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Transient global amnesia is common in the older adult, but the cause and mechanism remain unclear. Focal brain lesions allow for causal links between the lesion location and resulting symptoms, and we based on the reported TGA-causing lesions and used lesion network mapping to explore the causal neuroanatomical substrate of TGA.Fifty-one cases of transient global amnesias with DWI lesions from the literature were identified, and clinical data were extracted and analyzed. Next, we mapped each lesion volume onto a reference brain and computed the network of regions functionally connected to each lesion location using a large normative connectome dataset.Lesions primarily occurred in the hippocampus, and in addition to the hippocampus, there are also other locations of TGA-causing lesions such as the cingulate gyrus, anterior thalamic nucleus (ATN), putamen, caudate nucleus, corpus callosum, fornix. More than 90% of TGA-causing lesions inside the hippocampus were functionally connected with the default mode network (DMN).Structural abnormality in the hippocampus was the most consistently reported in TGA, and besides the hippocampus, lesions occurring at several other brain locations also could cause TGA. The DMN may also be involved in the pathophysiology of TGA. According to the clinical and neuroimaging characteristics, TGA may be a syndrome with multiple causes and cannot be treated simply as a subtype of TIA.

This paper presents a new-concept aircraft with a diamond joined-wing morphing configuration, which simultaneously adjusts the sweep angles of both the front wing and rear wings by a telescopic support rod. The compressible Navier-Stokes equations in the conservative form are solved to analyze the configuration characteristics and the aerodynamic benefits of this aircraft with different values of sweep angle (15°, 60°) and Mach number. The maximum lift-to-drag ratio is about 13.5 at M = 0.5 and α = 4 ° , 12.8 at M = 0.75 and α = 4 ° , and 3.4 at M = 1.5 and α = 6 ° , respectively. Compared with traditional morphing aircraft, the main advantages of this configuration include better transonic and supersonic performance, better lift characteristics in the state of a high-aspect ratio, and lower zero-lift drag in the supersonic state. The lift ratio of the front and rear wings shows a good similarity at different Mach numbers, especially for the 15° model, and the value eventually tends to be 1.3 at α = 12 ° . Meanwhile, the flow field characteristics and interference characteristics of the front and rear wings are studied. The increase in the angle of attack, incoming flow velocity, and distance between the front and rear wings can reduce the interference between front and rear wings. The influence from upstream components is proven to improve the aerodynamic characteristics of the rear wing, especially at α = 8 ° .

Background Migraine is a highly disabling health burden with multiple symptoms; however, it remains undertreated because of an inadequate understanding of its neural mechanisms. Neuropeptide Y (NPY) has been demonstrated to be involved in the modulation of pain and emotion, and may play a role in migraine pathophysiology. Changes in NPY levels have been found in patients with migraine, but whether and how these changes contribute to migraine is unknown. Therefore, the purpose of this study was to investigate the role of NPY in migraine-like phenotypes. Methods Here, we used intraperitoneal injection of glyceryl trinitrate (GTN, 10 mg/kg) as a migraine mouse model, which was verified by light-aversive test, von Frey test, and elevated plus maze test. We then performed whole-brain imaging with NPY-GFP mice to explore the critical regions where NPY was changed by GTN treatment. Next, we microinjected NPY into the medial habenula (MHb), and further infused Y1 or Y2 receptor agonists into the MHb, respectively, to detect the effects of NPY in GTN-induced migraine-like behaviors. Results GTN effectively triggered allodynia, photophobia, and anxiety-like behaviors in mice. After that, we found a decreased level of GFP+ cells in the MHb of GTN-treated mice. Microinjection of NPY attenuated GTN-induced allodynia and anxiety without affecting photophobia. Furthermore, we found that activation of Y1—but not Y2—receptors attenuated GTN-induced allodynia and anxiety. Conclusions Taken together, our data support that the NPY signaling in the MHb produces analgesic and anxiolytic effects through the Y1 receptor. These findings may provide new insights into novel therapeutic targets for the treatment of migraine. Graphical Abstract

BackgroundRemnant cholesterol (RC) has been suggested to be implicated in atherosclerosis. The objective of the study was to evaluate the association between RC and first-ever stroke in the Chinese general population and to investigate whether the association is mediated via hypertension or diabetes.MethodsThis study is a retrospective cohort analysis of participants from the China Health and Nutrition Survey. Participants without previous stroke and myocardial infarction in 2009 were enrolled and followed up in 2011 and 2015. Logistic regression analyses were adopted to explore the association of RC with stroke risk. Propensity score methods and doubly robust estimation method were used to ensure the robustness of our findings. Potential mediators were identified by mediation analyses.ResultsA total of 7,035 participants were involved, and during 6 years of follow-up, 78 (1.1%) participants experienced a first-ever stroke. Participants with high RC had a significantly higher incidence of stroke (1.4% versus 0.8%; p = 0.007). High RC was associated with 74% higher stroke risk after adjusting for multiple relevant variables (odds ratio [OR], 1.74; 95% CI, 1.06–2.85). The association was consistent in analyses using propensity score methods and doubly robust estimation method. Hypertension showed a significant mediating effect on the association between RC and stroke, while the mediating effect of diabetes was not significant.ConclusionHigh RC increased the risk of first-ever stroke in the Chinese general population without previous stroke and myocardial infarction, partially through the pathway of hypertension. RC might be a potential target for the primary prevention of stroke.

Dysregulation of long non-coding RNAs (lncRNAs) and microRNAs (miRNAs) plays important roles in atrial fibrillation (AF). This study aimed to identify crucial lncRNAs, miRNAs, and mRNAs in AF based on whole transcriptome sequencing.Thirty Sprague Dawley rats were randomly stratified into control and chronic intermittent hypoxia (CIH) groups (n = 15 in each). Hematoxylin-eosin staining, Masson staining, immunohistochemical assay, and western blotting were used to evaluate this model. Thereafter, atrial tissues were sent for whole transcriptome sequencing. Finally, fibrosis-related competing endogenous RNA (ceRNA) regulatory networks were built, and the relative levels of lncRNAs, miRNAs, and mRNAs were validated by real-time quantitative polymerase chain reaction (RT-qPCR) or western blotting.A CIH-induced atrial fibrosis rat model was successfully constructed. After sequencing, 268 differentially expressed lncRNAs (DELs), 20 differentially expressed miRNAs (DEMs), and 436 differentially expressed genes (DEGs) were identified. Functional analyses showed that these DEGs were associated with several processes and pathways, including "cell division," "IL-17 signaling pathway," "NOD-like receptor signaling pathway," and "cell adhesion molecules." Fibrosis-related ceRNA networks were then built, comprising five lncRNAs, seven miRNAs, and 19 DEGs. RT-qPCR and western blotting results showed that the patterns of lncRNAs (NONRATT016396.2, NONRATT001596.2, NONRATT011456.2), miRNAs (miR-10b-3p, miR-29b-3p), and mRNAs (Gng7 and Wnt2b) were consistent with sequencing analyses.The DELs, DEMs, and DEGs identified in this study may participate in atrial fibrosis processes, and the occurrence and progression of AF.

The recurrence of atrial fibrillation (AF) after cryoablation still needs to be prioritized, including discriminating predictive indicators.Eighty-seven patients aged 43-83 years who underwent cryo-balloon ablation were divided into paroxysmal atrial fibrillation (PAF) and non-paroxysmal atrial fibrillation (non-PAF) groups. Baseline data, intraoperative index, and miRNA21, IL-18, NLRP3, and visfatin levels in peripheral venous blood and left atrial blood were assessed. Follow-up was performed for 6 months to observe the recurrence of AF. A Cox risk ratio model was used to analyze indicators for predicting AF recurrence.The non-PAF and PAF group recurrence rates of AF were statistically different (p 0.05) at 9/22 (40.9%) and 11/65 (16.9%), respectively. Biomarker levels in the left atrial blood were higher in the non-PAF group than in the PAF group (p 0.05). The effects of non-PAF and levels of miRNA21 and IL-18 in left atrial serum on the recurrence of AF after cryoablation statistically differed (p 0.05).The levels of miRNA21 and IL-18 were higher in left atrial blood than in peripheral blood, which may be related to the severity of AF and recurrence of AF after cryoablation.

Atrial fibrillation (AF) is a common cardiac arrhythmia that induces serious complications. However, pharmacological treatments of AF remain challenging. This study aimed to screen crucial long non-coding RNAs (lncRNAs), microRNAs (miRNAs) and messenger RNA (mRNAs) for AF using the microarray datasets (lncRNAs and mRNAs: GSE79768, GSE115574; miRNAs: GSE68475) collected from the Gene Expression Omnibus database. Weighted correlation network analysis of GSE79768 and GSE115574 datasets identified five modules were highly related to AF status. Among 118 module-related differentially expressed mRNAs, FBXW7, EGFR, CXCR2, ROCK1 and UBE2D1 were considered as hub genes according to the gene significance, module membership and the topological characteristics for the nodes in the protein-protein interaction network. lncRNA MIR100HG and LINC01105 may function by co-expressing with (MIR100HG-ROCK1/FBXW7/UBE2D1, LINC01105-EGFR) mRNAs or sponging miRNAs to regulate mRNAs (LINC01105-miR-125a-3p-EGFR, MIR100HG-miR-200b-3p- FBXW7, MIR100HG-miR-561-3p-CXCR2, MIR100HG-miR-548z-UBE2D1). Connectivity Map and Comparative Toxicogenomics Database searches predicted dexamethasone may treat AF by reversing the expression of MIR100HG; artemisinin may reverse the expression of hub DEGs. In conclusion, our results may provide novel molecular mechanisms and potential therapeutic targets and drugs for AF.

Patients undergoing cardiac valve replacement may experience cardiovascular adverse events during the preoperative period before anesthesia. The study was to compare the preemptive anti-stress response effects of oxycodone versus sufentanil for patients undergoing cardiac valve replacement. Ninety-four patients were enrolled and assigned to group Oxy, group Suf and group NS. Patients in group Oxy were administrated with oxycodone 0.1 mg/kg, group Suf received sufentanil 0.1 μg/kg and group NS were given equivalent volume of normal saline. The primary outcomes included serum levels of cortisol, norepinephrine, and adrenaline. The secondary outcomes involved bispectral index value and the observer's assessment of awareness/sedation grade, levels of mean arterial pressure, heart rate, and the adverse reactions. Compared to group NS, the serum levels of cortisol at T1 to T5 (P

BACKGROUND: More novel biomarkers need to be discovered to improve the therapeutic efficiency of non-small cell lung cancer (NSCLC). lncRNA ELFN1-AS1 (ELFN1-AS1) was proved to play crucial roles in numerous diseases, its intention in NSCLC remains unclear. OBJECTIVE: This study aimed to investigate the function of ELFN1-AS1 and its potential mechanism in NSCLC development. METHODS: A total of 117 NSCLC patients were recruited and provided paired NSCLC tissues and normal tissues. The expression of ELFN1-AS1 was analyzed by PCR. The biological function of ELFN1-AS1 was estimated by CCK8 and Transwell assay. Additionally, the potential mechanism underlying the function of ELFN1-AS1 was explored by the dual-luciferase reporter assay and western blotting. RESULTS: The significant upregulation of ELFN1-AS1 was found in NSCLC tissues and cells, which was closely associated with the TNM stage, lymph node metastasis status, and overall survival of patients. The knockdown of ELFN1-AS1 was found to inhibit the cellular processes and EMT of NSCLC. Moreover, ELFN1-AS1 was found to serve as a sponge to binding with miR-497, and CCNE1 was demonstrated to be the downstream target of miR-497, which was speculated as the potential mechanism underlying the function of ELFN1-AS1. CONCLUSIONS: ELFN1-AS1 acts as an independent prognostic biomarker and tumor promoter of NSCLC by sponging miR-497/CCNE1 axis.

Background Gut microbial dysbiosis and gut-brain axis dysfunction have been implicated in the pathophysiology of migraine. However, it is unclear whether migraine-related cephalic allodynia could induce the alteration of gut microbial composition. Methods A classic migraine rat model was established by repeated dural infusions of inflammatory soup (IS). Periorbital mechanical threshold and nociception-related behaviors were used to evaluate IS-induced cephalic allodynia and the preventive effect of topiramate. The alterations in gut microbial composition and potential metabolic pathways were investigated based on the results of 16 S rRNA gene sequencing. Microbiota-related short-chain fatty acids and tryptophan metabolites were detected and quantified by mass spectrometry analysis. Results Repeated dural IS infusions induced cephalic allodynia (decreased mechanical threshold), migraine-like behaviors (increased immobility time and reduced moving distance), and microbial composition alteration, which were ameliorated by the treatment of topiramate. Decreased Lactobacillus was the most prominent biomarker genus in the IS-induced alteration of microbial composition. Additionally, IS infusions also enhanced metabolic pathways of the gut microbiota in butanoate, propanoate, and tryptophan, while the increased tryptophan-related metabolites indole-3-acetamide and tryptophol in feces could be the indicators. Conclusions Inflammatory dural stimulation-induced cephalic allodynia causes the alterations of gut microbiota profile and microbial metabolic pathways.

Peripheral blood mononuclear cells (PBMC) were donated by a healthy 25-year-old Han Chinese man and reprogrammed with human transcription factors (Oct4, Sox2, Klf4, and c-Myc) using CytoTune™-iPS 2.0 Sendai Reprogramming Kit. The pluripotency was confirmed by pluripotency markers. The iPSC lines could be differentiated into three germ layers and be used as a control in drug development and studies on pathological mechanisms.

The aim of this study was to study the clinical efficacy and prognostic factors after revision and reconstruction of anterior cruciate ligament. All the patients who underwent the first revision of anterior cruciate ligament (ACL) reconstruction in the department of sports medicine from January 2001 to December 2015 were collected. The demographic information, the first revision and reconstruction information of ACL, and the information during the first ACL reconstruction were collected. A total of 335 cases were included. Lysholm score, Tegner activity score, and IKDC subjective score at the last follow-up were significantly higher than those before operation. Compared with graft failure caused by sports injury, the postoperative scores of patients with revision due to life accidents or initial reconstruction techniques were significantly lower ( P < 0.05 ). The postoperative Lysholm score of patients with femoral canal drilling through the tibial canal was lower than that of patients with anterior internal approach. The postoperative IKDC score of patients who underwent medial meniscus suture at the same time was higher than that of patients without meniscus combined injury. ACL revision can improve the stability and function of knee joint. Compared with the revision caused by life accident or technical reasons of primary reconstruction surgery, the patients with graft failure caused by sports injury have better postoperative recovery. Medial meniscus suture and anterior internal approach drilling of the femoral bone canal have a statistically protective effect on the clinical function after ACL revision.

Hyperglycemia is considered to induce neuronal apoptosis via activating microglia inflammatory responses, thus involving in the development and progression of diabetic encephalopathy and neurodegenerative disorders. Increasing evidences suggest that androgen exerts neuroprotective functions including antiapoptosis, anti-inflammation and antioxidative stress. In this study, we investigate the anti-inflammatory role of dihydrotestosterone (DHT) in high glucose (HG)-induced neuroinflammatory response in BV-2 microglia. Our results revealed that DHT significantly inhibited HG-induced production of nitric oxide and prostaglandin E2 through suppressing the expression of corresponding regulatory enzymes - inducible NO synthase and cyclooxygenase-2. Also, DHT inhibited HG-induced expression of TNF-α and IL-1β. Moreover, DHT suppressed the toll-like receptor 4 (TLR4)/nuclear factor-kappa B (NF-κB) signaling pathway. Furthermore, when SH-SY5Y neurons were cultured in HG-treated BV-2 microglial supernatant, DHT pretreatment significantly increased neuronal survival, indicating the neuroprotective role of DHT. Collectively, these results suggest that DHT could protect SH-SY5Y neurons from HG-mediated BV-2 microglia inflammatory damage through inhibiting TLR4/NF-κB signaling, suggesting that maintenance of androgen level in brain might have potential benefit in neurodegenerative diseases, especially in diabetes patients combined with cognitive disorders.

We performed this meta-analysis to evaluate the effectiveness of transcutaneous electrical acupoint stimulation (TEAS) for preventing postoperative nausea and vomiting (PONV) after general anesthesia.We searched PubMed, EMbase, Ovid, Web of Science for relevant randomized controlled trials (RCTs) about TEAS for the prevention of PONV, published through July 31, 2019. The primary outcome was the incidence of PONV, postoperative nausea (PON) and postoperative vomiting (POV) recorded within 24 h after surgery. Secondary outcomes included the numbers of patients needing antiemetic rescue and the incidence of postoperative adverse effects referred to general anesthesia. Data were pooled and analyzed by RevMan 5.3 software.Fourteen RCTs (1653 participants) were included in this meta-analysis. The current results suggested that application of TEAS showed obvious superiority in lower incidence of PONV (relative risk [RR] 0.54, 95% confidence interval [CI] 0.42 to 0.68, P 0.0001), PON (RR, 0.59, 95% CI 0.49 to 0.71, P 0.0001), POV (RR 0.46; 95% CI, 0.33 to 0.65, P 0.0001), lower numbers of patients needing antiemetic rescue (RR 0.56, 95% CI 0.40 to 0.78, P = 0.0005), lower incidence of dizziness (RR 0.43, 95% CI 0.31 to 0.60, P 0.0001) and pruritus (RR 0.43, 95% CI 0.31 to 0.58, P = 0.02), compared with controlled intervention.TEAS is a reasonable modality to incorporate into a multimodal management approach for the prevention of PONV, PON, POV and associated with lower numbers needing antiemetic rescue, lower incidence of adverse effects after general anesthesia.

Background: Etomidate used for the induction of general anesthesia can result in myoclonus. We tested the hypothesis that pretreatment with dexmedetomidine (Dex) reduces the incidence of etomidate-induced myoclonus during the induction of general anesthesia. Materials and methods: One hundred patients who were scheduled for selective operations under general anesthesia were included in this randomized, double-blind controlled trial. Patients were randomized to receive either Dex 0.5 µg/kg in 20 mL of normal saline or the same volume of normal saline as pretreatment agents 15 mins before the injection of etomidate 0.3 mg/kg. The primary endpoint was the incidence of etomidate-induced myoclonus. Secondary endpoints were the severity of etomidate-induced myoclonus and the incidence of adverse effects from the onset of action of Dex or normal saline to the injection of etomidate, such as dizziness, respiratory depression, bradycardia, hypotension and nausea/vomiting. Results: All of the 100 patients completed the trial. Dex resulted in a significant 38% reduction in the number of patients who experienced etomidate-induced myoclonus: 13 (26%) vs 32 (64%) (P=0.0001). Additionally, the severity of myoclonus was also reduced in the Dex group than that in the placebo group (P=0.02). Incidence of dizziness, respiratory depression, bradycardia, hypotension and nausea/vomiting was similar in both groups. Conclusions: Pretreatment with Dex 0.5 µg/kg 15 mins before the induction of general anesthesia not only resulted in a 38% reduction in the incidence of etomidate-induced myoclonus, but also reduced the severity of myoclonus, without inducing any adverse effects.

Objective This meta-analysis was performed to evaluate the safety and efficacy of the oblique-axis plane in ultrasound-guided internal jugular vein puncture. Methods We searched Embase, PubMed, the Cochrane Library, Web of Science, and China National Knowledge Infrastructure for relevant randomized clinical trials comparing the oblique axis with the short axis in ultrasound-guided internal jugular vein puncture. Results Five randomized clinical trials were included in this meta-analysis. The pooled meta-analysis showed that the incidence of arterial puncture in the oblique-axis group was significantly lower than that in the short-axis group. No significant difference was found in the first-pass success rate between the oblique-axis group and short-axis group. Additionally, there were no significant differences in the puncture success rate or number of attempts required between the two groups. Conclusion Ultrasound-guided internal jugular vein puncture using the oblique-axis plane reduced the risk of arterial puncture, but no difference was found in the first-pass success rate, puncture success rate, or number of attempts required.

In this paper, a nonlinear positivity-preserving finite volume scheme for the heterogeneous and anisotropic diffusion problems is proposed. Firstly, a linear diamond finite volume scheme is introduced. This scheme has both cell-centered unknowns and vertex unknowns. The vertex unknowns are treated as auxiliary ones and are expressed as linear combinations of the surrounding cell-centered unknowns, which reduces the scheme to a pure cell-centered one. Two new interpolation algorithms are suggested through the linearity-preserving approach and a novel discretization of diffusion coefficient. The new vertex interpolation algorithms improve a great deal the numerical performance of the linear scheme on distorted meshes with strongly anisotropy. Secondly, a new positivity-preserving cell-centered scheme is constructed via the aforementioned linear scheme and a nonlinear correction technique proposed by [28] . This nonlinear scheme is different from most existing nonlinear two-point flux approximation schemes in the way that it is not based on the nonlinear two-point flux approximation and it doesn't require the positivity-preserving vertex interpolation. Its implementation is also very easy and simple. Numerical experiments conducted in this paper indicate that the new positivity-preserving scheme is efficient and has approximately second order accuracy in most extreme cases.

To numerically simulate the radiation diffusion problem with high parallel efficiency, we present a new parallel iteration algorithm for nonlinear diffusion equations. The algorithm is based on the domain decomposition method, and it integrates time extrapolation techniques and an advanced Jacobi explicit scheme. The domain decomposition method decomposes a large global problem into multiple sub-problems which can be solved on multiple processors in parallel. The time extrapolation technique gives the prediction values with the second or third order accuracy in time for the current time layer by specific combinations of the previous two or three time layers. The advanced Jacobi explicit scheme further improves the precision of the prediction values. Overall, the proposed algorithm makes the prediction values of the inner boundary more reasonable and offers accurate iterative initial values for all cells, which reduces the number of nonlinear iterations and improves the parallel computation efficiency remarkably.

To investigate the impact of menstrual cycle on patients undergoing gynecological endoscopic surgery. 220 patients scheduled for gynecological endoscopic surgery under general anesthesia were selected. The patients were divided into three groups based on 3 phases of menstrual cycle which are the follicular phase (Group F), ovulatory phase (Group O) or luteal phase (Group L). It is based on their duration of menstruation and the last day of menstrual bleeding from the date of surgery. Primary outcomes were the incidences of early and late postoperative nausea and vomiting (PONV) in the three patient groups. Preoperative venous blood was taken to determine the estrogen and progesterone levels of the patients. A total of 207 patients were enrolled. The incidence of early PONV was highest in group O (22.22% vs 43.33% vs 17.86%, P

Background Higher red cell distribution width (RDW) predicts adverse events in patients with cardiovascular diseases. However, there are limited data regarding the relationship between RDW and thromboembolism risk in the patients with atrial fibrillation (AF). We aimed to investigate the association between RDW and CHADS2, CHA2DS2-VASc scores used for the evaluation of thromboembolic risk in patients with non-valvular atrial fibrillation (AF). Methods Our study included 99 patients with AF (68 paroxysmal AF; 31 persistent AF). We calculated CHADS 2 and CHA 2 DS 2 -VASc risk scores for each patient, and we carefully recorded clinical characteristics as well as laboratory and echocardiographic parameters. According to CHADS 2 and CHA 2 DS 2 -VASc scores, we divided the AF patients into 2 groups (low-intermediate risk and high risk group). Subsequently, we compared the aforementioned parameters between the 2 groups, and we evaluated the relationship between RDW and CHADS 2 /CHA2DS 2 -VASc score. Finally, multivariate logistic regression analysis was performed to find independent predictors of high CHADS 2 , CHA 2 DS 2 -VASc scores. Results Patients with high CHADS 2 , CHA 2 DS 2 -VASc scores had older age, higher RDW, and creatinine levels, increased left atrial diameter and lower left ventricular ejection fraction, compared to the low CHADS 2 , CHA 2 DS 2 -VASc score group. Multivariate logistic regression analysis showed that RDW was an independent predictor for high CHADS 2 , CHA 2 DS 2 -VASc scores(OR: 2.184 and OR: 5.748; all P Conclusion RDW is significantly correlated with CHADS 2 and CHA 2 DS 2 -VASc score in the patients with AF, while is an independent predictor for high CHADS 2 and CHA 2 DS 2 -VASc score.

The Rho/Rho kinase (ROCK) pathway serves as molecular switches in many biological processes including the immune response. ROCK inhibitors lead to amelioration of some autoimmune diseases. The present study was designed to define whether a selective ROCK inhibitor, fasudil, was effective in experimental autoimmune myasthenia gravis (EAMG) and investigate the underlying mechanisms. Here we found fasudil effectively attenuated the development of ongoing EAMG. Fasudil abolished the antibody production and function by decreasing follicular helper T cells and CD19(+) B cells, especially germinal center B cells. Moreover, fasudil reduced the expression of CD80 on lymph node mononuclear cells. These findings suggest the inhibition of ROCK might be a potential therapeutic strategy for antibody-mediated autoimmune diseases.

Postoperative cognitive dysfunction (POCD) is a common complication after orthopedic surgery, which is not conducive to the prognosis of the elderly. We performed this study to investigate the effects of oxycodone applied for patient-controlled intravenous analgesia (PCIA) on postoperative cognitive function in elderly patients after total hip arthroplasty (THA). Ninety-nine participants were enrolled and allocated into two groups: oxycodone group (group O) and sufentanil group (group S). The primary outcome was the incidence of POCD, diagnosed according to the changes in the Mini-mental status examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores. The secondary outcomes included the plasma levels of S-100B protein and neuron-specific enolase (NSE), the amount of postoperative analgesic consumption and the incidence of adverse reactions. The incidence of POCD was significantly lower in patients receiving oxycodone up to the 3rd postoperative day (POD, 1st POD 27.3% vs. 51.1%, P = 0.021; 3rd POD 20.5% vs. 40.0%, P = 0.045), as compared to patients receiving sufentanil. The MMSE and MoCA scores of both groups decreased to varying degrees. However, compared with group S, the MMSE scores at 1st POD, 3rd POD, 5th POD and 7st POD in group O were higher than that in group S, while MoCA scores at 1st POD, 3rd POD and 5th POD in group O were higher. Compared with group S, the plasma levels of S-100B protein in group O at 4 h, 8 h, 12 h post-surgery were lower. While the plasma levels of NSE in group O at 4 h, 8 h, 12 h, 24 h post-surgery were lower. Number of PCIA boluses and consumption of analgesic drug during the first two POD were similar between two groups. However, postoperative incidence of nausea, vomiting and pruritus was significantly lower in patients receiving oxycodone. Oxycodone applied for PCIA in elderly patients after THA could reduce the incidence of POCD, improve postoperative cognitive function and decrease the adverse reactions.

To compare the clinical outcomes of microfracture and autogenous osteochondral mosaic transplantation in the treatment of knee joint cartilage injury.A retrospective analysis of 71 patients with articular cartilage defects on the femoral condyles who were by autogenous osteochondral mosaic transplantation or microfracture from February 2011 to February 2016, and these patients were followed up for at least 2 years. According to the sugical procedures, the patients were divided into two groups. In the microfracture group, there were 33 patients, 20 males and 13 females, with a mean age of(28.1±4.2) years old; in the mosaicplasty group, there were 38 patients, 26 males and 12 females, with a mean age of(27.8±3.5) years old. The Lysholm knee score, Hospital for Special Surgery (HSS) knee score and the Ahlbäck classification grade were recorded to evaluate the clinical efficacy. Complications were also recorded.The mean Lysholm scores of the microfracture group and the mosaicplasty group improved from 62.9±6.8 and 60.3±7.5 preoperatively to 77.0±5.4 and 85.8±5.6 post-operatively, respectively(Autogenous osteochondral mosaicplasty and microfracture are proved to be safe and effective procedures for knee articular cartilage defects. However, the mosaicplasty has better clinical outcome than the microfracture.

Signal peptide-CUB-EGF domain-containing protein 2 (SCUBE2) belongs to a secreted and membrane-associated multi-domain SCUBE protein family. Recently, it was found to play an important role in tumor development. However, the role of SCUBE2 in non-small cell lung cancer (NSCLC) has never been revealed. Here, we explored the roles and mechanism of SCUBE2 in the progression of NSCLC. Our result showed that SCUBE2 was expressed in low levels in NSCLC cell lines. In addition, overexpression of SCUBE2 significantly inhibited the proliferation, migration and invasion of NSCLC cells. Further mechanistic analysis showed that SCUBE2 overexpression efficiently inhibited the protein expression of Shh, Smo, and Gli1 in NSCLC cells. Moreover, experiments with recombinant sonic hedgehog protein rh-Shh dramatically dampened the decrease in cell proliferation, invasion, and migration triggered by SCUBE2. Taken together, these results suggest that overexpression of SCUBE2 inhibits NSCLC cell proliferation and invasion through suppressing the Sonic hedgehog signaling pathway. Thus, SCUBE2 may be a potential therapeutic target for NSCLC.

Objective To analyze the clinical features, diagnostic strategies and therapeutic methods associated with paraneoplastic neurological syndromes. Methods A retrospective study of paraneoplastic neurological syndromes was performed at a single center in Shandong, East China. The medical records and follow-up data of 28 patients were intensively reviewed between February 2011 and December 2014. Results Twenty-four (85.7%) patients experienced subacute or chronic onset of disease, and the most common symptoms reported were mild myasthenia and paresthesias. Twenty-five (89.3%) patients presented nervous system lesions prior to occult tumors, and the median time frame between paraneoplastic neurological syndromes onset and the diagnosis of a tumor was 15 weeks. Sensorimotor neuropathy, Lambert-Eaton myasthenic syndrome and limbic encephalitis were the three most common neurological syndromes reported. Elevated serum tumor markers were observed in 44.0% of patients, while 40.7% of patients were positive for onconeural antibodies. Tumors were detected in 21 (75.0%) patients after repeated whole-body screening, and lung carcinomas were the most common primary tumor detected. Seventeen patients received anti-tumor or immunological therapy, and clinical symptoms were relieved in 13 (76.5%) of these patients. Conclusions In the majority of paraneoplastic neurological syndromes patients, the onset of disease is subacute or chronic with mild clinical symptoms. Nervous system lesions usually occur prior to occult tumors with complicated and various clinical manifestations. Neither tumor markers nor onconeural antibodies exhibit a high rate of occurrence, while repeated whole-body screening is helpful in identifying occult tumors. Early diagnosis and treatment are crucial to these patients.

Introduction: Medial compartment osteoarthritis is usually accompanied by medial meniscal tear. The treatment of symptomatic mild medial compartment osteoarthritis and medial meniscal tears in middle-aged and elderly patients is controversial. Aim: This study aimed to assess the efficacy of proximal fibulectomy combined with Arthroscopic Partial Meniscectomy (APM) for symptomatic middle-aged and elderly patients with mild medial compartment osteoarthritis and medial meniscal tears. Materials and Methods: Consecutive hospitalised patients treated with concomitant proximal fibulectomy and APM from April 2013 to June 2014 were included in the study. Proximal fibulectomy and APM were done by the same group of surgeons. APM was performed initially to manage medial meniscal tears. This was followed by the proximal fibulectomy, during which a 20-mm long proximal fibular segment was excised. Preoperative and postoperative Visual Analog Scale (VAS) pain scores, Hospital for Special Surgery (HSS) knee scores, and Ahlbäck grading of knee osteoarthritis were collected. Postoperative complications and subjective patient satisfaction were recorded. For statistical analysis of the VAS and HSS score, Wilcoxon signed-rank test and the paired t-test were used to compare over time, respectively. Results: A total of 31 out of 38 patients were included. Seven patients were excluded due to follow up loss. The mean follow up duration was 25.3±1.5 months. The postoperative median VAS score and Interquartile Range (IQR) were 0 (0–1), which was significantly lower than the preoperative median VAS score and interquartile range 6 (5–7) (p< 0.001). The mean HSS score improved from 78.2±8.2 points preoperatively to 90.1±4.5 points postoperatively (p< 0.001). No patients had radiographic evidence of osteoarthritis progression or fibular bony union, or required conversion to other surgeries. Subjective patient satisfaction was rated very satisfied in 7 patients (22.6%), satisfied in 20 patients (64.5%), fairly satisfied in 3 patients (9.7%), and not satisfied in 1 patient (3.2%). Complication in a single patient included a temporary palsy of the superficial peroneal nerve. Conclusion: Proximal fibulectomy combined with APM produced satisfactory surgical outcomes in our patient cohort at two years after treatment. Concomitant proximal fibulectomy and APM may be considered to be a safe and minimally invasive treatment.

The joint effects of an ac field and intralead interaction on shot noise of a Kondo quantum dot coupled to Luttinger liquid leads is investigated. A general photon-assisted zero-frequency shot noise formula is derived by use of the extended equation of motion of the nonequilibrium Green function. The photon-assisted shot noise demonstrates antiresonant-like behavior. The differential shot noise versus bias voltage exhibits steps the widths of which are just the ac frequency. With the increase of the intralead interaction, the antiresonances and step-structure are gradually smoothed and eventually disappear in the limit of the strong intralead interaction. In the limit, the shot noise scales as a power law in bias voltage, a signature of strong intralead interactions. The measurements of the photon-assisted zero-frequency shot noise can provide valuable information of the intralead interaction.

Ultrasound assisted hot air drying of Flos Lonicerae was investigated in this study. The effects of drying parameters such as ultrasonic radiation distance, ultrasonic power and drying temperature on drying characteristics were discussed. The results showed that ultrasound application has positive and significant effects on hot air drying. Shortening ultrasonic radiation distance is beneficial to improve both ultrasonic energy efficiency and drying rate. Higher ultrasonic power had more positive and significant effects on drying rate. The influence of ultrasound power on drying rate decreased along with the decrease of moisture content during drying process, especially at low ultrasound powers. The increase of drying temperature significantly caused the reduction of drying time. D eff values ranged from 5.05 × 10(-11) to 20.33 × 10(-11) m(2)/s in ultrasound assisted hot air drying of Flos Lonicerae, and increased with the increase in drying temperature and ultrasonic power. The corresponding activation energy values ranged from 28.90 to 36.05 kJ/mol, and decreased with the increase in applied ultrasonic power. Therefore, ultrasound assistance is a helpful and promising method to enhance hot air drying process.

Many quality degradation problems are related to the high O2 content of normal air atmosphere during drying. To reduce O2 content in drying atmosphere and obtain food products with high quality, modified atmosphere drying was conducted. In this study, carrots were used as experimental materials to investigate the effects of drying parameters on the drying characteristics and product quality. Results showed that the increase in drying temperature and the decrease in O2 content positively influenced drying rate and effective moisture diffusivity. High carotenoid content, ascorbic acid retention ratio, and rehydration ratio were produced with low drying temperature and O2 content. The color parameters of products were highly correlated with carotenoid content, and low color difference could be achieved as drying temperature and O2 content decreased. Drying temperature and O2 significantly influenced carotenoid content, ascorbic acid content, rehydration, and color difference of dried products. Good quality parameters were obtained only at low drying temperature under the drying condition of normal atmosphere and could be achieved at drying temperatures of 40 to 70 °C when O2 content is 5 %. Therefore, the modified atmosphere drying is a promising method to protect the quality of dried products.

Vacuum far-infrared radiation (VFIR) drying of Flos Lonicerae was conducted, and the far-infrared radiation heater's temperature and chamber's pressure level ranged from 90 to 130C and from 400 to 40,000 Pa, respectively. Drying characteristics of VFIR drying were studied, and the results showed that the drying time decreased with the increase of the heater's temperature and the decrease of pressure. Chlorogenic acid content of dried Flos Lonicerae increased with the decrease of pressure level, and had a peak value when the heater's temperature increased. A mathematical model was developed for predicting the moisture ratio of Flos Lonicerae undergoing VFIR drying, and the nonlinear regression technique was applied to determine model parameters n and k. Comparing with calculated and experimental values, the model shows quite good accuracy for the estimation of the moisture ratio of Flos Lonicerae during the VFIR drying process. Practical Applications The traditional method for Flos Lonicerae drying is hot-air drying, and there are some other drying ways for Flos Lonicerae such as microwave drying and vacuum drying. But there is no research on vacuum far-infrared radiation (VFIR) drying of Flos Lonicerae in existing literature. Comparing with hot-air drying or microwave drying, the effective component conservation ratio of VFIR drying of Flos Lonicerae is much better. A drying model including the parameters of heater's temperature and pressure level has been developed, which could predict moisture ratio in VFIR drying of Flos Lonicerae very well. Therefore, VFIR drying technology could be applied to produce Flos Lonicerae with high quality and could be developed for drying other agricultural products.

Modified atmosphere drying of Flos Lonicerae is conducted, and the effects of drying temperature and oxygen content on drying characteristics and product quality are investigated in this study. Nitrogen gas is aerated into the dryer to adjust the oxygen content, and a heat pump system is used to control the drying temperature. The results showed that the increase in drying temperature and the decrease in oxygen content could improve the drying rate and effective moisture diffusivity. Increase in chlorogenic acid and chlorophyll contents as well as decrease in color difference were observed with decreasing drying temperature and oxygen content. High product quality could be achieved at all drying temperature levels when oxygen content was as low as 5%. Therefore, reducing oxygen content in the drying atmosphere is an effective method to improve product quality. Practical Application A modified atmosphere dryer equipped with a heat pump system is developed. The effects of drying parameters, including drying temperature and oxygen content, on drying characteristics and quality of Flos Lonicerae are studied. Nitrogen gas is used to replace certain portions of air to achieve different oxygen content levels in drying processes. The results show that drying under low oxygen content increases effective moisture diffusivity (Deff). It also promotes higher chlorogenic acid and chlorophyll contents as well as better product appearance. Therefore, modified atmosphere drying is a promising method to protect the quality of dried products. The results of this study are helpful to the technological application of modified atmosphere drying with heat pump system for Flos Lonicerae dehydration and preservation.

Higher red cell distribution width (RDW) predicts adverse events in patients with cardiovascular diseases. However, there are limited data regarding the relationship between RDW and thromboembolism risk in the patients with atrial fibrillation (AF). We aimed to investigate the association between RDW and CHADS2, CHA2DS2-VASc scores used for the evaluation of thromboembolic risk in patients with non-valvular atrial fibrillation (AF).Our study included 99 patients with AF (68 paroxysmal AF; 31 persistent AF). We calculated CHADSPatients with high CHADSRDW is significantly correlated with CHADS

A type of imidazoline inhibitor was synthesized using stearic acid and diethylenetriamine (DETA) as raw materials. Self-assembled monolayers (SAMs) of stearic imidazoline (IM) were prepared on copper surface. The copper electrode modified by IM was detected by electrochemical impedance spectros-copy (EIS), Tafel polarization curves, X-ray photoelectron spectroscopy (XPS) and Fourial transform reflection spectroscopy (FTIR). The biggest inhibition efficiency for copper corrosion of IM was 99% in NaCl solution according to EIS results. The XPS results provided evidence that the IM was adsorbed on copper surface. The theoretical calculations of molecular simulation supported the experimental results and showed that the IM molecules were tilted at an angle to the copper surface.

Background/Aims: Anti-oxidation is an effective strategy for curing acute kidney injury (AKI). Herein, we suggest that extracellular vesicles (EVs) derived from mesenchymal stromal cells (MSCs) might play an anti-oxidative role by enhancing Nrf2/ARE activation in AKI. Methods: EVs isolated from the conditioned medium of human Wharton's Jelly mesenchymal stromal cells and human foreskin fibroblast were intravenously injected in rats immediately after 45 min of unilateral kidney ischemia. Animals were sacrificed 24 h after injury. Results: Results showed that renal tubular injury was alleviated and renal function was improved by MSC-EVs. Cell apoptosis and sNGAL levels, which reflect kidney cell injury, were reduced. Moreover, MSC-EVs decreased oxidative stress in injured kidney tissues and NRK-52E cells under hypoxia injury. Nrf2/antioxidant response element (ARE) enhancement and HO-1 up-regulation were further observed after MSC-EV treatment both in vivo and in vitro. Conclusions: MSC-EVs may protect against AKI possibly through anti-oxidation by enhancing Nrf2/ARE activation.

Shuai Miao,1 Shi-Yao Zhou,2 Chun-Shan Han,3 Le-Ning Zhang,3 Hong-Bin Sun,3 Bin Yang3 1Department of Geriatrics, China-Japan Union Hospital of Jilin University, 2Department of Clinical Medicine, Jilin University, 3Department of Thoracic Surgery, China-Japan Union Hospital of Jilin University, Changchun, People’s Republic ofChina Background: The MMP-7 basement membrane and extracellular matrix may be essential for tumor invasion and metastasis, and the results presented herein showed a relationship between MMP-7 expression and esophageal cancer (EC). However, its clinicopathological value for EC patients remains inconsistent. To clarify their associations, a meta-analysis of the relevant published literature was conducted.Materials and methods: Databases including PubMed, Embase, Web of Science, Cochrane Library, CISCOM, CINAHL, and Google Scholar were electronically searched. Only those studies analyzing MMP-7 expression in EC patients with regard to series of different demographic variables and clinicopathological stages (TNM stage, differentiation and invasion grade, and lymph-node [LN] metastasis) were eligible for inclusion. Summary odds ratios (ORs) were pooled in accordance with the random-effect model.Results: Fourteen clinical cohort studies (tumor samples =935) were incorporated into the current meta-analysis. Results revealed that increased MMP-7 expression in EC patients was positively correlated to TNM stage III–IV (OR 3.04, 95% confidence interval [CI] 1.43–6.46; P=0.004). Similar connections were also detected in the differentiation grade, invasion grade, and LN metastasis (all P

Treating bone cancer pain continues to be a clinical challenge and underlying mechanisms of bone cancer pain remain elusive. Here, we reported that sonic hedgehog signaling plays a critical role in the development of bone cancer pain. Tibia bone cavity tumor cell implantation produces bone cancer-related mechanical allodynia, thermal hyperalgesia, and spontaneous and movement-evoked pain behaviors. Production and persistence of these pain behaviors are well correlated with tumor cell implantation-induced up-regulation and activation of sonic hedgehog signaling in primary sensory neurons and spinal cord. Spinal administration of sonic hedgehog signaling inhibitor cyclopamine prevents and reverses the induction and persistence of bone cancer pain without affecting normal pain sensitivity. Inhibiting sonic hedgehog signaling activation with cyclopamine, in vivo or in vitro, greatly suppresses tumor cell implantation-induced increase of intracellular Ca2+ and hyperexcitability of the sensory neurons and also the activation of GluN2B receptor and the subsequent Ca2+-dependent signals CaMKII and CREB in dorsal root ganglion and the spinal cord. These findings show a critical mechanism underlying the pathogenesis of bone cancer pain and suggest that targeting sonic hedgehog signaling may be an effective approach for treating bone cancer pain.

The potential involvement of the endocrine/paracrine mechanisms in the mesenchymal stromal cells (MSCs) therapy for acute kidney injury (AKI) has been increasingly studied. The aim of the present meta-analysis was to systematically review the therapeutic role of MSC-conditioned medium (CM) or MSCs released by extracellular vesicles (Evs) for the treatment of AKI in rodent models. Studies were identified using PubMed and Scopus databases using a custom search strategy and eligibility criteria. Data regarding serum creatinine (SCr) concentration, CM or Evs, measurement time point, AKI model (toxic or non-toxic) and other parameters, including delivery route, animal type and animal numbers, were extracted. Pooled analysis and subgroup analysis as well as multivariable meta-regression were performed. Heterogeneity and publication bias were also investigated. A total of 13 studies were included and analyzed. Pooled analysis showed reduced SCr (0.93 [0.67, 1.20], mg/dl) in rodent models of AKI after CM/Evs therapy. The results of the subgroup analysis suggested that Evs induced an increased therapeutic effect, in the form of SCr reduction, as compared with CM (P=0.05). There were also other significant influential factors for SCr reduction including measurement time point (P=0.0004) and therapeutic time point (P

Introduction Studies have demonstrated that mesenchymal stromal cells (MSCs) could reverse acute and chronic kidney injury by a paracrine or endocrine mechanism, and microvesicles (MVs) have been regarded as a crucial means of intercellular communication. In the current study, we focused on the therapeutic effects of human Wharton-Jelly MSCs derived microvesicles (hWJMSC-MVs) in renal ischemia/reperfusion injury and its potential mechanisms. Methods MVs isolated from conditioned medium were injected intravenously in rats immediately after ischemia of the left kidney for 60 minutes. The animals were sacrificed at 24 hours, 48 hours and 2 weeks after reperfusion. The infiltration of inflammatory cells was identified by the immunostaining of CD68+ cells. ELISA was employed to determine the inflammatory factors in the kidney and serum von Willebrand Factor (VWF). Tubular cell proliferation and apoptosis were identified by immunostaining. Renal fibrosis was assessed by Masson’s tri-chrome straining and alpha-smooth muscle actin (α-SMA) staining. The CX3CL1 expression in the kidney was measured by immunostaining and Western blot, respectively. In vitro, human umbilical vein endothelial cells were treated with or without MVs for 24 or 48 hours under hypoxia injury to test the CX3CL1 by immunostaining and Western blot. Results After administration of hWJMSC-MVs in acute kidney injury (AKI) rats, renal cell apoptosis was mitigated and proliferation was enhanced, inflammation was also alleviated in the first 48 hours. MVs also could suppress the expression of CX3CL1 and decrease the number of CD68+ macrophages in the kidney. In the late period, improvement of renal function and abrogation of renal fibrosis were observed. In vitro, MVs could down-regulate the expression of CX3CL1 in human umbilical vein endothelial cells under hypoxia injury at 24 or 48 hours. Conclusions A single administration of MVs immediately after ischemic AKI could ameliorate renal injury in both the acute and chronic stage, and the anti-inflammatory property of MVs through suppression of CX3CL1 may be a potential mechanism. This establishes a substantial foundation for future research and treatment.

Ultrasound can enhance mass transfer rate inside and outside materials during dehydration, so it's often used to strengthen osmotic dehydration. Yet osmotic dehydration can't obtain dry products and is usually applied as pretreatment for other drying process. Ultrasonic osmotic dehydration combined hot-air drying process is investigated in this paper. The influences of operation parameters such as time, ultrasound power, solution concentration and system temperature on water removal ratio are discussed. The effects of ultrasonic osmosis on total dehydration time of drying carrot slices are also studied.

During acute kidney injury (AKI), tubular cell dedifferentiation initiates cell regeneration; hepatocyte growth factor (HGF) is involved in modulating cell dedifferentiation. Mesenchymal stem cell (MSC)-derived microvesicles (MVs) deliver RNA into injured tubular cells and alter their gene expression, thus regenerating these cells. We boldly speculated that MVs might induce HGF synthesis via RNA transfer, thereby facilitating tubular cell dedifferentiation and regeneration. In a rat model of unilateral AKI, the administration of MVs promoted kidney recovery. One of the mechanisms of action is the acceleration of tubular cell dedifferentiation and growth. Both in vivo and in vitro, rat HGF expression in damaged rat tubular cells was greatly enhanced by MV treatment. In addition, human HGF mRNA present in MVs was delivered into rat tubular cells and translated into the HGF protein as another mechanism of HGF induction. RNase treatment abrogated all MV effects. In the in vitro experimental setting, the conditioned medium of MV-treated injured tubular cells, which contains a higher concentration of HGF, strongly stimulated cell dedifferentiation and growth, as well as Erk1/2 signaling activation. Intriguingly, these effects were completely abrogated by either c-Met inhibitor or MEK inhibitor, suggesting that HGF induction is a crucial contributor to the acceleration of cell dedifferentiation and growth. All these findings indicate that MV-induced HGF synthesis in damaged tubular cells via RNA transfer facilitates cell dedifferentiation and growth, which are important regenerative mechanisms.

In our previous study, microvesicles (MVs) released from human Wharton's jelly mesenchymal stem cells (hWJ-MSCs) retard the growth of bladder cancer cells. We would like to know if MVs have a similar effect on human renal cell carcinoma (RCC). By use of cell culture and the BALB/c nu/nu mice xeno-graft model, the influence of MVs upon the growth and aggressiveness of RCC (786-0) was assessed. Cell counting kit-8 (CCK-8) assay, incidence of tumor, tumor size, Ki-67 or TUNEL staining was used to evaluate tumor cell growth in vitro or in vivo. Flow cytometry assay (in vitro) or examination of cyclin D1 expression (in vivo) was carried out to determine the alteration of cell cycle. The aggressiveness was analyzed by Wound Healing Assay (in vitro) or MMP-2 and MMP-9 expression (in vivo). AKT/p-AKT, ERK1/2/p-ERK1/2 or HGF/c-MET expression was detected by real-time PCR or western blot. Our data demonstrated that MVs promote the growth and aggressiveness of RCC both in vitro and in vivo. In addition, MVs facilitated the progression of cell cycle from G0/1 to S. HGF expression in RCC was greatly induced by MVs, associated with activation of AKT and ERK1/2 signaling pathways. RNase pre-treatment abrogated all effects of MVs. In summary, induction of HGF synthesis via RNA transferred by MVs activating AKT and ERK1/2 signaling is one of crucial contributors to the pro-tumor effect.

Oxidative stress is known as one of the main contributors in renal ischemia/reperfusion injury (IRI). Here we hypothesized that Micro-vesicles (MVs) derived from human Wharton Jelly mesenchymal stromal cells (hWJMSCs) could protect kidney against IRI through mitigating oxidative stress. MVs isolated from hWJMSCs conditioned medium were injected intravenously in rats immediately after unilateral kidney ischemia for 60 min. The animals were sacrificed at 24 h, 48 h and 2 weeks respectively after reperfusion. Our results show that the expression of NOX2 and reactive oxygen species (ROS) in injured kidney tissues was declined and the oxidative stress was alleviated in MVs group at 24 h and 48 h in parallel with the reduced apoptosis and enhanced proliferation of cells. IRI-initiated fibrosis was abrogated by MVs coincident with renal function amelioration at 2 weeks. NOX2 was also found down-regulated by MVs both in human umbilical vein endothelial cells (HUVEC) and NRK-52E cell line under hypoxia injury model in vitro. In conclusion, a single administration of hWJMSC-MVs might protect the kidney by alleviation of the oxidative stress in the early stage of kidney IRI through suppressing NOX2 expression. Moreover, it could reduce the fibrosis and improved renal function.