mining / 药学实践杂志

Objective To provide new ideas for promoting wound healing by digging and sorting out the medication rules in ancient classics and modern literatures. Methods The prescriptions for promoting wound healing recorded in literatures were collected to establish the database. The data mining technology was used for the analysis. Results 75 prescriptions and 203 traditional Chinese medicines were recorded in the ancient TCM literatures for promoting wound healing. The core medicines included frankincense, liquorice, angelica sinensis, angelica dahuricae, cortex phellodendri, myrrh, etc. They mainly belong to the class of clearing-heat drugs, promoting-circulation drugs, reinforcing drugs, relieving drugs, detoxification and tissue granulation drugs. Cluster analysis and association rule analysis were conducted for 16 core drugs. 4 cluster combinations ,15 groups of drug pairs and drug group association rules were obtained. Conclusion The prescription rules for wound healing mainly included clearing heat, promoting circulation, reinforcing, relieving, detoxification, and promoting tissue granulation. TCM wound treatment should be based on syndrome differentiation for fever, blood stasis, deficiency, anabrosis, exterior syndrome and poisoning.

Specialty construction and accomplishment of rehabilitation medicine in Fenglin Community Health Service Center of Shanghai Xuhui District / 中华全科医师杂志

Rehabilitation medicine is one of the most important specialties in community health institutions. This article introduces the 12 year′s development of rehabilitation medicine in Fenglin Community Health Service Center, focusing on the talent allocation, service capabilities, resource expansion, basic facilities, personnel recruiting, department operating, service scope, and its achievements and influence, to provide reference for planning and construction of featured specialty in community health service centers.

Effect of arachidonic acid cytochrome P450ω hydroxylase Cyp4a14 gene knockout on skeletal muscle regeneration after injury / 生理学报

The objective of this study was to explore the roles of arachidonic acid cytochrome P450ω hydroxylase CYP4A14 in skeletal muscle regeneration after injury. Wild-type (WT) control mice and Cyp4a14 knockout (A14

Arachidonic acid Alox15/12-HETE signaling inhibits vascular calcification / 生理学报

This study aims to explore the effects of arachidonic acid lipoxygenase metabolism in vascular calcification. We used 5/6 nephrectomy and high-phosphorus feeding to establish a model of vascular calcification in mice. Six weeks after nephrectomy surgery, vascular calcium content was measured, and Alizarin Red S and Von Kossa staining were applied to detect calcium deposition in aortic arch. Control aortas and calcified aortas were collected for mass spectrometry detection of arachidonic acid metabolites, and active molecules in lipoxygenase pathway were analyzed. Real-time quantitative PCR was used to detect changes in the expression of lipoxygenase in calcified aortas. Lipoxygenase inhibitor was used to clarify the effect of lipoxygenase metabolic pathways on vascular calcification. The results showed that 6 weeks after nephrectomy surgery, the aortic calcium content of the surgery group was significantly higher than that of the sham group (P < 0.05). Alizarin Red S staining and Von Kossa staining showed obvious calcium deposition in aortic arch from surgery group, indicating formation of vascular calcification. Nine arachidonic acid lipoxygenase metabolites were quantitated using liquid chromatography/mass spectrometry (LC-MS) analysis. The content of multiple metabolites (12-HETE, 11-HETE, 15-HETE, etc.) was significantly increased in calcified aortas, and the most abundant and up-regulated metabolite was 12-HETE. Furthermore, we examined the mRNA levels of metabolic enzymes that produce 12-HETE in calcified blood vessels and found the expression of arachidonate lipoxygenase-15 (Alox15) was increased. Blocking Alox15/12-HETE by Alox15 specific inhibitor PD146176 significantly decreased the plasma 12-HETE content, promoted calcium deposition in aortic arch and increased vascular calcium content. These results suggest that the metabolism of arachidonic acid lipoxygenase is activated in calcified aorta, and the Alox15/12-HETE signaling pathway may play a protective role in vascular calcification.

Optimization of blending method of Shuanghuanglian injection and its stability study in different solvents / 国际中医中药杂志

Objective:To optimize the blending method of Shuanghuanglian injection, and to investigate its stability in different solvents (0.9% sodium chloride injection, 5% glucose injection, 10% glucose injection, glucose and sodium chloride injection). Methods:By using orthogonal test to optimize the best dissolution method of Shuanghuanglian injection By measuring the content change of insoluble particles, pH value and principal components (baicalin, forsythione, chlorogenic acid) in the finished products to investigatethe stability of Shuanghuanglian injection in different solvents. Results:The optimal blending method of Shuanghuanglian injection was to add 5 ml sterilized water for injection into the vial and oscillate at 1 200 r/min frequency for 5 min. The main constituents of Shuanghuanglian injection were stable in 8 h in the infusion of four kinds of finished products. Insoluble particles in 0.9% sodium chloride infusion and 5% glucose infusion met the requirements within 8 h, and insoluble particles in 10% glucose infusion and 6 h glucose and sodium chloride infusion met the requirements. The pH value of 0.9% sodium chloride infusion within 8 h met the optimal requirements of the best compatibility, 5% glucose infusion within 2 h met the requirements, and 4 h sodium chloride infusion met the requirements of the best compatibility. Conclusion:This study optimized the best preparation method of Shuanghuanglian (freeze-dried) for injection. Sodium chloride injection should be used as the solvent to prepare finished infusion in clinical application, and 5% glucose injection should be prepared just before use.

Chronic Toxicity of Tanreqing Injection in Beagle Dogs / 中国实验方剂学杂志

Objective:To observe the possible toxicity of long-term intravenous injection of Tanreqing injection in Beagle dogs， so as to provide experimental data for its clinical safe medication. Method:A total of 32 Beagle dogs （16 males and 16 females） were randomly divided into the low- （2.5 mL·kg^-1）， medium- （5.0 mL·kg^-1）， and high-dose （10.0 mL·kg^-1） Tanreqing injection groups and control group according to their body mass indices， with eight dogs in each group. In the waking state， the dogs were treated with intravenous injection of corresponding drugs into the medial cephalic vein of forelimb for 13 weeks， followed by four-week drug withdrawal. After the observation of general condition， body mass， and food consumption， the Beagle dogs were subjected to electrocardiography， ophthalmoscopy， hematological examination， serum biochemistry， and blood coagulation test in the middle of medication （week 6）， at the end of medication （week 13）， and during recovery （week 17）. Then the gross anatomy was conducted for calculating the major organ coefficients and observing the histopathological changes. Result:No obvious toxic reaction was found in each group， but the decreased fibrinogen and increased Kupffer's cells phagocytizing yellow-brown pigment in hepatic sinusoids were observed in the high-dose Tanreqing injection group following three months of medication. Reduction of fibrinogen was not observed in recovery period， but Kupffer's cells that phagocytized yellow-brown pigment still existed. Conclusion:The intravenous injection of Tanreqing injection at 2.50 mL·kg^-1（low dose）， 5.00 mL·kg^-1 （medium dose） or 10.00 mL·kg^-1（high dose） for three months in Beagle dogs resulted in no obvious toxic reaction. However， it is still suggested to test the liver function and blood coagulation after long-term administration of high-dose Tanreqing injection.

Effect of Microelectronic Electromyography Bridge on Motor Function of Extensor Carpi Radialis Longus in Patients with Cervical Spinal Cord Injury / 中国康复理论与实践

Objective:To observe the effect of microelectronic EMG bridge (EMGB) training on the motor function of extensor carpi radialis longus in patients with complete cervical 5 spinal cord injury. Methods:From March, 2016 to March, 2017, 20 patients with complete cervical 5 spinal cord injury were randomly divided into control group (n = 10) and experimental group (n = 10). The control group received routine wrist extensor muscle training, and the experimental group received EMGB training in addition, for 180 days. The motor function of the affected limb was evaluated by sEMG of extensor carpi radialis longus, Manual Muscle Test (MMT), Wolf Motor Function Test (WMFT) and Spinal Cord Lesion Independence Measure (SCIM). Results:After treatment, the peak value and average value of sEMG of extensor carpi longus of both sides increased in both groups (t > 2.510, P < 0.05), the peak value and average value of the left side were higher (t > 2.759, P < 0.05), and the peak value of the right side was higher (t = 2.691, P < 0.05) in the experiment group than in the control group, however, there was no significant difference in average value of the right side between two groups (t = 2.063, P = 0.054). The scores of MMT increased in both groups (t > 2.569, P < 0.05), and were higher in the experimental group than in the control group (t > 2.278, P < 0.05). The scores of WMFT and SCIM increased in both groups (t > 3.839, P < 0.05), however, there was no significant difference between two groups (t < 1.498, P > 0.05). Conclusion:EMGB training could improve the motor function of extensor carpi radialis longus in patients with complete cervical 5 spinal cord injury.

Quality Comparison of Ziziphi Spinosae Semen under Different Packaging and Storage Conditions / 中国药房

ABSTRACT OBJECTIVE：To determine the suitable storage conditions，packaging materials and packaging methods of Ziziphi Spinosae Semen，and to provide reference for guaranteeing the quality. METHODS：The same batch of Ziziphi Spinosae Semen samples were packed in plastic woven bag，plastic bag，plastic bag in vacuum，aluminum-plastic composite bag，aluminum-plastic composite bag in vacuum and kraft coated paper bag. They were stored in a cool warehouse（temperature ≤20 ℃，relative humidity was 45％-75％） and drug stability test box [temperature was（40±2）℃，relative humidity was（75±5）％]. Five evaluation indexes were detected during 6-month of long-term cool stability test and accelerated stability test，including characters and the contents of moisture，aflatoxins，jujubosides A and spinosin. RESULTS：The results of 6-month long-term cool stability test showed that the character and the content of moisture，aflatoxins and jujubosides A of Ziziphi Spinosae Semen under different packaging conditions were in line with the requirements of 2015 edition of Chinese Pharmacopeia （part Ⅰ）（shorted for “pharmacopeia”）. The content of spinosin didn’t meet the requirement of pharmacopeia（no less than 0.080％），but the content of spinosin（0.079％）of aluminum-plastic composite bag in vacuum was close to the requirements of pharmacopeia. The results of 6-month accelerated stability test showed that the sample packed in kraft coated paper bag and plastic woven bag were seriously moldy；the sample packed in plastic bag and plastic bag in vacuum were blackened；the color of the sample packed in aluminum-plastic composite bag was slightly darker；but the appearance of the sample packed in aluminum-plastic composite bag in vacuum was basically unchanged. Only when stored for 2-month，the content of aflatoxin B1 in the sample packed in plastic woven bag was 8.64 μg/kg，which exceeded the pharmacopoeia regulation. The moisture content of the sample packed in plastic woven bag and kraft coated paper bag exceeded the highest value （9.0％） required by the pharmacopoeia. Although the content of jujuboside A of samples in each package decreased，it meet the requirements of the pharmacopoeia. Only the content of spinosin （0.084％）of sample packed in plastic bag in vacuum meet the requirements of the pharmacopoeia，and the content of spinosin （0.071％）of sample packed in aluminum-plastic composite bag in vacuum was relatively high. CONCLUSIONS：Ziziphi Spinosae Semen should be stored in a cool and dry place after packed in aluminum-plastic composite bag in vacuum.

Advance in Geriatric Traumatic Spinal Cord Injury (review) / 中国康复理论与实践

The incidence and proportion of traumatic spinal cord injury in the elderly are increasing year by year, and it has become the main affected population of spinal cord injury in developed countries. Fall is the main cause of injury. The increase of spinal stenosis, the biomechanical changes of the spine and the hyperextension injuries may be the mechanism of spinal cord injury caused by minor trauma in this population. Traumatic spinal cord injury in the elderly usually requires early surgical treatment. When there are complicated comorbidities, unstable vital signs or mild spinal cord injury without major fracture or dislocation, non-surgical treatment and active rehabilitation can be considered. However, the specific indications and timing of surgery are still controversial. Compared with young people, most elderly patients present with incomplete cervical spinal cord injury and are expected to restore better limb function, following poor recovery of self-care ability. It is important to monitor the functional change throughout rehabilitation and adjust the hours and intensity of training accordingly.

Advance in Return to Play after Spine and Spinal Cord Injury for Athletes (review) / 中国康复理论与实践

Spinal injuries caused by competitive sports are common. Spinal diseases are important issues that needs to be solved urgently in the fields of sports injury. Return to play recommendations are complicated due to a mix of medical factors, social pressures, and limited outcome data. This article reviewed the current situation of athletes return to play after spine and spinal cord injury based on disease classification, including cervical spine (cervical soft tissue injuries, cervical fracture and dislocation, cervical stenosis, cervical disk herniation, stingers and burners), thoracic spine (thoracic fracture), lumbar spine (lumbar strain, lumbar stenosis spondylolysis and spondylolisthesis, lumbar disk herniation), and spinal cord concussion and spinal cord injury. This article also analyzed the criteria for athletes to return to play after spine and spinal cord injuries. It may provide references for future clinical management and consensus/guidelines.

TMEM43-S358L mutation enhances NF-κB-TGFβ signal cascade in arrhythmogenic right ventricular dysplasia/cardiomyopathy

Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) is a genetic cardiac muscle disease that accounts for approximately 30% sudden cardiac death in young adults. The Ser358Leu mutation of transmembrane protein 43 (TMEM43) was commonly identified in the patients of highly lethal and fully penetrant ARVD subtype, ARVD5. Here, we generated TMEM43 S358L mouse to explore the underlying mechanism. This mouse strain showed the classic pathologies of ARVD patients, including structural abnormalities and cardiac fibrofatty. TMEM43 S358L mutation led to hyper-activated nuclear factor κB (NF-κB) activation in heart tissues and primary cardiomyocyte cells. Importantly, this hyper activation of NF-κB directly drove the expression of pro-fibrotic gene, transforming growth factor beta (TGFβ1), and enhanced downstream signal, indicating that TMEM43 S358L mutation up-regulates NF-κB-TGFβ signal cascade during ARVD cardiac fibrosis. Our study partially reveals the regulatory mechanism of ARVD development.

Neonatal Maternal Deprivation Followed by Adult Stress Enhances Adrenergic Signaling to Advance Visceral Hypersensitivity / 神经科学通报·英文版

The pathophysiology of visceral pain in patients with irritable bowel syndrome remains largely unknown. Our previous study showed that neonatal maternal deprivation (NMD) does not induce visceral hypersensitivity at the age of 6 weeks in rats. The aim of this study was to determine whether NMD followed by adult stress at the age of 6 weeks induces visceral pain in rats and to investigate the roles of adrenergic signaling in visceral pain. Here we showed that NMD rats exhibited visceral hypersensitivity 6 h and 24 h after the termination of adult multiple stressors (AMSs). The plasma level of norepinephrine was significantly increased in NMD rats after AMSs. Whole-cell patch-clamp recording showed that the excitability of dorsal root ganglion (DRG) neurons from NMD rats with AMSs was remarkably increased. The expression of β adrenergic receptors at the protein and mRNA levels was markedly higher in NMD rats with AMSs than in rats with NMD alone. Inhibition of β adrenergic receptors with propranolol or butoxamine enhanced the colorectal distention threshold and application of butoxamine also reversed the enhanced hypersensitivity of DRG neurons. Overall, our data demonstrate that AMS induces visceral hypersensitivity in NMD rats, in part due to enhanced NE-β adrenergic signaling in DRGs.

Regularity of Clinical Symptoms about Patients with Sympathetic Cervical Spondylosis / 中国康复理论与实践

Objective:To study the regularity of clinical symptoms of sympathetic cervical spondylosis. Methods:A retrospective study was conducted on 110 patients with sympathetic cervical spondylosis admitted to the outpatient department from 2017 to 2019. The regularity of clinical symptoms of the patients was analyzed, including the sympathetic symptoms of different systems, the property of dizziness, the sequence, time interval and correlation of the symptoms, and whether the numbness of the limbs was accompanied by the symptoms and signs of cervical spondylotic radiculopathy and cervical spondylotic myelopathy. Results:The sympathetic symptoms were complex, involved in digestive system (71.82%), cardiovascular system (83.64%), respiratory system (63.64%), sweat gland (48.18%), eyes (81.82%), ears (60.91%), brain (68.18%) and limbs (70%), mainly sympathetic excitatory. The dizziness of the patients was mainly manifested as muddled brain (66.36%), a few patients were accompanied by external objects or their own rotation and sloshing (23.64%), and a very few patients showed external objects or their own rotation and sloshing (8.18%). Most patients complained chronic neck pain before dizziness and other sympathetic symptoms, accounting for 58.18%. The mean time for progression from neck pain to dizziness was (68.98±64.42) months. There were 77 patients complaining limb numbness, but none of them was found symptoms or signs of cervical spondylotic radiculopathy or cervical spondylotic myelopathy. It seemed to be a part of sympathetic symptoms in the limbs. The severity of dizziness was positively correlated with the course of disease (r = 0.610, P < 0.001), and was also positively correlated with the score of sympathetic symptom (r = 0.301, P = 0.004). Conclusion:The symptoms of sympathetic cervical spondylosis are complex. Muddled brain is the main symptom of dizziness, not vertigo. As the disease progresses, dizziness and sympathetic symptoms gradually worsen. Most sympathetic cervical spondylosis develops from cervical spondylosis. Cervical spondylotic radiculopathy or cervical spondylotic myelopathy may be the more severe forms of cervical spondylosis that develop on this basis。

Effect of Virtual Reality on Therapeutic Pain in Children with Spastic Cerebral Palsy / 中国康复理论与实践

Objective:To observe the effect of virtual reality on therapeutic pain in children with spastic cerebral palsy, through the profiles of the pain stress and outcome of rehabilitation treatment. Methods:From September, 2018 to June, 2019, 49 children with spastic cerebral palsy were randomly divided into control group (n = 25) and observation group (n = 24). Both groups received conventional rehabilitative treatment. The observation group wore virtual reality head display, choosing appropriate panoramic cartoon play or head control game according to their intelligence level to immerse themselves in the virtual environment. Both groups were treated five days per week for three weeks, for a total of 15 treatment days. Saliva cortisol was measured same time on the first, fifth, ninth, and 13th treatment days. They were assessed with modified Ashworth Scale (MAS), the Chinese version of Gross Motor Function Test Scale (GMFM) and Pediatric Disability Assessment Scale (PEDI) before and three weeks after treatment. Results:The cortisol levels significantly increased on all the treatment days in both groups (|t| > 3.502, P < 0.05). On the fifth, ninth, and 13th treatment days, the cortisol level was lower in the observation group than in the control group (t > 2.224, P < 0.05). After treatment, the MAS score decreased (|Z| > 2.636, P < 0.01), and the scores of PBS and PEDI increased (|Z| > 3.629, P < 0.001) in both groups; the scores of PBS and PEDI were higher in the observation group than in the control group (|Z| > 2.000, P < 0.05) Conclusion:Virtual reality is helpful to alleviate the pain stress in children with spastic cerebral palsy, and it is helpful to improve the effect of rehabilitation treatment.