Remifentanil reduces multiple organ and energy metabolism disturbances in a rat sepsis model.

The aim of this study was to observe the effects of remifentanil on organ damage and energy metabolism in lipopolysaccharide (LPS)-induced septic rats. A total of 45 clean-grade male Wistar rats (weight 270-320 g) were randomly divided into three groups: a control group, an LPS group, and an LPS with remifentanil treatment (LPS+REM) group. After 6 hours of modeling, the levels of tumor necrosis factor α (TNF-α) and interleukin-6 (IL-6) in lung and kidney tissues of rats in each group were detected by ELISA. The activity of superoxide dismutase (SOD) and the content of malondialdehyde (MDA) in lung and kidney tissues were determined, and the content of lactic acid, pyruvate and epinephrine in heart and kidney tissues were detected. Reverse transcription polymerase chain reaction and the Western blot test were used to detect the expression of pyruvate dehydrogenase kinase 4 (PDK4) in the myocardial tissue. We found that remifentanil treatment inhibited the levels of IL-6, TNF-α, and MDA in the lung and kidneys 6 h after the administration of LPS and increased the level of SOD activity. Treatment with remifentanil reduced the expression of lactic acid, pyruvate, and epinephrine in the heart and kidney tissues and attenuated the expression of PDK4 messenger RNA and PDK4 protein in the myocardial tissue. We concluded that remifentanil might inhibit the release of tissue inflammatory factors, regulate the body's energy metabolism, and ultimately protect the sepsis tissue damage caused by LPS.

From cradle to grave? A global hotspot and new species of the genus Lobaria discovered in the Himalayas and the Hengduan Mountains.

In this study, the East Asian diversity of green-algal Lobaria was evaluated by applying both morphological and phylogenetic approaches. A multi-locus phylogenetic analysis of 72 green-algal Lobaria specimens was performed using a three-locus and time-calibrated species-tree approach. The analyses demonstrate that pairs of sexually and vegetatively reproducing lineages split into highly supported monophyletic clades. Taxonomically, 11 green-algal Lobaria species were identified as new to science, while 10 were previously described species. The species differentiated during the Pliocene and Pleistocene. The coincidence of paleoclimatic events with estimated dates of divergence support a bioclimatic hypothesis for species evolution in the green-algal Lobaria. Molecular phylogenies, a summary of diversity, detailed new species descriptions and geographical analyses are provided. Special recognition of species with a long evolutionary history, which merit high conservation priority, will be critical for preserving geographically restricted endemics in the Himalayas and the Hengduan Mountains, where habitat loss is driving rapid declines.

Taurine Reduces Liver Damage in Non-Alcoholic Fatty Liver Disease Model in Rats by Down-Regulating IL-9 and Tumor Growth Factor TGF-ß.

The study employed a rat model to examine the effects of taurine (Tau) on prevention and therapy of non-alcoholic fatty liver disease (NAFLD). In model rats maintained on a high-fat diet (HFD), the serum levels of ALT, AST, triglycerides, cholesterol, and LDL were higher than the corresponding levels in normal control and NP groups (p<0.05). In Tau-prevention and Tau-treatment groups, the serum levels of AST and triglycerides were lower than in HFD rats (p<0.05). In HFD rats, diffuse fatty degeneration and infiltration with inflammatory cells was observed in the liver; in the ileal mucosa, the villi were fractured or absent, the epithelium was exfoliated and infiltrated with inflammatory cells. The levels of TGF-ß, IL-9, and their mRNA in the liver and ileal mucosa of HFD rats were significantly higher than in normal control and NP groups (p<0.05). In Tau-prevention and Tau-treatment groups, these levels were significantly lower than in HFD rats (p<0.05). Thus, TGF-ß and IL-9 can be implicated in NAFLD genesis, while Tau can preventively or therapeutically diminish the damage to the liver and ileal mucosa in rats with this disease by down-regulating the expression of TGF-ß and IL-9.

[Advances in research of pyroptosis in the mechanism of periodontal disease].

Pyroptosis is a pro-inflammatory form of programmed cell death that has been gradually recognized in recent years. It plays an important role in recognizing the invasion of exogenous pathogens and sensing endogenous danger signals. The initiation of pyroptosis depends on the activation of intracellular inflammasome and its downstream caspases, as well as the active fragment of the key protein Gasdermin. The invasion of periodontal pathogens induces an inflammatory response of the host, involving the activation of inflammasome and triggering pyroptosis as well. Meanwhile, it leads to the release of a large number of inflammatory cytokines such as interleukin (IL)-1ß and IL-18 to amplify the inflammatory response and mediate periodontal tissue destruction eventually. This article reviews the research progress of the signaling pathways of pyroptosis, as well as its mechanism induced by periodontal pathogens and the mechanism of periodontal tissue damage in periodontitis in order to provide new targets and ideas for the prevention and treatment of periodontitis.

Late gadolinium enhancement is a risk factor for major adverse cardiac events in unrecognised myocardial infarction without apparent symptoms: a meta-analysis.

AIM: To assess the prognostic role of unrecognised myocardial infarction (UMI) detected at late gadolinium enhancement cardiac magnetic resonance imaging (LGE-CMRII). MATERIALS AND METHODS: Electronic databases including PubMed, EMBASE, Medline, and Cochrane were searched systematically for studies exploring the predictive value of UMI detected by LGE-CMRI for major adverse cardiac events (MACEs) and all-cause mortality in patients without apparent symptoms. Pooled hazard ratios (HRs) along with their 95% confidence intervals (CIs) were obtained from a random-effects model. Subgroup analyses were performed according to the different participants and outcomes. RESULTS: Eight studies (2,009 participants) were identified comprising 442 patients with UMI detected at LGE-CMRI and 1,567 without UMI. The presence of UMI on LGE was associated with a significantly increased risk for MACEs (HRs: 3.44, 95% CI: 2.06 to 5.75; p<0.001) and all-cause mortality (HRs: 2.43, 95% CI: 1.00 to 5.87; p=0.05). In the subgroup analysis, the presence of UMI on LGE remained significantly associated with the risk of MACEs in patients with suspected coronary artery disease (HRs: 3.82, 95% CI: 2.49 to 5.85; p<0.01) and diabetes mellitus (HRs: 4.97, 95% CI: 3.02 to 8.18; p<0.01). CONCLUSION: The presence of UMI detected by LGE-CMRI is associated with an increased risk of MACEs and all-cause mortality in patients without symptoms. LGE-CMRI could provide important prognostic information and guide risk stratification in patients with UMI.

[Assessment of schistosomiasis transmission risk in Nanjian County of Yunnan Province in 2019].

OBJECTIVE: To assess the schistosomiasis transmission risk in Nanjing County, so as to provide the scientific evidence for the development of the schistosomiasis control strategy and consolidation of the control achievements. METHODS: On May 2019, the Deqiu Village in Deqiu Town and Baiyun Village in Nanjing Town of Yunnan Province, where schistosomiasis were historically relatively highly endemic, were selected to assess the risk of transmission of schistosomiasis by means of a retrospective review of the data pertaining to the historical endemic situation and schistosomiasis control, combined with a cross-sectional survey of snail and wild feces distribution. RESULTS: During the period between 2017 and 2018, the mean sero-prevalence rates of Schistosoma japonicum infections were 6.76% (202/2 990) and 2.86% (142/4 971) in humans and 0 (0/1 160) and 10.65% (31/291) in bovines in Deqiu and Baiyun villages of Nanjian County, respectively; however, no egg-positives were identified; in addition, there were 21.06 hm2 snail habitats found, but no S. japonicum infections were detected in snails. In 2019, there was 6.17 hm2 snail habitats detected, with 2.17% (245/11 298) occurrence of frames with snails and a 0.06 snails/0.1 m2 density of living snails; however, no positives for nucleic acid detection were seen in snails; among the 136 wild fecal samples captures from 23 settings, no S. japonicum infections were identified. CONCLUSIONS: The risk of schistosomiasis transmission remains at a low level in Nanjian County; however, the factors affecting the transmission of schistosomiasis have not been completed eliminated. The integrated schistosomiasis control strategy with an emphasis on the control of the source of S. japonicum infections requires to be reinforced to consolidate the control achievements.

[Analysis of clinical characteristics of 21 cases of acute fibrinous and organizing pneumonia].

Objective: To summarize the clinical features of 21 cases of acute fibrinous and organizing pneumonia (AFOP) confirmed by pathology, thereby improving clinicians' understanding of this disease and avoiding misdiagnosis in clinical practice. Methods: Twenty-one patients diagnosed pathologically with AFOP from January 2016 to April 2019 were analyzed retrospectively. The clinical symptoms, laboratory examination results, imaging features, treatments and outcomes were analyzed comprehensively. Results: There were 10 males and 11 females, with an average age of (58±10) years. All the cases presented subacute disease onset. The main symptoms were cough, expectoration and fever. The results from laboratory examination showed that the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were significantly higher than the normal levels. The total number of leukocytes, the percentage of neutrophils, and procalcitonin were also higher than the normal levels. Among these patients, 4 cases showed positive sputum bacteriology. Nine patients were found to have probable etiological factors (infections in 4, tumors in 4 cases, and connective tissue disease in 1 case). Twelve patients had no confirmed etiological factors. As to radiological findings, the patterns were multiple patchy infiltrates(16/21), solitary mass (3/21) and multiple nodules in both lungs (2/21). Most lesions were subpleural in distribution (15/21), with air bronchogram sign (11/21), pleural effusion (9/21), and cavity (4/21). Three patients received anti-infective therapy only. The infiltration in lung disappeared within 2 months in one patient, but the lesion still existed in one case after three years of follow-up. However, one patient were lost during the follow-up. Eighteen patients were treated with oral glucocorticoids, and about 50% of the patients showed significant improvement in symptoms and imaging findings within one month. The average follow-up time was (22±10) months, and there was no death. Conclusions: The clinical and imaging findings of AFOP are nonspecific. The exact mechanism of its pathogenesis is not clear. Infection and tumor may be related to the pathogenesis of AFOP. AFOP with subacute onset has a good response to glucocorticoid treatment with a better prognosis.

Voxel-wise meta-analysis of structural changes in gray matter of Parkinson's disease patients with mild cognitive impairment.

Evidence from previous voxel-based morphometry (VBM) studies indicates that widespread brain regions are involved in Parkinson's disease with mild cognitive impairment (PD-MCI). However, the spatial localization reported for gray matter (GM) abnormalities is heterogeneous. The aim of the present study was to quantitatively integrate studies on GM abnormalities observed in PD-MCI in order to determine whether a pattern exists. Eligible whole-brain VBM studies were identified by a systematic search of articles in PubMed and EMBASE databases spanning from 1995 to January 1, 2019. A meta-analysis was performed to investigate regional GM abnormalities in PD-MCI. The anisotropic effect size version of seed-based d mapping (AES-SDM) meta-analysis was conducted to explore the GMV differences of PD-MCI compared with PD patients with normal cognitive function (PD-NC). A total of 12 studies comprising 243 PD-MCI patients and 326 PD-NC were included in the meta-analysis. PD-MCI patients showed a robust GM decrease in the left insula and left superior temporal gyrus. Moreover, meta-regression analysis demonstrated that age, PD duration and stage, and Unified Parkinson's Disease Rating Scale III and Mini-Mental State Examination scores might be partly correlated with the GM abnormalities observed in PD-MCI patients. The convergent findings of this quantitative meta-analysis revealed a characteristic neuroanatomical pattern in PD-MCI. The findings provide some evidence that MCI in PD may result in the breakdown of the insula and temporal gyrus, which may serve as specific regions of interest for further investigations.

MiR-19a suppress apoptosis of myocardial cells in rats with myocardial ischemia/reperfusion through PTEN/Akt/P-Akt signaling pathway.

OBJECTIVE: To detect differentially expressed micro ribonucleic acids (miRNAs) in rats with myocardial ischemia/reperfusion (MIR), and to explore the influence of miR-19a on MIR rats and its mechanism. MATERIALS AND METHODS: Firstly, the Sprague-Dawley (SD) rats were used to prepare MIR models, RNAs were extracted, and miRNA sequencing analysis was carried out to determine differentially expressed miRNAs related to MIR. Secondly, the predicted target genes of miR-19a were collected, and WebGestalt was applied to analyze gene ontology (GO) and pathway enrichment. Thirdly, the expression of the related proteins and the apoptosis of myocardial cells in MIR rats were detected via Western blotting. Fourthly, the interaction between miR-19a and the target gene phosphatase and tensin homolog (PTEN) was examined through Luciferase reporter assay. RESULTS: Compared with that in the Sham operation (Sham) group, the miR-19a expression in rat myocardial tissues in the MIR group was significantly increased (p<0.05). Compared with those in the miR-negative control (miR-NC) group, the messenger RNA (mRNA) and protein expressions of PTEN in the miR-19a group were notably decreased (p<0.05). In comparison with the miR-NC group, miR-19a group had elevated expression of phosphorylated protein kinase B (p-Akt) (p<0.05). The Luciferase reporter gene assay manifested the direct binding of miR-19a to PTEN mRNA. CONCLUSIONS: MiR-19a inhibits the PTEN expression by directly binding to the 3'-UTR of PTEN mRNA, thus activating the Akt/p-Akt signaling pathway to suppress the apoptosis of myocardial cells in MIR injury.

[Effect of different support angles on the fitness of removable partial denture framework fabricated using selective laser melting technique].

Objective: To evaluate the fitness of bilateral free-end dentition defect removable partial denture framework fabricated by selective laser melting (SLM) technique with different support angles. Methods: After the control group has been set to eliminate the system error, and according to the standard model of bilateral mandibular posterior teeth loss, eighteen titanium alloy removable partial denture frameworks fabricated by SLM technology were divided into 3 groups with support angles of 0° (horizontal group), 45°(45° group) and 90° (vertical group). Plaster cast with duplicated structure of tissue surface of the removable partial denture (RPD) framework was obtained. A three-dimensional scanner was used to scan original and duplicated plaster casts. The gaps between framework and the model in different parts were analyzed using Geomagic Qualify software to evaluate the fitness of the framework with visual method. Results: The framework fits on the plaster model completely, and its tissue surface fitted on the plaster model well. The deviation between frameworks and plaster casts was calculated as follow: the total deviations of the horizontal, 45°, and vertical group were (0.146±0.017), (0.182±0.015) and (0.185±0.022) mm respectively. The mean deviation of the horizontal group was significantly less than those of the 45° group and the vertical group (P<0.05). Moreover, there was no significant difference in the total deviation between the 45° group and the vertical group. The total deviation of occlusal rest of the horizontal group was significantly less than that of the 45° group (P<0.05). However, no significant difference was detected in the deviation of occlusal rest among the vertical group, the horizontal group, and the 45° group (P>0.05). There was no significant difference in the deviation of occlusal rest among the vertical group, the horizontal group, and the 45° group. The deviation of clasp of the horizontal group was significantly smaller than those of the 45° group and the vertical group (P<0.05). Whereas, there was no significant difference in the deviation of clasp between the 45° group and the 90° group (P>0.05). No significant difference was found in the deviation of lingual bar among the three groups (P>0.05). Conclusions: Among the three kinds of bilateral free-end dentition defect RPD framework fabricated by SLM in different support angles, horizontal printing was proved to reach the minimal deviation, even though the fitness of all three kinds of frameworks can fullfil clinical requirements according to previous studies.

Voxel-wise meta-analysis of structural changes in gray matter of Parkinsons disease patients with mild cognitive impairment

Evidence from previous voxel-based morphometry (VBM) studies indicates that widespread brain regions are involved in Parkinson's disease with mild cognitive impairment (PD-MCI). However, the spatial localization reported for gray matter (GM) abnormalities is heterogeneous. The aim of the present study was to quantitatively integrate studies on GM abnormalities observed in PD-MCI in order to determine whether a pattern exists. Eligible whole-brain VBM studies were identified by a systematic search of articles in PubMed and EMBASE databases spanning from 1995 to January 1, 2019. A meta-analysis was performed to investigate regional GM abnormalities in PD-MCI. The anisotropic effect size version of seed-based d mapping (AES-SDM) meta-analysis was conducted to explore the GMV differences of PD-MCI compared with PD patients with normal cognitive function (PD-NC). A total of 12 studies comprising 243 PD-MCI patients and 326 PD-NC were included in the meta-analysis. PD-MCI patients showed a robust GM decrease in the left insula and left superior temporal gyrus. Moreover, meta-regression analysis demonstrated that age, PD duration and stage, and Unified Parkinson's Disease Rating Scale III and Mini-Mental State Examination scores might be partly correlated with the GM abnormalities observed in PD-MCI patients. The convergent findings of this quantitative meta-analysis revealed a characteristic neuroanatomical pattern in PD-MCI. The findings provide some evidence that MCI in PD may result in the breakdown of the insula and temporal gyrus, which may serve as specific regions of interest for further investigations.

[Long-term stability of periodontal root coverage procedures for gingival recession].

Gingival recession could result in root exposure, dental hypersensitivity and poor aesthetics. It has been demonstrated that varieties of root coverage procedures can significantly improve gingival recession in short-term (≤6 months), of which coronally advanced flap combined with connective tissue graft is the gold standard technique for treatment of gingival recession. It could obtain the optimally complete root coverage and maintain long-term stability (≥2 years). However, clinical knowledge about the long-term effectiveness of the other alternative graft materials remain very limited. Based on the existing clinical evidence, this article reviews coronally advanced flap, coronally advanced flap combined with connective tissue graft or alternative graft materials, with particular attention to the long-term stability of them, in order to provide reference for the design of further clinical trials and the plan of clinical treatments.

[Role of TNF-α in vascular remodeling in rats with chronic thromboembolic pulmonary hypertension].

Objective: To analyze the relationship between TNF-α and pulmonary vascular remodeling in order to explore the pathogenesis of CTEPH. Methods: Autologous blood clots were repeatedly injected into the left jugular vein of rats to establish the CTEPH model. Then mean pulmonary artery pressure (mPAP), histopathology, the plasma level of TNF-α, and the expressions of mRNA and protein of TNF-α in pulmonary artery were measured. Results: In the experiment group, the mPAP and vessel wall area/total area (WA/TA) ratio gradually increased as emblism extended, and increased significantly compared with the sham operation group. The plasma TNF-α concentration in the experimental group increased significantly (P<0.05). The TNF-α proteins expressed in pulmonary artery in the 1-week, 2-week, and 4-week subgroups of experimental group increased significantly compared with the sham operation group (1.62±0.08 vs 0.85±0.12, P<0.05; 1.85±0.08 vs 0.89±0.13, P<0.05; 1.37±0.12 vs 0.91±0.15, P<0.05, respectively). Immunohistochemical results showed that TNF-α expression was higher in pulmonary artery endothelial cells of the experimental group compared with the sham operation group. The expression of pulmonary artery TNF-α protein was positively related with mPAP (r=0.605, P<0.01), and with WA/TA (r=0.629, P<0.01). The expression of serum TNF-α was positively related with that of pulmonary artery TNF-α protein (r=0.721, P<0.01). Conclusion: A rat model of CTEPH can be established by repeatedly introducing autologous blood clots into the pulmonary artery with injecting TXA. Thrombosis induced higher expression of TNF-α in pulmonary arterial endothelial cells, and released into the blood. TNF-α may play an important role in the development of CTEPH, especially by contributing to vascular remodeling and PH.

Efficacy, acceptability, and tolerability of antidepressant treatments for patients with post-stroke depression: a network meta-analysis.

The aim of this study was to investigate the efficacy, acceptability, and tolerability of antidepressants in treating post-stroke depression (PSD) by performing a network meta-analysis of randomized controlled trials of the current literature. Eligible studies were retrieved from online databases, and relevant data were extracted. The primary outcome was efficacy as measured by the mean change in overall depressive symptoms. Secondary outcomes included discontinued treatment for any reason and specifically due to adverse events. Fourteen trials were eligible, which included 949 participants and 9 antidepressant treatments. Few significant differences were found for all outcomes. For the primary outcome, doxepin, paroxetine, and nortriptyline were significantly more effective than a placebo [standardized mean differences: -1.93 (95%CI=-3.56 to -0.29), -1.39 (95%CI=-2.59 to -0.21), and -1.25 (95%CI=-2.46 to -0.04), respectively]. Insufficient evidence exists to select a preferred antidepressant for treating patients with post-stroke depression, and our study provides little evidence that paroxetine may be the potential choice when starting treatment for PSD. Future studies with paroxetine and larger sample sizes, multiple medical centers, and sufficient intervention durations is needed for improving the current evidence.

Effect of IFN-λ2 on combined allergic rhinitis with nasal polyps.

OBJECTIVE: This study sought to investigate the expression of interferon-λ2 (IFN-λ2) in patients with combined allergic rhinitis and nasal polyps (AR+NP), analyze the correlation between IFN-λ2 and tryptase, interleukin 10 (IL-10), and interleukin 12 (IL-12), and identify its peripheral blood cell origins. PATIENTS AND METHODS: ELISA kits were used to investigate plasma levels of IFN-λ2, tryptase, IL-10, and IL-12 in AR+NP patients and healthy controls (HC). Flow cytometry analysis was carried out to detect IFN-λ2 expression in peripheral blood leukocytes. Immunocytochemical staining was performed to detect nasal polyp IFN-λ2 expression in AR+NP patients. RESULTS: Elevated plasma IFN-λ2 levels and positive correlations between plasma IFN-λ2 and tryptase levels in AR+NP patients indicated that IFN-λ2 likely contributes to AR+NP pathogenesis. IFN-λ2 expression was upregulated in cytotoxic T cells and eosinophils in AR+NP patients. Nasal polyp mast cells and macrophages in AR+NP patients expressed IFN-λ2. CONCLUSIONS: The close correlation between IFN-λ2 expression and AR+NP may provide experimental evidence for a possible effect of IFN-λ2 against the allergic inflammatory reaction. Therefore, IFN-λ2 actions may have a potential utility for the treatment and prevention of AR+AP.

Effects of NGX6 expression on proliferation and invasion of nasopharyngeal carcinoma cells and survival of patients.

OBJECTIVE: To detect the expressions of nasopharyngeal carcinoma-associated gene 6 (NGX6) in nasopharyngeal carcinoma cells and tissues, and to investigate the effects of NGX6 on the proliferation and invasion of nasopharyngeal carcinoma cells and the survival of patients. PATIENTS AND METHODS: The human nasopharyngeal carcinoma cells (HONE1) and immortalized human nasopharyngeal epithelial cells (NP69) were selected and cultured. The mRNA and protein expression levels of NGX6 were detected via quantitative reverse transcription polymerase chain reaction (qRT-PCR) and Western blot. The expression of NGX6 in HONE1 was up-regulated using the gene transfection technique. Moreover, the effects of NGX6 on the proliferation and invasion capacities of HONE1 were observed via methyl thiazolyl tetrazolium (MTT) assay and Transwell assay. 50 biopsy tissue specimens of nasopharyngeal carcinoma and 20 non-neoplastic nasopharyngeal biopsy tissue specimens were collected, and the immunohistochemical method was used to detect the protein expression of NGX6 in tumor tissues of patients with esophageal carcinoma. Finally, the follow-up data of patients were recorded, Kaplan-Meier method was used for survival analysis, and the difference in survival rates was detected using the Log-rank test. RESULTS: The results of qRT-PCR and Western blot showed that the mRNA and protein expressions of NGX6 in HONE1 were significantly lower than those in nasopharyngeal carcinoma cells (NP69). After the overexpression of NGX6, the protein expression of NGX6 in HONE1 was significantly increased, but the proliferation and invasion capacities of HONE1 were significantly decreased. Besides, the immunohistochemical results revealed that the expression of NGX6 in tumor tissues of patients with nasopharyngeal carcinoma was significantly lower than that in normal tissues; the survival analysis showed that the level of NGX6 was positively correlated with the survival and prognosis of patients with nasopharyngeal carcinoma. CONCLUSIONS: NGX6 is lowly expressed in nasopharyngeal carcinoma, and it can inhibit the proliferation and invasion of nasopharyngeal carcinoma cells, whose expression is positively correlated with the survival and prognosis of patients with nasopharyngeal carcinoma.

[A preliminary discussion on the contents and value of Shi er mai (Twelve Channels) and Bie mai (Allo-channels), the medical bamboo slips unearthed from Han tomb in Laoguanshan of Chengdu].

The 52 medical bamboo slips entitled Si er ma (Twelve Channels) and Bie mai (Allo-channels) , unearthed from Han tomb in Laoguanshan, are the exclusive medical books concerning channels. Shi er mai is the first work bearing the term " heart dominating channel" , and the running pathways and manifestations of 12 channels. This book could be the major original sources of the 12-channel theories described in the Chapter of Jing mai (Channels) of Ling shu (Miraculous Pivot) . While Bie mai suggests the coexistence of the multi-channel systems at the time when the book was compiled and, together with the 12 "channel" , and 3 "branched collaterals" , these 2 books represent the original condition before the establishment of the mode of channel circulation in Ling shu, and is significant to explore the nature and origin of channel.

The effect of three-dimensional conformal radiotherapy on locally recurrent nasopharyngeal carcinoma and on the expression of succinate dehydrogenase B.

OBJECTIVE: Investigate the effect of three-dimensional conformal radiotherapy (3DCRT) on locally recurrent nasopharyngeal carcinoma (NPC) on the expression of succinate dehydrogenase B (SDHB). PATIENTS AND METHODS: Eighty-six patients diagnosed with locally recurrent NPC in our hospital were selected and divided into the control group (43 cases) and observation group (43 cases). Conventional two-dimensional radiotherapy was applied in the control group, and 3DCRT was adopted in the observation group. The curative effect of both groups was compared. RESULTS: The effective rate and the degree of alleviation of the observation group were higher than those of the control group, and the differences were statistically significant (p<0.05). There were no differences in the occurrence rate of complications from radiotherapy between the two groups (p>0.05). The survival rate and median survival time of the observation group were significantly higher than those of the control group (p<0.05). The positive expression rate of SDHB in the observation group after radiotherapy was significantly higher than that of the control group (p<0.05), and the median survival time of patients with positive expression of SDHB was significantly higher than patients with negative expression (p<0.05). CONCLUSIONS: 3DCRT applied for treatment of locally recurrent NPC was safe and effective. It also improved the positive expression rate of SDHB, which was associated with increased survival time.

Continuous monitoring of intracranial pressure for prediction of postoperative complications of hypertensive intracerebral hemorrhage.

OBJECTIVE: This study evaluates the value of continuous dynamic monitoring of intracranial pressure (ICP) in patients with hypertensive intracerebral hemorrhage to predict early postoperative complications. PATIENTS AND METHODS: Data from 80 patients treated in our hospital from February 2014 to February 2015 were analyzed. The patients all underwent decompressive craniectomies, and their ICP changes were monitored invasively and continuously for 1 to 7 days after surgery. The average blood loss during surgery for the group of patients was 65.3 ± 12.4 ml and the mean GCS score 8.7 ± 2.4. Cases were divided into three groups according to ICP values to compare early postoperative complications of the groups: a normal and mildly increased group (51 cases), a moderately increased group (19 cases) and a severely increased group (10 cases). RESULTS: To validate the analysis we first showed that comparisons among groups based on gender, age, systolic pressure, diastolic pressure, bleeding time, blood loss, operation time, craniectomy localization, and preoperative mannitol dosage yielded no statistically significant differences. In contrast, the following comparisons produced statistically significant differences: the comparison of postoperative Glasgow Coma Scale (GCS) scores showing that the lower intracranial pressure, the higher the GCS score; the postoperative rehemorrhage, cerebral edema and death ratios showing the higher the intracranial pressure, the higher the rehemorrhage ratio; the average ICP and the time to occurrence of rehemorrhage, cerebral edema or cerebral infarction, showing the relationship between the average ICP and the time to a complication. Patients with higher ICP averages suffered a complication of rehemorrhage within the first 9.6 ± 2.5 hours on average. Nevertheless, the comparison of GCS scores in those patients and the others showed no significant differences. CONCLUSIONS: Based on the findings, the dynamic monitoring of intracranial pressure can early and sensitively predict postoperative complications of patients with hypertensive cerebral hemorrhage, and guide the clinical intervention actively to improve the surgery outcome.

Effects of perinatal exposure to nonylphenol on delivery outcomes of pregnant rats and inflammatory hepatic injury in newborn rats.

The current study aimed to investigate the effects of perinatal exposure to nonylphenol (NP) on delivery outcome of pregnant rats and subsequent inflammatory hepatic injury in newborn rats. The pregnant rats were divided into 2 groups: control group (corn oil) and NP exposure group. Thirty-four pregnant rats were administered NP or corn oil by gavage from the sixth day of pregnancy to 21 days postpartum, with blood samples collected at 12 and 21 days of pregnancy and 60 days after delivery. The NP concentration was measured by HPLC, with chemiluminescence used for detection of estrogen and progesterone levels. Maternal delivery parameters were also observed. Liver and blood of the newborn rats were collected and subjected to automatic biochemical detection of liver function and blood lipid analyzer (immunoturbidimetry), and ultrastructural observation of the hepatic microstructure, with the TNF-α and IL-1ß hepatic tissue levels evaluated by immunohistochemistry. Compared with the control group, the pregnant and postpartum serum NP and estradiol levels of the mother rats in the NP group were significantly increased, together with lowered progesterone level, increased number of threatened abortion and dystocia, and fewer newborn rats and lower litter weight. Serum and hepatic NP levels of the newborn rats measured 60 days after birth were significantly higher than those of the control group, as well as lower testosterone levels and increased estradiol levels. When observed under electron microscope, the hepatocyte nuclei of the control group were large and round, with evenly distributed chromatin. The chromatin of hepatocytes in the NP group presented deep staining of the nuclei, significant lipid decrease in the cytoplasm, and the majority of cells bonded with lysate. The results of immunohistochemistry showed that there was almost no TNF-α or IL-1ß expression in the hepatocytes of the control group, while the number of TNF-α-, PCNA-, and IL-1ß-positive cells in the NP group was increased, with higher integral optical density than the control group. Compared to the control group, the serum levels of alanine aminotransferase, aspartate aminotransferase, triglyceride and low-density lipoprotein in the newborn rats of the NP group were significantly increased. There was no significant difference in the serum level of high-density lipoprotein or cholesterol between the groups. Perinatal exposure to NP can interfere with the in vivo estrogen and progesterone levels of pregnant rats, resulting in threatened abortion, dystocia and other adverse delivery outcomes. High liver and serum NP levels of the newborn rats led to alteration of liver tissue structure and function. The NP-induced hepatotoxicity is probably mediated by inflammatory cytokines TNF-α and IL-1α.