A novel intelligent model for visualized inference of medical diagnosis: A case of TCM.

How to present an intelligent model based on known diagnostic knowledge to assist medical diagnosis and display the reasoning process is an interesting issue worth exploring. This study developed a novel intelligent model for visualized inference of medical diagnosis with a case of Traditional Chinese Medicine (TCM). Four classes of TCM's diagnosis composed of Yin deficiency, Liver Yin deficiency, Kidney Yin deficiency, and Liver-Kidney Yin deficiency were selected as research examples. According to the knowledge of diagnostic points in "Diagnostics of TCM", a total of 2000 samples for training and testing were randomly generated for the four classes of TCM's diagnosis. In addition, a total of 60 clinical samples were collected from hospital clinical cases. Training samples were sent to the pre-training language model of Chinese Bert for training to generate intelligent diagnostic module. Simultaneously, a mathematical algorithm was developed to generate inferential digraphs. In order to evaluate the performance of the model, the values of accuracy, F1 score, Mse, Loss and other indicators were calculated for model training and testing. And the confusion matrices and ROC curves were plotted to estimate the predictive ability of the model. The novel model was also compared with RF and XGBOOST. And some instances of inferential digraphs with the model were displayed and analyzed. It may be a new attempt to solve the problem of interpretable and inferential intelligent models in the field of artificial intelligence on medical diagnosis of TCM.

Influencing factors of survival of patients with airway stenosis requiring clinical interventions after lung transplantation / 器官移植

Objective To analyze the influencing factors of survival of patients with airway stenosis requiring clinical interventions after lung transplantation. Methods Clinical data of 66 patients with airway stenosis requiring clinical interventions after lung transplantation were retrospectively analyzed. Univariate and multivariate Cox’s regression models were adopted to analyze the influencing factors of survival of all patients with airway stenosis and those with early airway stenosis. Kaplan-Meier method was used to calculate the overall survival and delineate the survival curve. Results For 66 patients with airway stenosis, the median airway stenosis-free time was 72 (52,102) d, 27% (18/66) for central airway stenosis and 73% (48/66) for distal airway stenosis. Postoperative mechanical ventilation time [hazard ratio (HR) 1.037, 95% confidence interval (CI) 1.005-1.070, P=0.024] and type of surgery (HR 0.400, 95%CI 0.177-0.903, P=0.027) were correlated with the survival of patients with airway stenosis after lung transplantation. The longer the postoperative mechanical ventilation time, the higher the risk of mortality of the recipients. The overall survival of airway stenosis recipients undergoing bilateral lung transplantation was better than that of their counterparts after single lung transplantation. Subgroup analysis showed that grade 3 primary graft dysfunction (PGD) (HR 4.577, 95%CI 1.439-14.555, P=0.010) and immunosuppressive drugs (HR 0.079, 95%CI 0.022-0.287, P<0.001) were associated with the survival of patients with early airway stenosis after lung transplantation. The overall survival of patients with early airway stenosis after lung transplantation without grade 3 PGD was better compared with that of those with grade 3 PGD. The overall survival of patients with early airway stenosis after lung transplantation treated with tacrolimus was superior to that of their counterparts treated with cyclosporine. Conclusions Long postoperative mechanical ventilation time, single lung transplantation, grade 3 PGD and use of cyclosporine may affect the survival of patients with airway stenosis after lung transplantation.

Analysis of success rate of organoid construction of nasopharyngeal carcinoma by first-day suspension method / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the efficacy of the first-day suspension method for improving the success rate of construction of nasopharyngeal carcinoma-patient derived organoids (NPC-PDO). Methods: The tumor samples of 14 nasopharyngeal carcinoma(NPC) patients, i.e.,13 males and 1 female, with a mean age of 43.0±12.0 years old, were collected from the Affiliated Tumor Hospital of Guangxi Medical University and the First Affiliated Hospital of Guangxi Medical University from January 2022 to July 2022. The tumor samples of 3 patients were digested into single cell suspension and divided into 2 groups, for comparing the efficacy of NPC-PDO construction by the direct inoculation method and the first-day suspension method. The remaining 11 patients were randomized to receive either the direct inoculation method or the first-day suspension method for NPC-PDO construction. The diameter and the number of spheres of NPC-PDO constructed by the two methods were compared by optical microscope; the 3D cell viability detection kit was used to compare the cell viability; the survival rates were compared by trypan blue staining; the success rates of the two construction methods were compared; the number of cases which could be successfully passaged for more than 5 generations and were consistent with the original tissue by pathological examination was counted; and the dynamic changes of cells in suspension overnight were observed by live cell workstation. The independent sample t-test was applied to compare the measurement data of the two groups, and the chi-square test was used to compare the classification data. Results: Compared with the direct inoculation, the diameter and the number of spheres of NPC-PDO constructed by the first-day suspension method were increased, with a higher cell activity, and the success rate of construction was obviously improved (80.0% vs 16.7%, χ2=4.41, P<0.05). In the suspension state, some of the cells aggregated and increased their ability to proliferate. Conclusion: The first-day suspension method can improve the success rate of NPC-PDO construction, especially for those whose original tumor sample size is small.

Research progress on protective effect of hydrogen molecule and its products on lung transplantation / 器官移植

Ischemia-reperfusion injury after lung transplantation is the main cause of primary graft dysfunction, which will subsequently reduce the function of lung allograft and lower the overall survival rate of lung transplant recipients. As a physiological regulatory molecule, hydrogen molecule has the functions of anti-inflammation, easing oxidative stress, alleviating direct cell injury and mitigating epithelial edema. Recent studies have demonstrated that hydrogen molecule and its products (hydrogen and hydrogen-rich solution) could significantly mitigate ischemia-reperfusion injury and postoperative complications after lung transplantation. In this article, the protective effect and exact mechanism of hydrogen molecule and its products in lung transplantation were reviewed, aiming to provide theoretical basis for the application of hydrogen molecule and its products as a novel treatment for lung transplantation-related complications, enhance the overall prognosis and improve the quality of life of lung transplant recipients

Repair of soft tissue defect of forefoot with free posterior tibial artery perforator flap: Report of 13 cases / 中华显微外科杂志

Objective:To investigate the clinical effect of free posterior tibial artery perforator flap in repair of forefoot soft tissue defect.Methods:From January 2017 to January 2021, a retrospective study was conducted on 13 patients with forefoot soft tissue defect, metatarsal head exposed, and forefoot transverse arch integrity, including 9 males and 4 females. The age was (40.0±13.0) years old. Cause of injury: 8 cases of traffic accident injury, 5 cases of heavy object smashing injury. Seven cases had forefoot skin defect and toe damage, and 6 cases had forefoot skin avulsion injury, open toe fracture with tendon, blood vessel and nerve injury. The wound area was 4.5 cm×3.0 cm-8.0 cm×6.0 cm. VSD treatment was performed in the first stage, and free posterior tibial artery perforator flap was used for the second stage. The flap area was 5.5 cm×4.0 cm-9.0 cm×7.0 cm. Outpatient reviews scheduled at 1, 2, 3, and 6 months after surgery, through outpatient clinic, telephone or WeChat. The flaps were evaluated according to appearance, texture, sensory recovery, and the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hind foot function scoring system.Results:All 13 flaps survived. The follow-up lasted for 6 to 24 months. The feet were in good shape, walking with weight beries, and the flaps had satisfactory appearance without wear and tear. Five cases were S 3, 6 were S 2, and 2 were S 1. According to AOFAS ankle-hindfoot function score, 4 had excellent scores, 7 were in good, and 2 in fair. Conclusion:The free posterior tibial artery perforator flap has relatively constant perforators, and the pedicle of the middle and upper perforators is longer, and the flap can build part of the sensation. Posterior artery perforator flap is a good flat for repairing the soft tissue defects of the metatarsal head of the forefoot.

A modified mouse model of orthotopic left lung transplantation based on "pendulum" anastomosis of the reverse-view plane (with video demonstration) / 器官移植

Objective To modify the mouse model of orthotopic left lung transplantation from different perspectives, aiming to establish a simpler, faster and stabler mouse model of lung transplantation. Methods Based on preliminary modified rat model of orthotopic left lung transplantation established by our team, varying extent of modifications were made regarding the tracheal intubation, cannula preparation and anastomosis procedures of orthotopic left lung transplantation in the recipient mice. Orthotopic left lung transplantation in 40 mice were performed by an operator with microsurgical experience. The dissection of the recipient's hilar structure was carried out at the plane of the hilar clamp model within the reverse-view, and the three branches (left main bronchus, pulmonary artery and pulmonary vein) of the pulmonary hilum were anastomosed in turn by the "pendulum" anastomosis method. The operation time of each procedure was recorded. The recipient mice were sacrificed at postoperative 2 weeks, and the incidence of postoperative complications was recorded. Results Lung transplantation was successfully completed in 40 mice, with no bronchial and vascular tearing or twisting, and no bleeding at the anastomosis site. The overall cardiopulmonary procurement time was (10.7±1.5) min, cannula preparation time was (16.2±1.5) min, cold ischemia time was (25.1±2.4) min, warm ischemia time was (19.4±1.6) min, and the total operation time was (57.2±2.9) min, respectively. During the follow-up from 6 to 14 days after surgery, one recipient mouse died of pleural effusion, probably caused by infection. No pneumothorax, thrombosis or atelectasis was found in the remaining recipient mice during postoperative follow-up. Conclusions The modified mouse model of orthotopic left lung transplantation based on "pendulum" anastomosis of the reverse-view plane possesses multiple advantages of short operation time, high success rate and few complications, which is expected to become an alternative model of studying pathological changes after lung transplantation and worthy of further application.

Improved Prediction of Cognitive Outcomes via Globally Aligned Imaging Biomarker Enrichments Over Progressions.

OBJECTIVE: Longitudinal neuroimaging data have been widely used to predict clinical scores for automatic diagnosis of Alzheimer's Disease (AD) in recent years. However, incomplete temporal neuroimaging records of the patients pose a major challenge to use these data for accurately diagnosing AD. In this paper, we propose a novel method to learn an enriched representation for imaging biomarkers, which simultaneously captures the information conveyed by both the baseline neuroimaging records of all the participants in a studied cohort and the progressive variations of the available follow-up records of every individual participant. METHODS: Taking into account that different participants usually take different numbers of medical records at different time points, we develop a robust learning objective that minimizes the summations of a number of not-squared l2-norm distances, which, though, is difficult to efficiently solve in general. Thus we derive a new efficient iterative algorithm with rigorously proved convergence. RESULTS: We have conducted extensive experiments using the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset. Clear performance gains have been achieved when we predict different cognitive scores using the enriched biomarker representations learned by our new method. We further observe that the top selected biomarkers by our proposed method are in perfect accordance with the known knowledge in existing clinical AD studies. CONCLUSION: All these promising experimental results have demonstrated the effectiveness of our new method. SIGNIFICANCE: We anticipate that our new method is of interest to biomedical engineering communities beyond AD research and have open-sourced the code of our method online.11The code package of this paper have been made publicly available online at https://github.com/lyujian/Improved-Prediction-of-Cognitive-Outcomes.

Learning curve and key procedures analysis of modified rat models of orthotopic left lung transplantation / 器官移植

Objective To summarize and analyze the key procedures of the modified rat model of orthotopic left lung transplantation, aiming to provide more experience for the establishment of rat models of lung transplantation. Methods Two surgeons (A and B) performed complete transplantation in consecutive 15 rat models, and every 5 surgeries were divided into 1 practice stage. The operating time of each transplantation procedure was recorded. The differences of overall success rate and 1-week survival rate were calculated among different practice stages. The learning curve was delineated by the cumulative sum method. Results For surgeons A and B, the number of the first successful transplantation was the 5th and 6th time, the overall success rates of transplantation were 80% and 87% respectively, and the 1-week survival rates of rats both were 92%. Along with the increasing number of surgeries, the entire cardiopulmonary procurement, cannula preparation, cold ischemia, warm ischemia, transplantation and total operation time by two surgeons showed a significantly downward trend (all P < 0.05). For surgeons A and B, 3 and 2 rats died of heart failure due to overdose anesthesia, and 1 rat died of vein distortion at postoperative 1 d and 1 died of atelectasis at postoperative 7 d, respectively. The goodness of fit (R2) of cumulative sum method was 0.992 8 and 0.976 6. The turning point of learning curve was achieved in the 7th and 8th transplantation for surgeons A and B. Conclusions The modified rat model of orthotopic left lung transplantation yields high operability and repeatability both theoretically and technologically, and has multiple advantages of short learning curve, short operation time, high survival rate of the recipients and few complications, which is worthy of application in the basic research of lung transplantation.

Progress in clinical application of urgent lung transplantation / 器官移植

Lung transplantation is the only effective treatment of end-stage lung diseases. Nevertheless, shortage of donor lungs has become increasingly prominent worldwide. A large quantity of patients died while waiting for lung transplantation. Urgent lung transplantation is a prioritized allocation strategy for donor lung transplantation according to the urgency of diseases, aiming to shorten the waiting time for donor lungs and reduce the fatality of patients on the waiting list for lung transplantation. However, no consensus has been reached worldwide on the definition, criteria and application of the terminology of urgent lung transplantation. In addition, the survival and net benefits of lung transplant recipients based on this allocation system are still controversial. On the basis of previous clinical research on urgent lung transplantation, the definition criteria, risk factors, survival outcomes, limitations and optimization measures were explicitly elucidated in this article, aiming to provide theoretical reference for comprehensive evaluation of the feasibility of urgent lung transplantation and further optimizing the allocation system of donor lungs.

Current status of diagnosis and treatment of chronic lung allograft dysfunction / 器官移植

Chronic lung allograft dysfunction (CLAD) is the largest obstacle to the long-term survival of lung transplant recipients, which represents a series of complicated clinical manifestations of significant and persistent deterioration of lung allograft function after surgery. Due to lack of effective strategies for early diagnosis and prevention, over half of lung transplant recipients will develop CLAD within postoperative 5 years, which is likely to increase to 75% within postoperative 10 years. At present, no drug can be administered to completely prevent or reverse the progression of CLAD. In recent years, since the definition, diagnosis and treatment of CLAD have been updated by International Society of Heart and Lung Transplantation (ISHLT) in 2019, the understanding of CLAD has been significantly deepened within the international community. In this article, comprehensive diagnostic methods and potential treatment strategies of CLAD were explicitly illustrated, aiming to provide theoretical reference and insights for early monitoring and management of the incidence and progression of CLAD.

Epidemiological survey on a family aggregation COVID-19 in Y County, Chenzhou City, Hunan / 上海预防医学

Objective To investigate epidemic characteristics of a family aggregation COVID-19, and to provide scientific basis for prevention and control of family aggregation epidemic. Methods] Field epidemiological methods were used to investigate the cases and close contacts of a family aggregation COVID-19 in Y County, Chenzhou City, Hunan Province. Descriptive statistical analysis was used on epidemiological data . The 2019-nCoV nucleic acid was detected by real-time fluorescence quantitative RT-PCR. Results It was found that Ms. Deng was infected with COVID-19 and became the infectious source of the family aggregation epidemic , who had lived in Wuhan Hubei Province. Her boyfriend Mr. Cao became a second-generation case of COVID-19..Another two asymptomatic but infected persons were family members living with Ms.Deng . Conclusion COVID-19 easily spreads within families. The awareness of family members' protection, the education of new coronavirus pneumonia prevention and control in key groups should be strengthened to avoid the occurrence and spread of family aggregation epidemic.

Research progress on gastrointestinal complications after lung transplantation / 器官移植

Due to the influence of immunosuppression, nerve injury and other comprehensive factors, the overall incidence of gastrointestinal complications after lung transplantation is relatively high, which can cause drug absorption disorder and chronic rejection. In recent years, more and more studies have been conducted on these complications. However, due to the great difference of the incidence of gastrointestinal complications among lung transplantation centers, clinicians lack of understanding of these. In this article, the general status, common types and risk factors of gastrointestinal complications after lung transplantation were reviewed, aiming to provide reference for comprehensive management of gastrointestinal complications after lung transplantation.

Effects of depression on healing and inflammatory responses of acute wounds in rats.

This study aimed to elucidate the effect of depression on the healing of acute wounds in rats. We hypothesized that depression would have negative effects on inflammation and wound healing and that antidepressant therapy would reverse these effects. This study included 100 rats randomly allocated into five groups: control group (CG), depression group (DG), pre-depression group (PDG), antidepressant group (AG), and pre-antidepressant group (PAG). Acute wounds were created on the rats' backs. The groups were subjected to no interventions (CG), aversive stimuli before (PDG) and after (DG) wound creation, and antidepressant treatment before (PAG) and after (AG) wound creation. On the day of wound creation and on days 3, 6, 9, and 12 after wound creation, observations of the wound area and degree of depression (evaluated using the sucrose preference test, open-field test, and weight change) were recorded. On days 6 and 12 after wound creation, venous serum and wound tissues were collected. Tumor necrosis factor alpha (TNF-α), interleukin (IL)-1ß, IL-6, and IL-10 levels were measured using the enzyme-linked immunosorbent assay. Results showed an initial increase followed by a decrease in the degree of depression in all groups except DG (continuous decline). The wound-healing rate was significantly lower in PDG and DG than in CG; it was higher in AG and PAG than in CG. DG and PDG had higher concentrations of inflammatory cytokines than CG, and AG and PAG had lower concentrations than CG. This indicates that the onset of depression delays the healing of acute wounds and aggravates the inflammatory response in rats. Antidepressant treatment counteracts both of these negative effects.

Progress in the clinical significance of subclassifying the circular and longitudinal muscle layers in patients with T2 e-sophageal cancer / 中华胸心血管外科杂志

T2 esophageal cancer refers to the invasion of esophageal tumors into the esophageal muscularis propria , of which staging, treatment and prognosis are more general and controversial than other stages of esophageal cancer .Although the TNM staging system for esophageal cancer has been continuously improved , T2 esophageal cancer has not been further subclas-sified.The accuracy of the current staging method has also been questioned.Accurate staging has important significance for the treatment of T2 esophageal cancer and prognosis.Although treatment has improved significantly in recent years , from surgery a-lone to surgery-based comprehensive treatment, from postoperative chemotherapy to preoperative neoadjuvant treatment, the treatment of T2 esophageal cancer is still inconclusive.Accurate staging and proper treatment have a significant impact on the prognosis of T2 esophageal cancer.In recent years, studies on T2 esophageal cancer have progressed rapidly, and the content of research has become more and more profound.This article reviews the research progress on the staging, treatment and prognosis of T2 esophageal cancer, providing reference for further improving the accuracy of T2 stage esophageal cancer staging, the scien-tific treatment plan and prognosis.

Investigation of ion liquid combined withultrasound-assisted extraction technology of total flavones from Microcos paniculata and study on its lipids regulation activity / 中草药

Objective: To explore the high-efficiency green environmental extraction method of total flavones from Microcos paniculata (MPTF), and investigate its lipid-lowering activity. Methods: The ionic liquid was used to assist the ultrasonic extraction of MPTF, and the extraction process was investigated by single factor experiment and orthogonal test. Wistar rats were randomly divided into normal control group and positive control group (Resuvastatin Calcium Tablets 5.2 mg/kg) by high fat diet, high-fat model group and MPTF low, medium and high dose groups (ig dose MPTF 300, 600, 900 mg/kg), with 10 rats in each group. The total cholesterol (TC), glycerol lipid (TG), high density lipoprotein (HDL-C), low density lipoprotein (LDL-C) levels were determinated. Results: The optimum process conditions for ultrasonic-assisted extraction of MPTF by ionic liquid were as follow: ionic liquid was [BMIM]Cl at concentration of 0.30 mol/L; ratio of material to liquid was 1:40, extraction solvent was 60% ethanol aqueous solution with extraction time of 30 min at 50 ℃. The verification test results showed that the extraction rate of total flavonoids obtained from the extraction process was high and the process was stable. The results of lipid-lowering test showed that the levels of TC, TG and LDL-C were decreased in all doses of MPTF groups, and the level of HDL-C was increased (P < 0.05). With the increase of MPTF dose, the indicators showed obvious trends in a dese-dependent manner. Conclusion: The ionic liquid combined with ultrasonic- assisted extraction of MPTF is stable and feasible, which provides reference for ionic liquid synergistic ultrasound-assisted extraction of poorly soluble active ingredients in Chinese materia medica. MPTF extract has better lipid-lowering effect.

Heavy-Tailed Noise Suppression and Derivative Wavelet Scalogram for Detecting DNA Copy Number Aberrations.

Most existing array comparative genomic hybridization (array CGH) data processing methods and evaluation models assumed that the probability density function (pdf) of noise in array CGH data is a Gaussian distribution. However, in practice, such noise distribution is peaky and heavy-tailed. Therefore, a Gaussian pdf is not adequate to approximate the noise in array CGH data and hence introduces wrong detections of chromosomal aberrations and leads misunderstanding on disease pathogenesis. A more accurate and sufficient model of noise in array CGH data is necessary and beneficial to the detection of DNA copy number variations. We analyze the real array CGH data from different platforms and show that the distribution of noise in array CGH data is fitted very well by generalized Gaussian distribution (GGD). Based on our new noise model, we propose a novel array CGH processing method combining the advantages of both the smoothing and segmentation approaches. The new method uses generalized Gaussian bivariate shrinkage function and one-directional derivative wavelet scalogram in generalized Gaussian noise. In the smoothing step, with the new generalized Gaussian noise model, we derive the heavy-tailed noise suppression algorithm in stationary wavelet domain. In the segmentation step, the 1D Gaussian derivative wavelet scalogram is employed to detect break points. Both real and simulated array CGH data with different noises (such as Gaussian noise, GGD noise, and real noise) are used in our experiments. We demonstrate that our new method outperforms other state-of-the-art methods, in terms of both root mean squared errors and receiver operating characteristic curves.

Povidone-iodine versus the benzethonium chloride wipe for penile skin disinfection before semen collection from sperm donors / 中华男科学杂志

<p><b>Objective</b>To study the influence of povidone-iodine (PI) versus that of the benzethonium chloride wipe (BCW) on semen collection and semen quality of sperm donors undergoing penile skin disinfection and provide some evidence for the selection of disinfection methods for semen collection.</p><p><b>METHODS</b>We used PI from August to December 2015 and BCWs from January to July 2016 for penile skin disinfection before semen collection, with two samples from each donor, one collected with and the other without penis skin disinfection (the blank control group). After semen collection, we conducted a questionnaire investigation on the influence of the two disinfection methods on semen collection and compared the semen parameters between the two groups of sperm donors.</p><p><b>RESULTS</b>Totally, 185 sperm donors were included in this study, of whom 63 underwent penile skin disinfection with PI and the other 122 with BCWs before semen collection. Statistically significant differences were found between the PI and BCW groups in the adaptability to the disinfectant and rigid disinfection procedures (P <0.05), but not in the other items of the questionnaire (P >0.05). Compared with the sperm donors of the blank control group, those of the PI group showed statistically significant difference in the percentage of progressively motile sperm (PMS) (［63.02 ± 3.18］% vs ［61.45 ± 4.78］%, P<0.05), but not in the abstinence time (［4.97 ± 1.79］ vs ［4.7 ± 0.94］ d, P >0.05), semen volume (［4.11 ± 1.54］ vs ［4.15 ± 1.61］ ml, P >0.05), sperm concentration (［110 ± 29.6］ vs ［107.5 ± 31.79］ ×10⁶/ml, P >0.05), or total sperm count (［439.10 ± 170.13］ vs ［434.02 ± 186.91］ ×106/ejaculate, P >0.05), while those of the BCW group exhibited no remarkable difference in any of the above parameters (P >0.05). Among the samples with abnormal semen quality, significantly fewer were found with abnormal PMS in the BCW than in the PI group (1.64% ［2/122］ vs 9.68% ［6/62］, P <0.05). However, there were no significant differences between the PI and BCW groups in the abnormal semen volume, abnormal sperm concentration, or the rate of semen bacterial contamination (P >0.05).</p><p><b>CONCLUSIONS</b>Before semen collection from donors, penile skin disinfection with povidone-iodine may affect both the semen collection process and the quality of donor sperm, while the benzethonium chloride wipe can reduce the influence on the semen collection process and does not affect the semen parameters.</p>

Toll-like receptor 4 antagonist protects against Wallerian degeneration after peripheral nerve injury / 中国组织工程研究

BACKGROUND:The mechanism underlying Wal erian degeneration fol owing peripheral nerve injury is complex. Immune regulation on Wal erian degeneration is beneficial for early repair of perpheral nerve injury. OBJECTIVE:To investigate the effects of Tol-like receptor 4 (TLR4) antagonist on Wal erian degeneration and axonal regeneration after early peripheral nerve injury in rats. METHODS:Fifty male Wistar rats were recruited and randomly divided into treatment group (n=20), model group (n=20) and sham group (n=10). The right sciatic nerves of rats in treatment and model groups were cut and sutured end-to-end, while the sciatic nerves of rats in sham group were only exposed. In the treatment group rats were intravenously injected with 0.15 mg/kg TAK-242 via tail vein 1 hour preoperatively and 7 days postoperatively, and the rats in the other two groups were given intravenous injection of the same volume of normal saline. The sciatic nerves were removed at 24 hours, 3, 4 and 7 days after surgery. RESULTS AND CONCLUSION:Real-time PCR indicated that the mRNA expressions of interleukin-1βand monocyte chemoattractant-1 were significantly increased in the model group compared with the sham group at 24 hours after surgery (both P<0.001), while the expressions were significantly decreased after TAK-242 injection (both P<0.001). Immunofluorescence showed that compared with the model group, down-regulated expression of CD68+and iba1+cel s appeared in the treatment group at 3 days after surgery (P<0.01, P<0.05). Luxol fast blue staining revealed that demyelination at the sciatic nerve stump appeared in both model and treatment groups at postoperative 7 days, but myelin debris clearance in the treatment group was significantly reduced compared with the model group (P<0.05). Hematoxylin-eosin staining showed that a lot of inflammatory cel s, Schwann cells and regenerated nerve fibers at the sciatic nerve stump were found in the model group, while there were few inflammatory cells, Schwann cel s and regenerated nerve fibers in the treatment group at 7 days after surgery. Immunohistochemistry found that the expression of growth-associated protein-43 in the treatment group was significantly lower than that in the model group at 4 days postoperatively (P<0.05). Besides, compared with the model group, a significantly decreased sciatic functional index was found in the treatment group at 20, 30 and 40 days after surgery (P<0.05). These results show that TLR4 antagonists delay early nerve regeneration in rats after sciatic nerve injury probably by inhibiting the TLR4 signaling pathway.

The clinical features and drug therapy of unilateral idiopathic vocal fold paralysis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the clinical features and medication of unilateral idiopathic vocal fold paralysis.@*METHOD@#Thirty-nine of medical treated patients with unilateral idiopathic vocal fold paralysis were retrospectively studied, and relevant literatures were reviewed.@*RESULT@#After 4 to 19 days of medical therapy, 9 patients were cured, the vocal fold movement of 18 sufferers were improved, and 12 pantients were not healed.@*CONCLUSION@#Unilateral idiopathic vocal fold paralysis is common, and the treatment efficacy of medicine is almost the same with others. Unilateral idiopathic vocal fold paralysis is a disease with spontaneous recovery, which should be followed up.

The relationship between the expression patterns of fibronectin and its receptors-α5β1 and αVβ3 integ-rins and the defect of angiogenesis after cerebral ischemia in aged mice / 中国神经精神疾病杂志

Objective To investigate the relationship between the expression patterns of fibronectin (Fn) and its receptors-α5β1 and αVβ3 integrins and angiogenesis after cerebral ischemia in aged mice. Methods Both young (2 months) and aged (18 months) C57BL6 male mice were subject to middle cerebral artery occlusion. The brain endothelial cells (BECs) proliferation was assessed by using dual-immunofluorescent staning (IF) for Ki67 and CD31 and the vessel density was quantified by counting the number of CD31-positive vessels per field of view. The expression patterns of Fn,α5β1 and αVβ3 on blood vessels was assessed by using dual-IF for CD31/ɑ5,CD31/β3 and CD31/Fn. Results The number of CD31/Ki67 dual-positive cells in the penumbra at day 7 after cerebral ischemia of was significantly lower in the aged mice than in the young mice (4.7±0.8/field, P<0.05). The number of CD31-positive vessels in the penumbra at day 7 and 14 of was both significantly lower in aged mice than in the young mice (38.3±3.9/field, 45±4.4/field, both P<0.01). Furthermore, the expression of Fn, α5 and β3 on blood vessels in the penumbra at day 7 after cerebral ischemia was significantly lower in age mice than in the young mice (P<0.05). Conclusions The cerebral angiogenesis after ce?rebral ischemia is impaired in the aged stroked mice, which is associated with the low expression of fibronectin and its receptors-α5β1 andαVβ3 integrins on blood vessels.