Effects of interleukin-17A on liver and kidney injury and prognosis in septic mice / 中华危重病急救医学

OBJECTIVE@#To explore the effect of interleukin-17A (IL-17A) on liver and kidney injury and prognosis in septic mice.@*METHODS@#A total of 84 SPF male C57BL/6 mice were randomly divided into sham operation group (Sham group), cecal ligation and puncture (CLP) induced sepsis model group (CLP group), and IL-17A intervention group. IL-17A intervention group were then divided into five subgroups according to the dose of IL-17A (0.25, 0.5, 1, 2, 4 μg). Mice in the IL-17A intervention group were intraperitoneally injected with the corresponding dose of IL-17A 100 μL immediately after surgery. The other groups were intraperitoneally injected with 100 μL phosphate buffer solution (PBS). The survival rate of mice was observed at 7 days, and peripheral blood and liver, kidney and spleen tissues were collected. According to the 7-day survival, another 18 mice were randomly divided into Sham group, CLP group, and 1 μg IL-17A intervention group. Peripheral blood samples were collected at 12 hours and 24 hours after CLP, and the mice were sacrificed to obtain liver, kidney, and spleen tissues. The behavior and abdominal cavity of each group were observed. The levels of peripheral blood liver and kidney function indexes and inflammatory factors were detected. The histopathological changes of liver and kidney were observed under light microscope. The peripheral blood and spleen tissues were inoculated in the medium, the number of bacterial colonies was calculated, and the bacterial migration of each group was evaluated in vitro.@*RESULTS@#Except for the Sham group, the 7-day survival rate of mice in the 1 μg IL-17A intervention group was the highest (75.0%), so this condition was selected as the intervention condition for the subsequent study. Compared with Sham group, the liver and kidney functions of CLP group were significantly damaged at each time point after operation. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood urea nitrogen (BUN) and serum creatinine (SCr) reached the peak at 24 hours after operation, and the liver and kidney pathological scores reached the peak at 7 days after operation, the levels of inflammatory cytokines interleukin (IL-17A, IL-6, IL-10) reached the peak at 12 hours after operation, and tumor necrosis factor-α (TNF-α) reached the peak at 24 hours after operation. In addition, a large number of bacteria proliferated in the peripheral blood and spleen, which reached the peak on day 7. Compared with the CLP group, exogenous administration of 1 μg IL-17A significantly delayed the rising trend of each index in the early stage of sepsis [24-hour ALT (U/L): 166.95±5.20 vs. 271.30±6.11, 24-hour AST (U/L): 599.42±7.25 vs. 1 013.27±3.37, 24-hour BUN (mg/L): 815.4±26.3 vs. 1 191.2±39.4, 24-hour SCr (μmol/L): 29.34±0.87 vs. 60.75±3.83, 7-day liver pathological score: 2.50 (2.00, 3.00) vs. 9.00 (8.50, 9.00), 7-day kidney pathological score: 1.00 (1.00, 2.00) vs. 5.00 (4.50, 5.00), 12-hour IL-17A (ng/L): 105.21±0.31 vs. 111.28±1.37, 12-hour IL-6 (ng/L): 83.22±1.01 vs. 108.88±0.99, 12-hour IL-10 (ng/L): 731.54±3.04 vs. 790.25±2.54, 24-hour TNF-α (μg/L): 454.67±0.66 vs. 576.18±0.76, 7-day peripheral blood colony count (CFU/mL): 600 (400, 600) vs. 4 200 (4 200, 4 300), 7-day spleen tissue colony count (CFU/g): 4 600 (4 400, 4 600) vs. 23 400 (23 200, 23 500), all P < 0.05].@*CONCLUSIONS@#Appropriate dose (1 μg) of exogenous IL-17A can reduce the lethal inflammatory response induced by CLP and improve the ability of bacterial clearance, thereby alleviating liver and kidney injury and improving the 7-day survival rate of septic mice.

fMRI Study of Speech Processing in Presbycusis Patients / 听力学及言语疾病杂志

Objective To study the brain functional activation under speech stimulation in presbycusis pa‐tients using blood oxygenation level dependent functional magnetic resonance imaging (BOLD - fMRI) .Methods Eighteen normal hearing young volunteers ,10 normal hearing elderly people and 10 presbycusis patients received fM ‐RI under auditory task .Experimental tasks included monosyllabic verbal stimulating at tone of 1 kHz and sound in‐tensity to 90 dB ± 3 dB(after ambient noise detector Smart Sensor AR844 measurement and calibration) randomly transmitted to left and right ear .Following block design ,each stimulus was repeated twice .The lateralization of brain activation analysis observed changes in hemispheric dominance cases (or ear advantage change) .We observed brain activation analysis and changes of hemispheric lateralization advantage (or ear advantages) .SPM5 software was used to deal with the original pictures in the off - line work station to get fictional maps ,volume and intensity of the acti‐vated brain regions of interest ,and calculate the laterality index (LI) .Results To young people ,regardless of left or right ear stimulation ,the contralateral (region of intrest ,ROI) activation volume and intensity significantly increased compared to ipsilateral ,appearing contralateral hemispheric dominance ,and laterality index were - 0 .58 (left ear stimulation) and 0 .37 (right ear stimulation) .Compared to young people ,elderly people with normal hearing and presbycusis contralateral hemisphere conduction advantage was significantly reduced under monaural stimulation ,and the laterality indexes were - 0 .24 ,0 .28 (the aged group) ,- 0 .18 ,0 .25 (presbycusis group) .Young people received the left and the right ear auditory task respectively ,and the ratio of the total volume of bilateral ROI activation was 1 :2 .06 ,appearing to the right ear advantage (left brain dominance) .While the aged and presbycusis group manifes‐ted as right ear advantage decreased (left ear advantage enhanced) ,whose the total volume ratio was 1 :1 .51 for the old normal subjects and 1 :1 .61 for the hearing impaired seniors .Conclusion Auditory verbal tasks activated brain regions in the superior temporal gyrus and middle temporal gyrus were most obvious .Aging may cause these brain regions to be activated weaker ,appearing to the trend of contralateral hemisphere .The aging and deafness lead to the cortical reorganization .This may be one of the reasons for the declined speech recognition .

The effects of Kidney-deficiency on auditory cortex metabolism in the elderly: a 1H-MRS study / 国际中医中药杂志

Objective To investigate the effects of kidney-deficiency on auditory cortex metabolism in the elderly by using the proton magnetic resonance spectroscopy(1H-MRS).Methods 50 volunteers,including 20 young subjects and 30 older subjects matched for gender,were measured by pure tone audiometry、“kidney-deficiency”-related test and were executed 3.0 T multi-voxel 1H-MRS tests,The ratios of N-acetylaspartate (NAA),choline (Cho) and lactate (Lac) to creatine (Cr) were measured and were compared between the two groups.The t-test analysis were used for statistic process.The relationship between auditory cortex metabolism and the symptom of kidney-deficiency was also analyzed.Resnlts The result of kidney-deficiency-related test and pure tone audiometry revealed that there was significant difference between the two groups and the older subjects had the more severity kidney-deficiency and high-frequency hearing loss (t=6.335、19.558,P＜0.05).The NAA/Cho ratio in the auditory cortex in the older group was significantly lower than that in the younger group (t=2.90,P＜0.05).There were no significant differences between two groups for the ratios of NAA/Cr and Cho/Cr (t=1.415、0.927,P＞0.05).Decrease of the ratio of NAA/Cho in the older group is significantly related with kidneT-deficiency(r=- 0.773,P=0.025).Conclusion kidney-deficiency play a very important role in the hearing loss and reduction of the number of neurons in auditory cortex of older healthy subjects.It suggests one possible underlying mechanism for the speech perception difficulties exhibited by aging adults.

The hemispheric lateralization of the auditory cortex after being stimulated by pure tone: a 1H-MRS study / 中华行为医学与脑科学杂志

Objective To explore the asymmetry of metabolic products of the auditory cortex in normal human brain after being stimulated by the pure tone with the proton magnetic resonance spectroscopy(1 H-MRS). Methods Twelve healthy volunteers, including 7 males and 5 females, were performed MRS tests before and after the stimulation of the pure tone of 90 dB in intensity and 1000 Hz in frequency. The the metabolites peak of the N-acetylaspartate (NAA) ,creatine(Cr) ,choline( Cho) , glutamine/glutamate ( Glx) and GABA in auditory cortex were investigated, The content of metabolic products were conducted with half-quantitative analysis. The differences of the NAA/( Cho + Cr) ,Glx/Cr and GABA/ Cr ratios before and after pure tone stimulation in the bilateral auditory cortex were analyzed. The difference of distribution of the metabolic products between the left and right auditory cortex was also analyzed to explore the asymmetry of the auditory cortex. Results The NAA/( Cho + Cr) and GABA/Cr ratios increased,the Glx/Cr ratio decreased in the left auditory cortex after being stimulated by the pure tone. There were significant differences in the NAA/( Cho + Cr) , Glx/Cr and GABA/Cr ratios before and after pure tone stimulation (P0.05). There were statistically significant differences in the Glx/Cr ratio of the auditory cortex between two sides after being stimulated by the pure tone. Conclusion The metabolic lateralization exists in auditory cortex of normal human brain after being stimulated by the pure tone, which may be the bases of the functional asymmetry.

Analysis of failure of transpedicular screw fixation for thoracolumbar fractures / 中华创伤杂志

Objective To discuss the causes of failure of transpedicular screw fixation in treatment of thoracolumbar fractures. Methods A retrospective analysis was done to analyze the failure causes of 24 patients (15 males and 9 females) who received pedicle screw fixation for their thoracolumbar fractures from June 2002 to June 2008 in our department. There were two patients with delayed infection, eight with pedicle screw breakage, one with connecting rod breakage, 10 with internal fixation loosening (including nut loosening) and three with poor screw position. Results All patients received reo-perations including removal of internal fixation plus debridement and lavage in two patients, simple removal of internal fixation in nine patients, removal of inter fixation and posterior fusion in two, replacement of the lengthened fixation plus posterior fusion in nine, and adjustment of the position and orientation of screw in two. All patients were followed up for 6-18 months (average 11 months) , which showed no any complications. Conclusion Improper surgical indication or approach, ineffective fusion, incorrect postoperative rehabilitation exercise, too late removal of the screws and improper surgical operation are main causes for failure of internal fixation.

Arthroscopic treatment of synovial chondromatosis of hip joint / 中国矫形外科杂志

[Objective] To evaluate the treatment effect of the synovial chondromatosis of the hip through arthroscopy,and to describe the arthroscopic classification.[Methods]From March 2001 to May 2008,21 patients underwent arthroscopic management for primary synovial chondromatosis of the hip.Of the 21 patients,15 were male and 6 were female,aged from 17 to 49 years.The disease was located on the left side in 9 patients,the right side in 12.Anterior and anteriolateral approaches were selected for synovectomy and removal of free bodies.The peripheral compartment received traction,and curved scraper and Slide Winder Blade(the bending radio frequency)were used to deal with the acetabular fossa.[Results]The range of motion of the hip was improved and the pain was released after operation.MRI showed hydrops articuli was reduced or vanished.Harris hip score for the series of patients improved from 56.2 points preoperatively to 92 points at the mean follow-up of 45 months(11 to 96).Of the 21 patients,18(85.7%)had excellent or good outcomes.No recurrent case was found.[Conclusion]Hip arthroscopy proved beneficial for patients diagnosed with synovial chondromatosis of the hip.It had the advantages of minimal invasion,quick recover and satisfactory outcomes.Arthroscopic classification may guide the procedure and avoid omision of the free bodies.