Construction and validation of a Nomogram model of intracranial infection after neurosurgery / 中国感染控制杂志

Objective To explore the risk factors for intracranial infection in patients after neurosurgery,con-struct and validate a Nomogram prediction model.Methods Data of 978 patients who underwent neurosurgery in a hospital in Nanjing from January 1,2019 to December 31,2022 were retrospectively analyzed.Independent risk fac-tors were screened through logistic univariate and multivariate analyses.Modeling variables were screened through Lasso regression.A Nomogram model was constructed and internally validated by logistic regression.Effectiveness of the model was evaluated with receiver operating characteristic(ROC)curve,calibration curve and decision curve.Results Among 978 patients underwent neurosurgery,293 had postoperative intracranial infection,with an inci-dence of healthcare-associated infection of 29.96％.There was no significant difference in age,gender,proportion of coronary heart disease,cerebral infarction,diabetes and hypertension between the infected group and the non-in-fected group(all P＞0.05).Multivariate logistic analysis showed that postoperative intracranial hypertension,fe-ver,increased neutrophil percentage in blood routine examination,turbid cerebrospinal fluid,positive Pan's test,decreased glucose concentration,abnormal ratio of cerebrospinal fluid/serum glucose,positive microbial culture,absence of indwelling external ventricular drainage tubes,presence of indwelling lumbar cistern drainage tubes,use of immunosuppressive agents,and long duration of surgery were independent risk factors for postoperative intracra-nial infection in patients who underwent neurosurgery(all P＜0.05).Fifteen variables were screened out through Lasso regression.Fourteen variables were finally included for modeling after collinear screening,missing data impu-tation(random forest method)and checking pairwise interaction items.A Nomogram prediction model was con-structed,with the area under ROC curve,sensitivity,specificity,and accuracy of 0.885,0.578,0.896,and 0.704,respectively.Internal validation of the model was conducted.The modeling and validation groups presented similar effects.The calibration curve and decision curve also indicated that the model had good predictive efficacy.Conclusion The constructed Nomogram prediction model for postoperative intracranial infection after neurosurgery is scientific,and the prediction indicators are easy to obtain.The model presents with high stability,reliability,and application value,thus can provide reference for the assessment of postoperative intracranial infection after neuro-surgery.

Application of enhanced recovery after surgery in total laparoscopic uncut Roux-en-Y gastrojejunostomy / 中国现代普通外科进展

Objective:To evaluate the safety and feasibility of enhanced recovery after surgery (ERAS) in total laparoscopic Uncut Roux-en-Y gastrojejunostomy after distal gastrectomy.Methods:The clinical data of 42 patients who were divided into ERAS group (n=20) and control group (n=22) were collected.Observation indicators included operation condition,postoperative clinical indexes and postoperative serum stress indexes.Measurement data with normal distribution were presented as-x±s and analyzed by T test.Count data were analyzed by the chi-square test.Results:The operative time,volume of intraoperative blood loss and number of patients with conversion to open surgery shown no statistically significant difference between the 2 groups(P＞0.05).Postoperative clinical indexes:time for initial anus exhaust,time for initial liquid diet intake,time for out-of-bed activity,duration of hoSpital stay of patients without complications in the ERAS group were lower than in the control group,with statistically significant differences between the 2 groups (P＜0.05).But the time to initial defecation,time of abdominal drainage-tube removal and the early postoperative complications between the 2 group had no statistically difference(P＞0.05). Postoperative complications:at the first days and the third days after operation,WBC,CRP and I L-6 in ERAS group were lower than in the control group,the differences were statistically significant (P＜0.05).Conclusion:The perioperative ERAS program in total laparoscopic Uncut Roux-en-Y gastrojejunostomy after distal gastrectomy is safe and effective and should be popularized,meanwhile,it can also reduce duration of hospital stay and improve the comfortable degree and satisfaction of patients.

Application value of enhanced recovery after surgery in the radical distal gastrectomy / 中国现代普通外科进展

Objective:To evaluate the safety and feasibility of enhanced recovery after surgery (ERAS) in the Radical Distal Gastrectomy.Methods:The clinical data of 52 patients who underwent radica distal gastrectomy surgery from Jan 2016 to Jan 2017 were collected,and divided into the ERAS group and the control group.Results:(1) Operation condition:the operative time,volume of intraoperative blood loss,number of patients with conversion to open surgery showed no statistically significant difference between the 2 groups (P＞0.05).(2)postoperative clinical indexes:time for initial anus exhaust,time for initial liquid diet intake,time for out-of-bed activity,time of urinary catheter removal,duration of hospital stay of patients without complications days in the ERAS group and days in the control group,respectively,have been with statistically significant differences between the 2 groups(P＜0.05).But the time to initial defecation,time of abdominal drainage-tube removal and the number of postoperative complications during hospitalization between the 2 group had no statistically difference(P＞0.05).(3)Postoperative complications:at the first days and the third days after operation,WBC,CRP and IL-6 in ERAS group were lower than thoese in the control group,the differences were statistically significant.Conclusion:The perioperative ERAS program in distal gastrectomy is safe and effective and should be popularized.

Research on relative factors of abnormal glycometabolism in chronic hepatitis C patients / 中华疾病控制杂志

Objective Hepatitis C virus patients are often accompanied by insulin resistance and diabetes.To probe the relative factors of abnormal glycometabolism in chronic HCV infections.Methods A total of 1 039 treatment-naive patients that were confirmed chronic HCV infected were enrolled in the study.The demographics,biochemical index parameters and other data about liver function and HCV viral load were got from infectious disease department of Jurong Pepole's Hospital in China.Results A total of 140 (13.5％) patients were diagnosed with some forms of abnormal glycometabolism.The body mass index (BMI) (x2 =9.231,P =0.010),waist circumference (x2 =7.984,P =0.018),systolic blood pressure (x2 =16.366,P ＜0.001),diastolic blood pressure (x2 =13.970,P =0.001),alanine aminotransferase(ALT) (x2 =4.809,P =0.028),HCV-RNA viral load (t =-3.818,P ＜0.001) were significantly different between non-diabetic HCV patients and abnormal glycometabolism patients.Multivariate logistic regression analysis showed that ALT(OR =2.986,95％ CI:1.171-7.615) and HCV-RNA viral load (OR =2.061,95％ CI:1.165-3.644) were found as risk factors in multivariate regression analysis for patients with chronic hepatitis C who had abnormal glucose metabolism.Conclusions Chronic hepatitis C patients with higher ALT and HCV-RNA level were more probably to suffer from abnormal glycometabolism.In order to find potentially novel risk factors of HCV with abnormal glucose metabolisn,further studies about genetic and other clinical factors need to be processed.

Effect of carnosol against proliferative activity of breast cancer cells and its estrogen receptor subtype's mediation and regulation mechanisms / 中国中药杂志

Carnosol has been proved to have anti-breast cancer effect in previous research. But its ER subtype's specific regulation and mediation mechanisms remain unclear. The aim of this study is to observe the effect of carnosol on cell proliferation and its estrogen receptor α and β's specific regulation and mediation mechanisms with ER positive breast cancer T47D cell. With estrogen receptor α and β antagonists MPP and PHTPP as tools, the MTT cell proliferation assay was performed to observe the effect of carnosol on T47D cell proliferation. The changes in the T47D cell proliferation cycle were detected by flow cytometry. The effect of carnosol on ERα and ERβ expressions of T47D cells was measured by Western blot. The findings showed that 1 x 10(-5)-1 x 10(-7) mol x L(-1) carnosol could significantly inhibit the T47D cell proliferation, which could be enhanced by MPP or weakened by PHTPP. Meanwhile, 1 x 10(-5) mol x L(-1) or 1 x 10(-6) mol x L(-1) carnosol could significantly increase ERα and ERβ expressions of T47D cells, and remarkably increase ERα/ERβ ratio. The results showed that carnosol showed the inhibitory effect on the proliferation of ER positive breast cancer cells through target cell ER, especially ERβ pathway. In the meantime, carnosol could regulate expressions and proportions of target cell ER subtype ERα and ERβ.

Retinoic acid incubation effect on proliferation of U251 cell line and effect on MAPK signal pathway / 中国生化药物杂志

Objective To investigate the retinoic acid incubation effect on proliferation of U251 cell line and effect on MAPK signal pathway. Methods ATRA solution of different concentration on the U25 1 glioma cells were incubated,the influence of ATRA on the proliferation of U25 1 cells were detected,and the proteins of MKPs and MAPK signaling pathways were detected by qRT-PCR and Western blot.Using Graph Prism 5 software for quantitative analysis of experimental results.Results Compared with control group,ATRA could effectively inhibit the proliferation of U25 1 glioma cells, in a concentration dependent manner.QRT-PCR results showed that,different concentrations of ATRA after incubation for 48 hours,the expression of MKPs mRNA changed,but the changes of MKP-5 and expression of 67LR was different,explained the main differences between the two methods of the MAPK signaling pathway was the regulation of MKP-5.Western blot results showed that the ATRA,after 48 hours of incubation,the protein MAPK pathway had changed in phosphorylation, which showed that ATRA protein in the MAPK signaling pathway through control of the degree of phosphorylation on U25 1 cell line regulation.Conclusion Retinoic acid and retinoic acid receptor play its physiological effects and regulate human glioma cell line U25 1 proliferation through different combination.Retinoic acid could not only reduce the expression of phosphorylated ERK1/2 to inhibit tumor proliferation,but also regulate three kinds of protein phosphorylation,therefore its mechanism will be more complex,at the same time that the MAPK signaling pathway plays a crucial role in tumor proliferation process.

Abnormal Spontaneous Neural Activity in Obsessive-Compulsive Disorder: A Resting-State Functional Magnetic Resonance Imaging Study.

Neuroimaging studies of obsessive-compulsive disorder have found abnormalities in orbitofronto-striato-thalamic circuitry, including the orbitofrontal cortex, anterior cingulate cortex, caudate, and thalamus, but few studies have explored abnormal intrinsic or spontaneous brain activity in the resting state. We investigated both intra- and inter-regional synchronized activity in twenty patients with obsessive-compulsive disorder and 20 healthy controls using resting-state functional magnetic resonance imaging. Regional homogeneity (ReHo) and functional connectivity methods were used to analyze the intra- and inter-regional synchronized activity, respectively. Compared with healthy controls, patients with obsessive-compulsive disorder showed significantly increased ReHo in the orbitofrontal cortex, cerebellum, and insula, and decreased ReHo in the ventral anterior cingulate cortex, caudate, and inferior occipital cortex. Based on ReHo results, we determined functional connectivity differences between the orbitofrontal cortex and other brain regions in both patients with obsessive-compulsive disorder and controls. We found abnormal functional connectivity between the orbitofrontal cortex and ventral anterior cingulate cortex in patients with obsessive-compulsive disorder compared with healthy controls. Moreover, ReHo in the orbitofrontal cortex was correlated with the duration of obsessive-compulsive disorder. These findings suggest that increased intra- and inter-regional synchronized activity in the orbitofrontal cortex may have a key role in the pathology of obsessive-compulsive disorder. In addition to orbitofronto-striato-thalamic circuitry, brain regions such as the insula and cerebellum may also be involved in the pathophysiology of obsessive-compulsive disorder.

Decreased regional homogeneity in major depression as revealed by resting-state functional magnetic resonance imaging / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Functional imaging studies indicate abnormal activities in cortico-limbic network in depression during either task or resting state. The present work was to explore the abnormal spontaneous activity shown with regional homogeneity (ReHo) in depression by resting-state functional magnetic resonance imaging (fMRI).</p><p><b>METHODS</b>Using fMRI, the differences of regional brain activity were measured in resting state in depressed vs. healthy participants. Sixteen participants firstly diagnosed with major depressive disorder and 16 controls were scanned during resting state. A novel method based on ReHo was used to detect spontaneous hemodynamic responses across the whole brain.</p><p><b>RESULTS</b>ReHo in the left thalamus, left temporal lobe, left cerebellar posterior lobe, and the bilateral occipital lobe was found to be significantly decreased in depression compared to healthy controls in resting state of depression.</p><p><b>CONCLUSIONS</b>Abnormal spontaneous activity exists in the left thalamus, left temporal lobe, left cerebellar posterior lobe, and the bilateral occipital lobe. And the ReHo may be a potential reference in understanding the distinct brain activity in resting state of depression.</p>

DPARSF: A MATLAB Toolbox for "Pipeline" Data Analysis of Resting-State fMRI.

Resting-state functional magnetic resonance imaging (fMRI) has attracted more and more attention because of its effectiveness, simplicity and non-invasiveness in exploration of the intrinsic functional architecture of the human brain. However, user-friendly toolbox for "pipeline" data analysis of resting-state fMRI is still lacking. Based on some functions in Statistical Parametric Mapping (SPM) and Resting-State fMRI Data Analysis Toolkit (REST), we have developed a MATLAB toolbox called Data Processing Assistant for Resting-State fMRI (DPARSF) for "pipeline" data analysis of resting-state fMRI. After the user arranges the Digital Imaging and Communications in Medicine (DICOM) files and click a few buttons to set parameters, DPARSF will then give all the preprocessed (slice timing, realign, normalize, smooth) data and results for functional connectivity, regional homogeneity, amplitude of low-frequency fluctuation (ALFF), and fractional ALFF. DPARSF can also create a report for excluding subjects with excessive head motion and generate a set of pictures for easily checking the effect of normalization. In addition, users can also use DPARSF to extract time courses from regions of interest.

Stereological study on the synapse loss in visual cortex of mouse after prenatal alcohol exposure / 药学学报

In order to understand the alcohol's toxicity to the quantitative alternations of synapses in mouse visual cortex, the expression of synaptophysin after prenatal alcohol exposure was investigated. In present study, the experimental mice at P0, P7, P14 and P30 were grouped, as control, 2 g x kg(-1) alcohol treatment and 4 g x kg(-1) alcohol treatment. The pre-synaptic elements which were used to represent synapses were marked with synaptophysin (a synaptic vesicle associated protein) by immunocytochemistry technique. The synaptophysin positive boutons in layer VI of visual cortex were imaged under laser confocal microscope. With stereological methods, the number cal density of synapse in visual cortex was calculated in different groups at various ages. Moreover, Western blotting was carried out to detect the expression of synaptophysin in visual cortex. The results showed that prenatal alcohol exposure could cause synaptic loss with long-term effect and in a dose dependent manner. For instance, there were significant difference among the different treatment groups of P0, P14 and P30 as well (P < 0.05). Western blotting supported the results of immunofluorescent labeling. In conclusion, prenatal alcohol exposure can induce the synaptic loss dose dependently and with long-term effect. Our findings implicate that the synaptic loss with long-term effect in CNS probably contributes to the lifelong mental retardation and memorial lowliness associated with childhood FAS.

Studies about the level of CD4+ CD25+ regulatory T cells and relation between expression of Foxp3 and CD127 in peripheral blood of chronic HBV infection / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To investigate the level of CD4+ CD25+ Foxp3+ regulatory T cells and observe relation between expression of Foxp3 and CD127 in peripheral blood of chronic HBV infection.</p><p><b>METHODS</b>CD4+ CD25+ Foxp3+ and CD4+ CD25+ CD127low Treg in peripheral blood from 34 patients of immune tolerance stage, 26 patients of immune clearance stage and 31 patients of non-active status were quantitatively analyzed by flow cytometry.</p><p><b>RESULTS</b>Immune tolerance group presented a higher fraction of CD4+ CD25+ Foxp3+ and CD4+ CD25+ CD127low Treg than non-active group in chronic HBV infection (Z = -2.693, P = 0.007 and t = 3.251, P = 0.002), and HBV positive group also presented a higher fraction than non-active group (t = 2.266, P = 0.026 and t = 3.208, P = 0.002), But ALT normal group is similar to ALT abnormal group (P > 0.05). In this study, the relation between expression of CD127low and Foxp3+ from CD4+ CD25+ regulatory T cells was observed, and CD4+ CD25+ CD127low Treg presented a higher fraction than CD4+ CD25+ Foxp3+ Treg.</p><p><b>CONCLUSION</b>Peripheral Treg in HBV active replication group is higher than HBV negative group of chronic HBV infection. Expression of CD127low is consistent with Foxp3+ in CD4+ CD25+ regulatory T cells, but the former is significantly higher than the latter.</p>