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Postoperative fatigue (POF) is the most common and long-lasting complication after surgery, which brings heavy burden to individuals and society. Recently, hastening postoperative recovery receives increasing attention, but unfortunately, the mechanisms underlying POF remain unclear. Propofol is a wildly used general anesthetic in clinic, and inspired by the rapid antidepressant effects induced by ketamine at non-anesthetic dose, the present study was undertaken to investigate the anti-fatigue effects and underlying mechanisms of propofol at a non-anesthetic dose in 70% hepatectomy induced POF model in rats. We first showed here that single administration of propofol at 0.1 mg/kg ameliorated acute POF in hepatectomy induced POF rats. Based on metabonomics analysis, we hypothesized that propofol exerted anti-fatigue activity in POF rats by facilitating free fatty acid (FFA) oxidation and gluconeogenesis. We further confirmed that propofol restored the deficit in FFA oxidation and gluconeogenesis in POF rats, as evidenced by the elevated FFA utilization, acetyl coenzyme A content, pyruvic acid content, phosphoenolpyruvic acid content, hepatic glucose output and glycogen storage. Moreover, propofol stimulated glucagon secretion and up-regulated expression of cAMP-response element binding protein (CREB), phosphorylated CREB, peroxlsome prolifeator-activated receptor-γ coactivator-1α (PGC-1α), phosphoenolpyruvate carboxykinade1 and carnitine palmitoltransferase 1A. In summary, our study suggests for the first time that propofol ameliorates acute POF by promoting glucagon-regulated gluconeogenesis via CREB/PGC-1α signaling and accelerating FFA beta-oxidation.

Studies about the pneumonia morbidity effects of various air pollution exposure are still limited in China. We aimed to explore the short-term effect of air pollutants exposure on pneumonia admission and identify the vulnerable groups in Qingdao, China. From January 2015 to October 2017, a prospective cohort involving 433,032 participants across 3 counties in Qingdao were enrolled in the study. Distributed lag nonlinear model (DLNM) was applied to assess the associations between air pollutants and pneumonia hospitalizations. There were 636 cases of pneumonia, with an annual incidence density of 54.33 per 100,000 person-years (95% CI: 50.11, 58.56). A 10 μg/m

Background: The COVID-19 pandemic is challenging the public health response system worldwide, especially in poverty-stricken, war-torn, and least developed countries (LDCs). Methods: We characterized the epidemiological features and spread dynamics of COVID-19 in Niger, quantified the effective reproduction number (Rt ), evaluated the impact of public health control measures, and estimated the disease burden. Results: As of 4 July 2020, COVID-19 has affected 29 communes of Niger with 1093 confirmed cases, among whom 741 (67.8%) were males. Of them 89 cases died, resulting in a case fatality rate (CFR) of 8.1%. Both attack rates and CFRs were increased with age (P < 0.0001). Health care workers accounted for 12.8% cases. Among the reported cases, 39.3% were isolated and treated at home, and 42.3% were asymptomatic. 74.6% cases were clustered in Niamey, the capital of Niger. The Rt fluctuated in correlation to control measures at different outbreak stages. After the authorities initiated the national response and implemented the strictest control measures, Rt quickly dropped to below the epidemic threshold (

ObjectiveTo compare the epidemiological characteristics and transmission dynamics in relation to interventions against the COVID-19 and severe acute respiratory syndrome (SARS) outbreak in mainland China.DesignComparative study based on a unique data set of COVID-19 and SARS.SettingOutbreak in mainland China.ParticipantsThe final database included 82 858 confirmed cases of COVID-19 and 5327 cases of SARS.MethodsWe brought together all existing data sources and integrated them into a comprehensive data set. Individual information on age, sex, occupation, residence location, date of illness onset, date of diagnosis and clinical outcome was extracted. Control measures deployed in mainland China were collected. We compared the epidemiological and spatial characteristics of COVID-19 and SARS. We estimated the effective reproduction number to explore differences in transmission dynamics and intervention effects.ResultsCompared with SARS, COVID-19 affected more extensive areas (1668 vs 230 counties) within a shorter time (101 vs 193 days) and had higher attack rate (61.8 vs 4.0 per million persons). The COVID-19 outbreak had only one epidemic peak and one epicentre (Hubei Province), while the SARS outbreak resulted in two peaks and two epicentres (Guangdong Province and Beijing). SARS-CoV-2 was more likely to infect older people (median age of 52 years), while SARS-CoV tended to infect young adults (median age of 34 years). The case fatality rate (CFR) of either disease increased with age, but the CFR of COVID-19 was significantly lower than that of SARS (5.6% vs 6.4%). The trajectory of effective reproduction number dynamically changed in relation to interventions, which fell below 1 within 2 months for COVID-19 and within 5.5 months for SARS.ConclusionsChina has taken more prompt and effective responses to combat COVID-19 by learning lessons from SARS, providing us with some epidemiological clues to control the ongoing COVID-19 pandemic worldwide.

Obesity-related traits have been associated with coronary artery disease (CAD) in observational studies, but these associations may be biased by confounding factors and reverse causation. In this study, we specifically conducted two-sample Mendelian randomization (MR) analyses to overcome these limitations and test the associations of obesity-related traits (other than body mass index (BMI)) (n = 322,154) with CAD (22,233 cases and 64,762 controls) by using summary-level data from previous studies. The methods utilized to estimate these associations included the inverse-variance weighted method, the weighted median method and MR-Egger regression. Our results supported causal effects of BMI, hip circumference (HC), waist circumference (WC), and waist-hip ratio (WHR) on CAD. The associations of BMI-adjusted HC and WC with CAD were reversed, unlike that of WHR. In MR analyses excluding overlapping single nucleotide polymorphisms (SNPs) from obesity-related traits, the associations of these traits with CAD were preserved. The associations of BMI-adjusted HC and WC with CAD require further investigation, as collider stratification may be occurring. Additionally, central adiposity (measured by WHR) separated from general adiposity (measured by BMI) and general adiposity might pose similar risks for CAD. In clinical practice, physicians should pay attention to the potential effects of different obesity-related traits on CAD.

Background: Investigate into the medical expenditures of chronic kidney disease (CKD) patients through path analysis method of three consecutive years within a Grade-A tertiary hospital in Beijing to conduct the main influencing factors in diagnosis-related groups (DRGs) grouping of the diagnosis, and reassess the present grouping process to provide information and reference on cost control for hospitals and medical management departments. Methods: Eight hundred and fifty-five inpatient cases whose first diagnosis were defined as CKD in the year 2014–2016 within the hospital were selected as the sample of the study, multiple linear regression and path analysis method were adopted in DRGs grouping process to investigate the main influencing factors of total medical expenditures and DRGs grouping process. Results: The maximum proportion of the medical costs within CKD patients was the costs on treatment, with the highest of 35.3% on the year 2014, the second was the costs on drug, which accounted for

There are many kinds of potentially undesirable teeth. At present, surgical extraction is the most efficient way to eliminate these teeth, but it's very complex and invasive. In this study, we investigated the effects of bleomycin (BLM) on dental follicle and tooth eruption as a potential conservative therapy for undesirable teeth. Our data showed that local injection of 0.2 U/kg BLM had no significant effects on tooth eruption compared to the control group in Wistar rats. With higher dose of BLM (0.5 or 2 U/kg), the eruption of treated teeth was interrupted and their root formation failed until 4 weeks postnatal without significant systemic toxicity. Additionally, those effects were not depending on the toxicity of overdose evidenced by TUNEL assay. In summary, injecting BLM into dental follicle at an early stage could interrupt tooth development and eruption, and may prevent the potentially clinical problems resulting from undesirable teeth instead of surgical removal.

Background/Aims: The study aimed to investigate the protective effect of curcumin against oxidative stress-induced injury of Parkinson’s disease (PD) through the Wnt/β-catenin signaling pathway in rats. Methods: The successfully established PD rat models and normal healthy rats were randomly assigned into the 6-hydroxydopamine (6-OHDA), the curcumin (Cur) and the control groups. Immunohistochemistry was used to detect the positive expression of tyrosine hydroxylase (TH), dopamine transporter (DAT) and glial fibrillary acidic protein (GFAP). Deutocerebrum primary cells were extracted and classified into the control, 6-OHDA, Cur (5, 10, 15 µmol/L), Dickkopf-1 (DKK-1) and Cur + DKK-1 groups. MTT assays, adhesion tests and TUNEL staining were used to assess cell viability, adhesion and apoptosis, respectively. Western blotting and qRT-PCR were used to examine the protein and mRNA expressions of Wnt3a and β-catenin and the c-myc and cyclinD1 mRNA expressions. Results: TH and DAT expressions in the Cur group were elevated and GFAP was reduced compared with the 6-OHDA group. Curcumin enhanced viability, survival and adhesion and attenuated apoptosis of deutocerebrum primary cells by activating the Wnt/β-catenin signaling pathway. Higher Wnt3a and β-catenin mRNA and protein expressions and c-myc and cyclinD1 mRNA expressions, enhanced superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) contents, decreased malondialdehyde (MDA) content and elevated mitochondrial membrane potential (∆ψm) were found in the 10 and 15 µmol/L Cur groups compared with the 6-OHDA group. However, opposite tendencies were found in the Cur + DKK-1 group compared to the 10 µmol/L Cur group. Conclusion: This study suggests that curcumin could protect against oxidative stress-induced injury in PD rats via the Wnt/β-catenin signaling pathway.

Nuclear factor kappa B (NF-κB) is the critical transcriptional factor in the pathogenesis of acute lung injury (ALI). NF-κB regulates the expression changes of inflammatory factors such as tumor necrosis factor alpha (TNF-α), interleukin-1β (IL-1β) and interleukin 6 (IL-6). In a previous study we showed that decompression sickness (DCS) caused by simulated unsafe fast buoyancy ascent escape (FBAE) could result in ALI, which was characterized by expression changes of inflammatory factors in rat lung tissue. The purpose of the present work was to study the roles of NF-κB and TNF-α in the process of DCS-induced rat lung injury caused by simulated unsafe FBAE. The research methods aimed to detect the rat lung tissue messenger ribonucleic acid (mRNA) and protein level variations of NF-κB, inhibitory ×B (I×B), TNF-α, IL-1β, IL-6, IL-10 and IL-13 by using pretreatment of the NF-κB inhibitor pyrrolidine dithiocarbamate (PDTC) and TNF-α antibody (Ab). Our experimental results demonstrated that PDTC could improve the survival rate of the rats with DCS caused by unsafe FBAE more effectively than TNF-α Ab. However, the inhibition of TNF-α Ab on the nuclear translocated protein expression of NF-κB was more effective than PDTC. Both PDTC and TNF-α Ab can abrogate the increment of the rat lung tissue mRNA levels of TNF-α, IL-1β, IL-6 and protein levels of NF-κB, TNF-α, IL-1β effectively and increase the rat lung tissue content of I×B significantly. In conclusion, TNF-α-mediated NF-κB signaling may be one of the critical signaling pathways in the pathogenesis of DCS-induced rat lung injury caused by simulated unsafe FBAE. PDTC may ameliorate this type of injury partly through inhibiting the NF-κB pathway.

Rationale: Isolated dissection of the celiac artery (IDCA) is one of isolated visceral artery dissection, which can occur alone, and can also be complicated with superior mesenteric artery dissection and splenic artery pseudoaneurysm. This disease is very rare in clinic. The exact pathogenesis of IDCA remains unknown. At present, no consensus has yet been reached on the best treatment strategy for this rare disease. In the present study, the clinical data of one IDCA patient diagnosed and treated in our hospital was retrospectively analyzed, and related literatures were reviewed, in order to improve the understanding of the disease. Patient concerns: The patient was a 49-year-old male, who was admitted in our hospital because of “pain of subxyphoid area for one month”. One month before, the patient presented with persistent pain in the subxyphoid area after he had a cold, on paroxysmal exacerbation occurred. After taking “stomach drug”, the subjective symptoms eased slightly, but the disease attacked again two hours later. Diagnoses: The patient was diagnosed with “isolated dissection of the celiac artery” by enhanced CT. Interventions: The patient was interventionally treated with bare stent implantation. Outcomes: The symptom of the patient disappeared after interventional therapy. Lessons: In the present study, the clinical symptoms and treatment process of one patient with IDCA were described. The clinical symptoms of IDCA are often atypical, and its incidence is extremely low, therefore it is extremely easily misdiagnosed. The definite diagnosis depends on imaging examination. Interventional therapy is the first choice for treating this disease due to its advantages of small trauma and good curative effect.

AIM To detect the expression of type I inositol 1,4,5-trisphosphate receptor (IP3RI) in the kidney of rats with hepatorenal syndrome (HRS). METHODS One hundred and twenty-five Sprague-Dawley rats were randomly divided into four groups to receive an intravenous injection of D-galactosamine (D-GalN) plus lipopolysaccharide (LPS; group G/L, n = 50), D-GalN alone (group G, n = 25), LPS alone (group L, n = 25), and normal saline (group NS, n = 25), respectively. At 3, 6, 9, 12, and 24 h after injection, blood, liver, and kidney samples were collected. Hematoxylin-eosin staining of liver tissue was performed to assess hepatocyte necrosis. Electron microscopy was used to observe ultrastructural changes in the kidney. Western blot analysis and real-time PCR were performed to detect the expression of IP3RI protein and mRNA in the kidney, respectively. RESULTS Hepatocyte necrosis was aggravated gradually, which was most significant at 12 h after treatment with D-galactosamine/lipopolysaccharide, and was characterized by massive hepatocyte necrosis. At the same time, serum levels of biochemical indicators including liver and kidney function indexes were all significantly changed. The structure of the renal glomerulus and tubules was normal at all time points. Western blot analysis indicated that IP3RI protein expression began to rise at 3 h (P < 0.05) and peaked at 12 h (P < 0.01). Real-time PCR demonstrated that IP3RI mRNA expression began to rise at 3 h (P < 0.05) and peaked at 9 h (P < 0.01). CONCLUSION IP3RI protein expression is increased in the kidney of HRS rats, and may be regulated at the transcriptional level.

Background The thoracoscope and minimally invasive techniques have been effectively used in cardiac surgery. Methods The study included 27 consecutive patients (aged 24.8±17.6 years), who underwent cardiac surgery from January 2012 to July 2013. Six patients were diagnosed with mitral valve stenosis (MS), 17 patients with atrial septal defects (ADSs), and four with ventricular septal defects (VSDs). All the patients underwent thoracoscope-assisted right vertical infra-axillary mini-incision (TARVAI). Results The procedure was successfully performed in all patients. For the patients with ASDs or VSDs, the times for cardiopulmonary bypass, aortic cross-clamping, operating (skin-to-skin), ventilation, ICU stay, postoperative hospital stay were 63±25 min, 28.1±15.5 min, 167.1±35.7 min, 5.2±2.7 h, 25.3±10.5 h, 8.7±3.6 days, and for the patients with MS, these were 143.3±25.2 min, 88.2±15.4 min, 236.5±48.5 min, 7.3±1.5 h, 36.7±9.1 h, and 13.5±4.4 days, respectively. The median postoperative drainage (total) for the ASD/VSD and MS patients was 136.3±54.5 ml and 203.8±94.4 ml, respectively. Conclusions In our institution, the TARVAI approach is feasible and safe in cardiac surgery. It may be particularly useful in young patients with simple congenital heart disease and mitral valve disease.

Acoustic trauma is being reported to damage the auditory periphery and central system, and the compromised cortical inhibition is involved in auditory disorders, such as hyperacusis and tinnitus. Parvalbumin-containing neurons (PV neurons), a subset of GABAergic neurons, greatly shape and synchronize neural network activities. However, the change of PV neurons following acoustic trauma remains to be elucidated. The present study investigated how auditory cortical PV neurons change following unilateral 1 hour noise exposure (left ear, one octave band noise centered at 16 kHz, 116 dB SPL). Noise exposure elevated the auditory brainstem response threshold of the exposed ear when examined 7 days later. More detectable PV neurons were observed in both sides of the auditory cortex of noise-exposed rats when compared to control. The detectable PV neurons of the left auditory cortex (ipsilateral to the exposed ear) to noise exposure outnumbered those of the right auditory cortex (contralateral to the exposed ear). Quantification of Western blotted bands revealed higher expression level of PV protein in the left cortex. These findings of more active PV neurons in noise-exposed rats suggested that a compensatory mechanism might be initiated to maintain a stable state of the brain.

Purpose Elderly acute myelocytic leukemia (AML) patients have limited treatment options because they poorly tolerate standard-dose chemotherapy. The present article describes our experience with ultra-low-dose decitabine combined with infusion of autologous cytokine-induced killer (CIK) cells for 2 elderly patients with myelodysplastic syndrome–transformed AML. Methods Decitabine (10 mg) was given on days 1 to 5, and CIK cells on day 14 with 2 to 8 × 10 9 cells per infusion. Findings The therapeutic regimen resulted in marked hematologic recovery and was associated with better than expected survival in both cases. Implications Our experience suggests that the combination therapy is safe and effective for elderly patients with myelodysplastic syndrome–transformed AML.

The survival benefit of postoperative adjuvant transcatheter arterial chemoembolization (TACE) remains controversial. We aim to investigate the survival effect of postoperative adjuvant TACE on the prognosis of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) patients (stage B, the Barcelona Clinic Liver Cancer staging). Sixty consecutive HBV-related HCC patients (stage B) from February 2006 to May 2009 undergoing surgical resection were included in this study. Of these 60 patients, 34 patients underwent surgery only (Group A) and 26 patients underwent surgery plus TACE (Group B). We followed-up until May 2013. Overall survival rates as well as prognostic factors were analyzed by the Kaplan–Meier method, the log-rank test or Cox’s proportional hazard model. All patients’ data were collected from the hospital medical records, which were described precisely after accurate clinical samples detection. The 1-, 2-, and 3-year overall survival rates in surgery-only group were 58.8, 32.4 and 12.6 %, and the rates in surgery plus TACE group were 73.1, 61.5, and 48.9 %, respectively (P = 0.033). The median survival time of the two groups after surgery and surgery plus TACE was 15.0 months [95 % confidence interval (CI) 10.714–19.286] and 35.0 months (95 % CI 20.974–49.026). In multivariate analysis, hemoglobin, HBeAg, peripheral blood regulatory T cells and tumor size were independent prognostic elements for HBV-related HCC patients (stage B). Postoperative adjuvant TACE improves the survival of patients with HBV-related HCC (stage B) after curative resection compared to surgery only.

Liver metastasis from prostate cancer is uncommon and remains poorly understood. We computer searched the clinical records of all our patients registered into a database to identify patients that presented or developed liver metastases. A total of 27 prostate cancer patients with ultrasound or CT/MR imaging evidence of liver metastases were included in our analysis. The liver metastasis rate from metastatic prostate cancer was 4.29 %. Eight (29.63 %) patients had previously untreated, hormone-naive prostate cancer (synchronous liver metastases at diagnosis of prostate cancer), whereas 19 (70.37 %) patients had already been diagnosed as having hormone-refractory prostate cancer. In the hormone-naive group, the median overall survival after liver metastases diagnosis was 38 months and half of the patients were still alive at the latest follow-up, whereas only 6 months in the hormone-refractory group (p = 0.003). High concentration of serum neuron-specific enolase and previous chemotherapy were associated with a significantly poor overall survival after liver metastases in the hormone-refractory group using Kaplan–Meier curves and logrank tests for univariate analysis.

Purpose This study was conducted to explore the diagnostic value of microRNA-143 (miRNA-143) in predicting in-stent restenosis (ISR) of lower extremity arterial occlusive disease (LEAOD). Methods From February 2012 to March 2015, 165 patients (112 males and 53 females) with LEAOD undergoing interventional treatment were enrolled in this study. Serum miRNA-143 expression was detected using quantitative real-time polymerase chain reaction (qRT-PCR). Patients were assigned into the restenosis and non-restenosis groups according to routine surveillance postoperative angiography. A logistic regression analysis was conducted to analyze the risk factors for ISR in LEAOD patients. A receiver operating characteristic (ROC) curve was drawn to evaluate the diagnostic value of miRNA-143 in predicting ISR for LEAOD patients. Results There were 74 and 91 patients in the restenosis and non-restenosis groups, respectively. Before the treatment, there were significant differences in history of diabetes, smoking status, blood sugar level (BSL) at admission, low-density lipoprotein cholesterol (LDL-C) level, and stent diameter between the restenosis and non-restenosis groups (all P

To study the diagnostic value of diffusion tensor imaging (DTI) in cervical spondylotic myelopathy.Twenty healthy volunteers and fifty patients with cervical spondylotic myelopathy underwent DTI in the Affiliated Hospital of Medical College of Ningbo University from January 2014 to April 2015. Healthy volunteers served as controls. Fifty patients were divided into three groups (group A , B, C) according to cervical MRI scan standard. Group A (17 cases) had only the dura mater spinalis compressed; Group B (23 cases) showed the cervical spinal cord compressed, but no high signal in it; Group C (10 cases) had the cervical spinal cord compressed with high signal in the same level. The average apparent diffusion coefficients(ADC) and fractional anisotropy (FA)values in these examinee were analyzed and all subjects were performed fiber tracking.There was no statistically significant differences in ADC and FA values in C2/C3, C3/C4, C4/C5, C5/C6, C6/C7 of control group (P0.05). The average ADC and FA values in control group were (0.875 +/- 0.096) x10(3) mm2/s and 0.720 +/- 0.051, respectively; compared with group A,there was no statistically significant difference; compared with group B and C, there was significant difference; comparison among group A, B, C, there was significant differences.DTI can early and accurately quantify the changes of microstructure in cervical spondylotic myelopathy. Fiber tracking can show the damage range of spinal cord lesions.

Background: Molecular targeted therapies were found to be efficacious and safer in the treatment of metastatic renal cell carcinoma (mRCC). Sorafenib is the first target agent (TA) to report a benefit in this disease and has largely established a prominent role in progression-free survival (PFS). However, there have been conflicting results across the trials that evaluated the efficacy of sorafenib. Objective: The aim of the study was to perform a meta-analysis to compare the efficacy and safety of sorafenib in first-line treatments of mRCC. Methods: We searched online electronic databases: PubMed, Embase, and the Cochrane Library updated on September 2017. Trials on the efficacy of sorafenib in first-line treatments of advanced RCC were included, of which the primary outcomes were objective response rate (ORR), PFS, overall survival (OS), and grade 3/4 adverse events (AEs). Results: A total of 5 trials were included in this analysis. The group of AEs showed significantly improved PFS (odds ratio [OR] = 0.78, 95% confidence interval [CI] = 0.70–0.86, P

Sodium salicylate (SS) can penetrate the blood-brain barrier to target neurons in the central auditory system. Understanding how SS alters functional behaviors of different types of central auditory neurons will provide insights into the neural mechanisms of SS-induced tinnitus. Here, we report the differential effects of SS on current-evoked firing of pyramidal neurons and fast-spiking interneurons in layer II/III of auditory cortex slices in young rats (P12-P19). The two neuronal types were identified according to their characteristic patterns of current-evoked firing as recorded with whole-cell patch-clamp techniques and by their morphological features. Following perfusion of the brain slice with 1.4mM SS, the threshold current needed to evoke an action potential remained unchanged for pyramidal neurons (68.96+/-10.68 pA vs 70.39+/-12.14 pA, n=7, P0.05), but significantly increased for fast-spiking interneurons (56.9+/-13.69 pA vs 74.04+/-15.73 pA, n=7, P0.05). The drug perfusion caused no significant change in current-evoked firing rates in pyramidal neurons (-2.43+/-7.07%, n=14, P0.05); however, it drastically and reversibly depressed those in fast-spiking interneurons by up to -49.88+/-10.39% (n=14, P0.05). Our results suggest that functionally impairing fast-spiking interneurons, which are GABAergic and inhibitory, is probably one of the pathways through which SS raises excitability in the central auditory system and consequently produces tinnitus.

Objective To observe the therapeutic effects of the point-injection with nerve growth factor (NGF) for the sound-perceiving nerve deafness and tinnitus. Methods The 140 cases in this series were randomly divided into a treatment group of 68 cases treated by NGF injection at the points of Yifeng (TE 17) and Wangu (GB 12), and a control group of 72 cases orally taking Xibiling () and adenosine triphosphate (ATP) and intramuscular injection with VB1 and VB12. Results The total effective rate was 78.6% in the treatment group and 31.8% in the control group, with significant difference between the two groups (P Conclusion For treating nervous deafness and tinnitus, NGF point-injection may show good therapeutic effects, but inversely proportional to the illness course, age and the extent of hypoacusis.

Available evidence suggests that sodium salicylate (SS) may produce tinnitus through altering the balance between inhibition and excitation in the central auditory system. Since serotonin (5-hydroxytryptamine, 5-HT) containing fibers preferentially innervate inhibitory GABA neurons, there exists a possibility that SS causes the imbalance between inhibition and excitation through influencing serotonergic modulation of the GABAergic synaptic transmission. In the present study, we examined the effects of SS on 5-HT-mediated GABAergic spontaneous inhibitory postsynaptic currents (sIPSCs) from neurons of the central nucleus of rat inferior colliculus with whole-cell patch-clamp technique and brain slice preparation. Perfusion of 40 μM 5-HT robustly enhanced both frequency and amplitude of GABAergic sIPSCs and this 5-HT-induced enhancement of GABAergic sIPSCs could be suppressed by 1.4 mM SS. Tetrodotoxin at 0.5 μM produced a similar effect as SS did, suggesting that SS suppresses the 5-HT-induced enhancement of GABAergic sIPSCs through depressing spontaneous action potentials of GABA neurons. Our findings suggest that SS may preferentially target GABA neurons and consequently interrupt a normal level of GABAergic synaptic transmissions maintained by the serotonergic system in SS-induced tinnitus.

Fast buoyancy ascent escape is the general submarine escape manner adopted by the majority of naval forces all over the world. However, if hyperbaric exposure time exceeds the time limit, fast buoyancy ascent escape has a high risk to result in decompression sickness (DCS). Tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and IL-6 have been all implicated in the process of inflammation associated with acute lung injury (ALI). Our work demonstrated that DCS caused by simulated fast buoyancy ascent escape could induce ALβ in the rat model. The purpose of the present work was to study the expression changes of TNF-α, IL-1β and IL-6 in the rat lung affected by DCS caused by simulated fast buoyancy ascent escape. The lung tissue mRNA levels of TNF-α, Il-1β and Il-6 were significantly increased at 0.5 hour after DCS caused by simulated fast buoyancy ascent escape. The lung contents of TNF-α, IL-1β and IL-6 were at an expression peak at 0.5 hour, although showing no statistical difference when compared with the normal control group. In conclusion, the rat lung expression variations of TNF-α, IL-1β and IL-6 are the most obvious at 0.5 hour within 24 hours after the lung injury by DCS caused by simulated fast buoyancy ascent escape.

Fast buoyancy ascent escape is one of the major naval submarine escape maneuvers. Decompression sickness (DCS) is the major bottleneck to increase the depth of fast buoyancy ascent escape. Rapid decompression induces the release of inflammatory mediators and results in tissue inflammation cascades and a protective anti-inflammatory response. In our previous study, we found that DCS caused by simulated fast buoyancy ascent escape could induce acute lung injury (ALI) and the expression changes of the proinflammatory cytokines: tumor necrosis factor alpha (TNF-α), interleukin (IL)-1β and IL-6 in rat lung tissue. In order to study the expression change characteristics of TNF-α, IL-1β, IL-6, IL-10 and IL-13 in the rat lung of DCS caused by simulated fast buoyancy ascent escape, we detected the rat lung mRNA and protein levels of TNF-α, IL-1β, IL-6, IL-10 and IL-13 at 0.5 hour after DCS caused by simulated fast buoyancy ascent escape (fast escape group), compared with the normal control group (control group) and diving DCS (decompression group). We observed that DCS caused by simulated fast buoyancy ascent escape could increase the mRNA levels of TNF-α, IL-1β, IL-6, IL-10, and the protein levels of TNF-α, IL-10 in rat lung tissue. At the same time, we found that the protein level of IL-13 was also downregulated in rat lung tissue. TNF-α, IL-10 and IL-13 may be involved in the process of the rat lung injury of DCS caused by simulated fast buoyancy ascent escape. In conclusion, the expression changes of inflammatory factors in the rat lung of DCS caused by simulated fast buoyancy ascent escape were probably different from that in the rat lung of diving DCS, which indicated that the pathological mechanism of DCS caused by simulated fast buoyancy ascent escape might be different from that of diving DCS.

To develop a practical and reproducible rat model of hepatorenal syndrome for further study of the pathophysiology of human hepatorenal syndrome.Sprague-Dawley rats were intravenously injected with D-galactosamine and lipopolysaccharide (LPS) via the tail vein to induce fulminant hepatic failure to develop a model of hepatorenal syndrome. Liver and kidney function tests and plasma cytokine levels were measured after D-galactosamine/LPS administration, and hepatic and renal pathology was studied. Glomerular filtration rate was detected in conscious rats using micro-osmotic pump technology with fluorescein isothiocyanate-labelled inulin as a surrogate marker.Serum levels of biochemical indicators including liver and kidney function indexes and cytokines all significantly changed, especially at 12 h after D-galactosamine/LPS administration [alanine aminotransferase, 3389.5 ± 499.5 IU/L; blood urea nitrogen, 13.9 ± 1.3 mmol/L; Cr, 78.1 ± 2.9 μmol/L; K(+), 6.1 ± 0.5 mmol/L; Na(+), 130.9 ± 1.9 mmol/L; Cl(-), 90.2 ± 1.9 mmol/L; tumor necrosis factor-α, 1699.6 ± 599.1 pg/mL; endothelin-1, 95.9 ± 25.9 pg/mL; P0.05 compared with normal saline control group]. Hepatocyte necrosis was aggravated gradually, which was most significant at 12 h after treatment with D-galactosamine/LPS, and was characterized by massive hepatocyte necrosis, while the structures of glomeruli, proximal and distal tubules were normal. Glomerular filtration rate was significantly decreased to 30%-35% of the control group at 12 h after D-galactosamine/LPS administration [Glomerular filtration rate (GFR)1, 0.79 ± 0.11 mL/min; GFR2, 3.58 ± 0.49 mL/min·kgBW(-1); GFR3, 0.39 ± 0.99 mL/min·gKW(-1)]. The decreasing timing of GFR was consistent with that of the presence of hepatocyte necrosis and liver and kidney dysfunction.The joint use of D-galactosamine and LPS can induce liver and kidney dysfunction and decline of glomerular filtration rate in rats which is a successful rat model of hepatorenal syndrome.

This study was aimed to investigate the morphological, immunophenotype, cytogenetic characteristics, clinical and therapy features in one elderly patient with chronic lymphocytic leukemia (CLL) combined with invasive aspergillose infection(IAI).The morphological features of bone marrow cells from patient were observed by light microscope, the immunophenotype were detected by flow cytometry, the cytogenetic characteristics were assayed by conventional chromosomal analysis and fluorescence in situ hybridization (FISH).at onset of disease, the patient was diagnosed as B-CLL, Rai stage is II. He was treated with a course of RF(fludarabine 50 mg×5, rituximab 600 mg×5) chemotherapy, and achived complete remission (CR) lasting for five years, then the patient was treated with multiple courses of chemotherapy and maintained at a steady state of disease. After the last chemotherapy, this patient developed a fever, his temperature fluctuated at 37.2-38.7°C, the lung CT showed the presence of massive shadow, repeated 1-3-β-D-glucan test was positive,and he was considered as invasive aspergillosis infection, voriconazole was intravenously injected him for 2 months, his lung CT showed better efficacy. However, the leukemia continued progress, his hemogram was extremely low, invasive aspergillosis infection relapsed,voriconazole treatment was poor effect,ultimately this patient died of the rapid progress of leukemia and multiple organ invasive aspergillosis. Autopsy showed chronic lymphocytic leukemia with multiple metastases and multiple organ invasive aspergillosis.invasive aspergillosis is a serious complication for CLL patients,once occurs, the prognosis is poor,so early diagnosis and prophylactic antifungal therapy may reduce fungal infection complication.

To observe the changes of apoptosis and protein kinase B/the mammalian target of Rapamycin (Akt/mTOR) signal pathway in hippocampal neurons of rat with post-straumatic stress disorder (PTSD), and to investigate the mechanism of PTSD.Sixty male adult SD rats were divided into control group (n = 10) and PTSD (n = 50) model group. The PTSD animal model was established by giving the rats single-prolonged stress followed a single inescapable electric foot shock (SPSS). The neuronal apoptosis of hiappocampus of PTSD rats at 1 d, 4 d, 7 d, 14 d and 28 d after model established was detected by flow cytometry (FCM). The expressions of phosphatase and tensin homology deleted on chromosome Ten (PTEN), phosphorylation of ARt and mTOR (p-Akt and p-mTOR) protein were detected by Western blotting.The apoptotic cell rate in PTSD 1 d, 4 d, 7 d and 14 d rats were higher than that in control rats (P0.05). The PTEN expression level was higher since PTSD 1 d than that in control group, and peaked in PTSD 4 d (P0.05). The p-Akt expression level was lower in PTSD 1 d than that in control group, and then increased in various time points after PTSD, but it was still lower in PTSD 28 d (P0.05). The p-mTOR expression level was lower than that in control group since PTSD 4 d, and then increased in various time points after PTSD 4 d, but it was still lower in PTSD 28 d (P0.05).The Akt/mTOR signal pathway was actived in hippocampal neurons of PTSD rats, and which was involved in neuronal apoptosis regulation.

BACKGROUND CD4+CD25+ forkhead box P3 (FOXP3)+ regulatory T cells (Tregs) accumulate in malignant tumors and negatively regulate antitumor immunity. However, the clinical significance of Tregs in HCC remains unclear. To determine the prognostic value of Tregs, we conducted a retrospective study on 264 patients with Barcelona Clinic Liver Cancer (BCLC) stage B hepatocellular carcinoma (HCC) who underwent transcatheter arterial chemoembolization (TACE). METHODS We measured the proportion of peripheral blood Tregs in 105 healthy donors and 264 HCC patients (stage B) prior to and following TACE between 2005 and 2007. All HCC patients were followed up until December 2012. The correlations between the proportion of Tregs and clinicopathologic factors were analyzed, and long-term survival rate after TACE according to the percentage of Tregs was assessed by univariate and multivariate analyses. RESULTS The 1-, 2-, 3-, 4- and 5-year cumulative survival rates were 62.1%, 32.6%, 16.5%, 10.4% and 6.9%, respectively, and the median survival time was 19.0 months. The cumulative survival rate was significantly lower in patients with higher levels of peripheral blood Treg cells compared to those with lower Treg levels (p

The purpose of this study was to explore the clinicopathological features, therapy and prognostic factors of elderly patients with non-Hodgkin's lymphoma (NHL). The clinical data including general clinical characteristics, pathological features, chemotherapy selection and treatment response of 30 patients with NHL in our hospital from January 2003 to December 2012 were analyzed retrospectively. The survival was analyzed by using Kaplan-Meier methods, and the prognosis was evaluated by COX regression multivariate analysis model. The clinical parameters selected include age, Ann Arbor stage, international prognostic index (IPI), B symptom and lactate dehydrogenase (LDH) levels. The results showed that all the patients suffered from underlying disease, and the cardiovascular disease (hypertension, coronary heart disease, arrhythmia) is the most common, and minority (8/30) combined with secondary tumor, the 63% (19/30) cases had B symptoms at diagnosis. only 2 cases were diagnosed as T-cell lymphoma; the 93% (28/30) cases combined with B-cell lymphoma, 57% (17/28) of them combined with diffuse large B-cell lymphoma. Ann-Arbor stage ≤ IIwas 37% (11/30);10(37%) patient's IPI score was ≤ 2, and 67% (20/30) was scored 3-5; 13(43%) patient's serum LDH level was abnormal. Modified R-CHOP chemotherapy was given individually on the basis of clinical features. The patients achieved complete remission, partial remission, stable disease, or progressive disease accounted for 14 (46.7%), 13 (43.3%), 1 (3.3%), and 2 (6.7%), respectively; the total reaction rate was 90% after 4 cycles of chemotherapy; the overall survival (OS) rate at 1 and 2 years was 73.3% and 43.3%, and progression-free survival (PFS)rate at 0.5 and 1 years was 62.2% and 54.9%; multivariate analysis by COX regression showed that B symptoms and Ann-Arbor stage were independent factors (P = 0.014, 0.039; RR = 6.678, 4.939, respectively) affecting the OS of elderly NHL, and IPI score affected PFS independently. It is concluded that elderly patients with NHL usually are of late stage at newly diagnosis and have suffered from underlaying diseases. Besides strengthening supportive treatment, modified R-CHOP chemotherapy should be given individually according to different prognosis. B symptoms and Ann-Arbor stageII are indicators for poor prognosis of elderly NHL.

The mechanism of renal failure during fulminant hepatic failure (FHF) or end-stage of liver disease is not fully understood. The present study aims to delineate the mechanisms of decreased glomerular filtration rate (GFR) in acute hepatic failure. A rat model of renal insufficiency in severe liver injury was established by lipopolysaccharide (LPS) plus D-galactosamine (GalN) exposure. GFR was evaluated by continuous infusion of fluorescein isothiocyanate-inulin with implanted micro-osmotic pumps. GalN/LPS intoxication resulted in severe hepatocyte toxicity as evidenced by liver histology and biochemical tests, whereas renal morphology remained normal. GFR was reduced by 33% of the controls 12 h after GalN/LPS exposure, accompanied with a decreased serum sodium levels, a marked increase in serum TNF-α and ET-1 levels as well as significantly upregulated renal type 1 inositol 1,4,5-trisphosphate receptor (IP3R1) expression. The upregulated IP3R1 expression was abrogated by the treatment of anti-TNF-α antibodies, but not by 2-aminoethoxydiphenylborate (2-APB), which blocks the inositol 1,4,5-trisphosphate signaling pathway. Treatments with either TNF-α antibodies or 2-APB also significantly improved the compromised GFR, elevated serum urea nitrogen and creatinine levels, and reversed the decrease in glomerular inulin space and the increase in glomerular calcium content in GalN/LPS-exposed rats. The extent of acute liver injury as reflected by serum ALT levels was much more attenuated by anti-TNF-α antibodies than by 2-APB. Liver histology further confirmed that anti-TNF-α antibodies conferred better protection than 2-APB in GalN/LPS-exposed rats. LPS-elicited TNF-α over-production is responsible for decreased GFR through IP3R1 overexpression, and the compromised GFR resulted in the development of acute renal failure in rats with FHF.

The diagnostic value of TMPRSS2:ERG detection in patients with prostate cancer is controversial. We performed a meta-analysis to consolidate current evidence regarding the use of TMPRSS2:ERG detection assays to diagnose prostate cancers. PubMed, Web of knowledge and other databases were searched for relevant original articles published until July 30, 2013. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. Studies that investigated the presence of TMPRSS2:ERG in the body fluid, needle biopsy and prostatectomy tissue of patients with prostate cancer were identified and reviewed. Sensitivities, specificities, and positive likelihood ratios (LR+) and negative likelihood ratios (LR−) of TMPRSS2:ERG detection in individual studies were calculated and meta-analyzed by random effects model. Thirty-two studies met the inclusion criteria for the meta-analysis. Overall sensitivity of TMPRSS2:ERG detection assays was 47.4 % (95 % CI, 45.5–49.3 %); specificity, LR+, and LR− was 92.6 % (95 % CI, 91.5–93.7 %), 8.94 (95 % CI, 5.65–14.13) and 0.49 (95 % CI, 0.43–0.55). The pooled sensitivity and specificity in the body fluid subgroup was 44.7 % (95 % CI, 41.5–47.9 %) and 85.8 % (95 % CI, 83.5–87.8 %), respectively. The pooled sensitivity and specificity based on the reverse transcripts PCR was 49.0 % (95 % CI, 45.9–52.1 %) and 90.2 % (95 % CI, 88.2–92.0 %), respectively. TMPRSS2:ERG may not be used as first-line screening test. However, due to the high specificity, TMPRSS2: ERG detection maybe can serve as a quick and noninvasive method for confirming prostate cancer diagnosis.

To investigate the clinical effect of penile augmentation with superficial fascia retrocession.The first annular incision line was designed, reserving the inner plate 0.5 -0.8 cm. The second annular incision line was determined, according to the length of penile erection. The skin tissue between the double loops was stripped, reserving the superficial fascia and the superficial dorsal veins. Before the closure of two annual incision with no tension, the superficial fascia tissue was pushed proximally and fixed sectionally to augment penis.From Jun 2009 to Jun 2011, 60 patients with redundant prepuce or phimosis were treated with this method. During 3 to 12 months follow-up, the postoperative penile perimeter increased significantly. The glans were exposed and the prepuce looked smooth. The function of the penis maintained undamaged.The penile augmentation with superficial fascia retrocession can make full use of autologous tissue to augment penis, meanwhile, redundant prepuce can be resected. It is very practical for clinical application.

To observe the clinical efficacies and costs of negative pressure wound therapy (NPWT) and basic fibroblast growth factor (bFGF) in the treatment of stage III or IV pressure ulcer (PU).From July 2008 to December 2011, 48 patients fulfilling the study inclusion or exclusion criteria at Weihai Municipal Hospital were divided randomly into experiment and control groups (n=24 each). On the basis of routine treatment and NPWT of each inpatient, the patients in the experiment group were treated with bFGF. The changes of healing rate of PU were measured at Days 7 and 14 post-treatment in each group. Meanwhile, the granulation duration, preoperative time and total preoperative cost were compared.The granulation duration, healing rate of Days 7 and 14, preoperative time and total preoperative cost in the experiment group was (10.8±2.7) days, 10.1%±2.9%, 22.3%±3.1%, (18.2±2.6) days and (7946±245) yuan RMB versus (16.3±3.9) days, 6.9%±1.9%, 13.4%±2.8%, (27.1±3.3) days and (10,951±285) yuan RMB in the control group respectively. The differences between two groups were statistically significant (all P0.01).As a preoperative therapeutic modality of intractable PU, NPWT and bFGF offer better therapeutic efficacies and lower therapeutic costs as compared with NPWT alone.

To study the expression of osteonectin (also called secreted protein acidic and rich in cysteine, SPARC) in the lens epithelium cells in cortex cataract and nucleus cataract.This is an experimental research. Forty-five capsulotomy specimens were obtained from 33 patients suffered form pure cortex or/and nucleus cataracts and classified as nucleus group and cortex group, between May to July of 2010. Immunohistochemistry was used to detect the SPARC, which was analyzed by gray value. TUNEL was used to examine the apoptosis of lens epithelium cell. The difference of SPARC expression and apoptosis rate between these two groups was analyzed by LSD-t.Twenty specimens were studied with immunohistochemistry (C/N = 8/12), and 25 specimens studied by TUNEL test (C/N = 9/16). Expression of SPARC in the cortex group was significantly less than that in the nucleus group (peripheral region: t = 2.827, P0.05; central region: t = 2.264, P0.05). Expression of SPARC in the central region was significantly less than that in the peripheral region (peripheral region: t = 3.473, P0.05; central region: t = 2.771, P0.05). Apoptosis rate in the nucleus group was significantly lower than the cortex group (nucleus group: t = 2.364, P0.05; cortex group: t = 2.723, P0.05). Apoptosis rate in peripheral region was significantly less than that in central region (nucleus group: t = 2.771, P0.05; cortex group: t = 2.473, P0.05).The expression of SPARC is different between nucleus cataract and cortex cataract and also different between central and peripheral regions. The expression of SPARC is related with apoptosis of lens capsule epithelium cells.

Activation of c-Jun NH(2)-terminal kinase (JNK) has been implicated in neuron apoptosis as well as autophagy in response to various stressors after traumatic brain injury (TBI). However, the underlying molecular pathway remains unclear. Our study assessed whether JNK-mediated p53 phosphorylation might be an important mechanism for enhancing neuron autophagy in response to TBI.A total of 186 male Sprague-Dawley (SD) rats (300 - 350 g) were used in this study. By randomized block method rats were randomly divided into four groups: sham-operated (n = 46), TBI (n = 60), TBI + dimethyl sulfoxide (DMSO) (n = 40), and TBI + SP600125 (n = 40). JNK was treated with SP600125, a specific JNK inhibitor. JNK, p-P53, Beclin-1, damage-regulated autophagy modulator (DRAM) and p-bcl-2 were evaluated by Western blotting analysis. The cellular localization and expression of Beclin-1 and DRAM was observed by immunofluorescence and immunohistochemistry, and the expression of Beclin-1-Bcl-2/Bcl-xL complexes was evaluated by immunoprecipitation. Multiple-group comparisons were conducted using analysis of variance (ANOVA). P values of less than 0.05 were considered statistically significant.It was observed that the expression of JNK, p-P53, Beclin-1, DRAM and p-bcl-2 was increasing after TBI, and the expression of Beclin-1 and DRAM was mainly located in the cytoplasm of neurons. But these were significantly inhibited in SP600125 group compared with sham group and TBI + SP600125 group (P0.05). The expression of Beclin-1-Bcl-2/Bcl-xL complexes was reduced after TBI.JNK-mediated p53 phosphorylation might be an important mechanism for enhancing neuron autophagy in response to TBI.

To explore the clinicopathological characteristics and prognostic factors in prostate cancer patients under 59 years of age.From January 2000 to October 2011, 566 prostate cancer patients underwent treatments. Among them, 72 (12.7%) patients under 59 years of age with the integrated clinical data were reviewed. The median follow-up period was 25 months (range: 1 - 108) and the median age 55 years (range: 16 - 59). Four (5.5%) cases had the clinical stage of II, 12 (16.7%) cases of stage III and 56 (77.8%) cases of stage IV. Progression-free survival (PFS), overall survival (OS) and prognostic factors were analyzed.The rate of adenocarcinoma was 86.1% (62/72) and the Gleason score of 8-10 69.1% (29/42). Special type carcinoma accounted for 13.9% (10/72). The median time to androgen-independent prostate cancer (AIPC) was 12 months after endocrine therapy. The 1-, 3- and 5-year PFS were 53.8%, 12.1% and 6.1% and those for OS 85.2%, 58.8% and 15.6% respectively. The prognostic factors were age, baseline prostate special antigen (PSA), types of pathology, tumor stage and local treatment by univariate analysis. The type of pathology was an independent prognostic factor of affecting significantly the prognosis by multivariate analysis.Prostate cancer patients under 59 years of age are characterized by misdiagnosis, complexity of pathology and high malignancy. Comprehensive regiment with predominant local therapy is an effective approach.

To study the effect and potential mechanism of expression of c-jun N-terminal kinase (JNK) signal pathway on neuron autophagy after diffuse brain injury (DBI).Male Sprague Dawley rats (n = 216) were randomly divided into four groups: DBI group (n = 54), SP600125 intervene group (n = 54), DMSO group (n = 54) and sham operation group (n = 54). DBI rat model was established according to the description of Marmarou DBI. At different time points (1, 6, 12, 24, 48 and 72 h) after operation, the histopathologic changes of neurons in cortex were observed by HE staining method; The expression of p-JNK, p-P53, DRAM and Beclin-1 were detected by Western blot and immunohistochemistry.The results showed that under light microscope degenerated and necrotic neurons were observed to be scattered in cortex at 6 h after operation in DBI group, but these changes were low in SP600125 intervene group. Compared with SP600125 intervene group, the expression of p-JNK in DBI group were enhanced obviously at 6, 12 and 24 h (F = 17.902, P0.05); the expression of p-P53 in DBI group were enhanced obviously at 12, 24, 48 and 72 h (F = 7.107, P0.05); the expression of DRAM in DBI group were enhanced obviously at 6, 12, 24, 48 and 72 h (F = 15.455, P0.05); the expression of Beclin-1 in DBI group were enhanced obviously at 6, 12, 24, 48 and 72 h (F = 11.517, P0.05). Compared with DBI group, the expression of p-JNK, p-P53, DRAM and Beclin-1 in DMSO group were similar at 1, 6, 12, 24, 48 and 72 h (F = 1.509, P0.05).The present results indicate that SP600125 can dramatically improve trauma brain injury from autophagy after DBI and the molecular mechanism is related to the modulation of JNK signal pathway following DBI, while it measures the neuron autophagy by means of intervening JNK signal pathway.

To evaluate the risk factors for chronic obstructive pulmonary disease (COPD) in Xinjiang rural areas.This was a population-based and cross-sectional survey on prevalence of COPD in Xinjiang from December 2007 to December 2010. The cluster random sampling method was performed to collect the data from 3575 people in rural areas in southern (mainly with the Uygur nationality and Han nationality) and northern (mainly with Hazakh nationality and Han nationality) parts of Xinjiang. The subjects were interviewed with questionnaires and tested with spirometry. A post-bronchodilator FEV(1)/FVC70% was defined as diagnostic of COPD.Completed data were obtained from 3489 participants. The average prevalence of COPD was 4.0% (138/3489). Of the 138 COPD patients, only 20 (14.5%, 20/138) had received diagnosis and treatment. The prevalence of COPD in Uygurs was higher (5.1%, 90/1774) than that in Hazakhs (3.3%, 26/784) and that in Hans (2.4%, 22/921). The prevalence of COPD in population older than 50 years increased significantly (10%, 94/743). Logistic regression model was conducted and statistical association of COPD was found with Uygurs (OR = 2.79, 95%CI: 1.71 - 4.57), older than 30 years (OR = 3.41, 95%CI: 1.62 - 7.18), family history of respiratory diseases (OR = 1.68, 95%CI: 1.11 - 2.53), and cooking behavior (OR = 1.47, 95%CI: 1.02 - 2.12).Higher risk for COPD was related with Uygurs, older age, family history of respiratory diseases, and cooking behavior. Whether difference in the prevalence of COPD among different ethnic is related to genetic background, and the relationship between biofuels and other risk factors for COPD need further study.

To evaluate the efficacy and safety of argon-helium cryoablation as a salvage therapy for the failure cases of non-small cell lung cancer (NSCLC) after radiochemotherapy.A total of 12 NSCLC patients (stage III) with a diagnosis of recurrence after radiochemotherapy received cryoablation. The endpoint objectives were overall response rate (RR), clinical benefit rate (CBR), 1-year survival rate, quality of life (QOL) and safety profile.Among them, the overall response rate was 6/12 cases and the clinical benefit rate 7/12 cases at 12 months post-cryoablation. The 1-year survival rate was 10/12 cases. No significant complications or adverse reactions occurred during the process of cryoablation. As shown by the QOL score, the quality of life was satisfactory.As a salvage treatment for the recurrence NSCLC cases after radiochemotherapy, cryoablation may achieve a high response rate, a favorable 1-year survival rate and a high safety profile. It has excellent prospects for clinical applications.

To assess the changes about numbers and immune functions of splenic DC (dendritic cell) after a combined therapy of cryoablation and GM-CSF (granulocyte macrophage-colony stimulating factor) for prostate cancer.Murine model of prostate cancer was established. And the tumor-bearing mice were divided into 4 groups: control group (Group A), GM-CSF treatment (Group B), cryoablation treatment (Group C) and a combined therapy of cryoablation and GM-CSF (Group D). Spleens were sampled before and 7, 14, 21 days after treatment. Immunohistochemistry of DC was performed. And splenic lymphocytes were isolated and their activated percents analyzed by flow cytometry. The tumor-specific cytolytic activity of cytotoxic T lymphocyte (CTL) was measured by LDH (lactate dehydrogenase) assay. And the lung metastasis rates were calculated.At Day 7 post-treatment, the number of DC per high-power field was 26.4 ± 1.1, 36.6 ± 2.1, 25.8 ± 1.3 and 58.2 ± 1.9 (P0.05); the activated percent of DC 13.60% ± 1.67%, 9.50% ± 0.21%, 14.40% ± 1.14% and 32.80% ± 2.39% (P0.05); cytolytic activity of CTL against prostate cancer cells 7.76% ± 0.11%, 8.10% ± 0.92%, 9.38% ± 0.45% and 41.68% ± 0.82% in Groups A, B and C respectively (P0.05). At Day 21 post-treatment, the rate of lung metastasis was 5/5, 4/5, 4/5 and 1/5 respectively.A combined therapy of cryoablation and GM-CSF may increase the number and activated percent of DC in spleen, enhance the tumor-specific immune responses and decrease lung metastasis rate.

To study the impact of digestive tract reconstruction techniques on plasma ghrelin level and body mass index (BMI) after subtotal gastrectomy.Eighty-one patients undergoing subtotal gastrectomy for T1-3N0M0 gastric cancer were divided into three groups according to digestive tract reconstruction techniques, which included Billroth I group (n=30), Billroth II group (n=25) and Roux-en-Y group(n=26). Plasma ghrelin level was determined by radioimmunoassay preoperatively and one day, one week, half a year, and one year after gastrectomy. BMI was similarly recorded.Plasma ghrelin levels of three groups decreased sharply to nadir one day after operation, which were (34.2±5.2)%, (37.7±4.7)% and (36.5±4.9)% respectively. A week after operation they were (52.6±6.5)%, (48.3±5.7)% and (48.1±6.0)%. There were no statistical difference between groups (P=0.075). Half a year postoperatively, they were (91.7±7.5)%, (80.4±8.1)% and (75.3±8.3)% and a year postoperatively(95.3±5.1)%, (84.5±6.3)% and (79.9±6.7)%, showing that Billroth I group was obviously higher than the other two groups (P0.01) and Billroth II group was higher than Roux-en-Y group (P0.05). BMI of three groups at a year after surgery descended by (2.1±1.1)%, (4.5±1.9)% and (5.7±1.8)% respectively, demonstrating statistical difference. Linear regression correlation existed in the three groups between decreasing amplitude of ghrelin and BMI (P0.01).Billroth I digestive tract reconstruction takes on the normal anatomy and physiology and therefore promotes compensatory ghrelin secretion. Falling of ghrelin level greatly contributes to the weight loss after subtotal gastrectomy.

Some athletes are diagnosed as suffering from sports anemia because of iron deficiency, but the regulatory mechanism remains poorly understood. It is reported that hepcidin may provide a way to illuminate the regulatory mechanism of exercise-associated anemia. Here the authors investigate the hepcidin-involved iron absorption in exercise-associated anemia. Twelve male Wistar rats (300 ± 10 g) were randomly divided into 2 groups, 6 in a control group (CG) and 6 in an exercise group (EG, 5 wk treadmill exercise of different intensities with progressive loading). Serum samples were analyzed for circulating levels of IL-6 by means of enzyme-linked immunosorbent assay (ELISA). The expression of hepatic hepcidin mRNA was examined by real-time polymerase chain reaction analysis. The protein levels of divalent metal transporter 1 (DMT1), ferroportin1 (FPN1), and heme-carrier protein 1 (HCP1) of duodenum epithelium were examined by Western blot. The results showed that the amount of iron and ferritin in serum were lower in EG than in CG (p < .05). The levels of IL-6 and white blood cells were greater in EG than in CG (p < .01). The expression of DMT1, HCP1, and FPN1 was significantly lower in EG than in CG (p < .01). The mRNA expressions of hepatic hepcidin and hemojuvelin in skeletal muscle were remarkably higher in EG than in CG. The data indicated that inflammation was induced by strenuous exercise, and as a result, the transcriptional level of the hepatic hepcidin gene was increased, which further inhibited the expression of iron-absorption proteins and led to exercise-associated anemia.

To evaluate the clinical efficacy, safety and application value of rectal ultrasound-guided targeted cryoablation of prostate (TCAP) in the treatment of T3N0M0 prostate cancer.Transrectal ultrasound (TRUS)-guided TCAPs were performed. And prostate-specific antigen (PSA), TRUS-measured prostate volume, endorectal magnetic resonance imaging (MRI) and spectroscopic imaging (MRSI) at before, 12, 24, 36 months after TCAP were recorded and evaluated. The biochemical relapse free survival (bRFS) and clinical progression (local recurrence and distant metastasis) at 1, 2 and 3 years post-cryoablation were also recorded. The post-TCAP quality of life was also observed by the EORTC questionnaire QLQ-PR25.The suess rate of this technique was 100%. The follow-up period had a range of 10 to 45 months. The PSA level decreased dramatically (P0.01). The TRUS-measured prostate volumes significantly decreased (P0.01) versus those at pre-cryoablation. The bRFS at 1, 2 and 3 years post-TCAP was 92.5% (37/40), 87.1% (27/31) and 73.3% (11/15) respectively. The result of quality of life showed that the sexuality scores decreased at 6 months post-TCAP, but there was no statistical significance (P = 0.06) and recovered to baseline level at 12 months. Urinary symptoms improved significantly (P0.01). The clinical progression rate in this study at 3 years was 24.4% (11/45). To be specific, local recurrence rate was 54.5% (6/11) and distant metastasis rate 45.5% (5/11). Repeated cryoablation was performed for the patients with local recurrence and satisfactory results were achieved during a follow-up of 10 - 15 months. Endocrine treatment was adopted for the patients with distant metastasis and appeared to have biochemical progression free survival during a follow-up of 6 - 13 months. The therapy was safe. Most of side effects were mild and there was no occurrence of severe complications such as urethral fistulas, etc.Treating T3N0M0 prostate cancer with TCAP as a monotherapy can obtain a satisfactory outcome during a follow-up of 3 years. But its clinical application value deserves further studies.

The extracellular signal-regulated kinase (ERK) signaling transduction pathway has been implicated in multiple physiological processes. It is not clear whether the ERK1/2 pathway participates in post-traumatic stress disorder (PTSD). The aim of this study was to provide novel insights into the mechanisms of how the amygdala participates in PTSD by investigating changes in the ERK1/2 pathway induced by single prolonged stress (SPS). The level of phosphorylated ERK1/2 (pERK1/2) protein was defined in a single-prolonged stress (SPS) animal model of post-traumatic stress disorder. A total of 100 male Wistar rats were randomly divided into a normal control group and SPS groups of 0, 30, 60 and 120 min. pERK1/2 distribution in the amygdala neurons was observed using immune electron microscopy. The expression of pERK1/2 was examined by immunohistochemistry and Western blotting. The pERK protein was located in some cell organelles, such as the mitochondria and neuraxon. Quantitatively, the expression of pERK protein level was significantly increased in the SPS rats. The results suggest that the ERK signal transduction pathway may play a crucial role in the pathology of PTSD.

Substances and fluid in the brain and subarachnoid spaces may be drained into extracranial lymphatics. This study aimed to investigate the possible role of cerebral lymphatic drainage in the process of cerebral injury following subarachnoid hemorrhage (SAH). Wistar rats were divided into non-SAH, SAH, and SAH plus cervical lymphatic blockage (SAH + CLB) groups. Autologous arterial hemolysate was injected into rats' cisterna magna to induce SAH. At time of 24 and 72 h after SAH, the rats were sacrificed for serum lactate dehydrogenase (LDH) activity, brain tissue superoxide dismutase (SOD) activity, and brain tissue malonaldehyde (MDA) content detection. It was found that serum LDH activity increased in rats of SAH group comparing with non-SAH group. SAH also resulted in decreased brain tissue SOD activity and increased brain tissue MDA content. In rats of SAH + CLB group, the increase of serum LDH activity was to a lager extent. Meanwhile, brain tissue SOD activity decreased and MDA content increased to a lager extent, as compared with SAH group. It was concluded that blockage of cerebral lymphatic drainage deteriorates cerebral oxidative injury after SAH, indicating cerebral lymphatic drainage may exert intrinsic protective effects against cerebral injury following SAH.

Evidence suggests that the volume of the amygdala is significantly reduced in patients with post-traumatic stress disorder (PTSD), and that this may be related to neuronal apoptosis. However, the precise molecular mechanism of this decrease in amygdala volume during PTSD remains unclear. In this study, we investigated the relationship between the activity of the 5-HT1A receptor and amygdala neuronal apoptosis. Rats were exposed to a single-prolonged stress (SPS) procedure to create a PTSD rat model, with or without prior treatment with WAY100635, a 5-HT1A receptor antagonist. The expression of Bax, a pro-apoptotic protein, and Bcl-2, an anti-apoptotic protein, was examined by Western Blotting. TUNEL staining and flow cytometry (FCM) were employed for the detection of apoptotic cells in the amygdala. Our results indicate that SPS induces amygdala neuronal apoptosis, which was partially inhibited by WAY100635, and suggest that this apoptosis may be related to the activity of the 5-HT1A receptor.

This study tried to use CD133 positive U251 glioblastoma stem cells to establish nude mice model of transplanted tumor. CD133 positive U251 stem cells were isolated and identified. Twenty-five male nude mice were divided into three groups: U251 cell group, U251 stem cell group and normal control group. U251 cells and stem cells were respectively inoculated into mouse brain to establish model of transplanted tumor. Mice growing condition and behavior were observed. Magnetic resonance imaging (MRI) was performed to detect tumor growth in brain. HE staining assay, immunohistochemical assay and CD34 marked microvascular density (MVD) test were performed. As a result, the successful rates of both model groups were 100%. Growing condition and behavior in U251 stem cell group was more significantly exaggerated and tumor growth and image in magnetic resonance in U251 stem cell group was more significantly malignant than that in U251 cell group. It could be found that models in U251 stem cell group showed stronger pathogolical malignance features than that in U251 cell group. Glial fibrillary acidic protein (GFAP) expression in U251 cell and stem cell group showed the transplanted tumor originated from astrocytes. CD34 in U251 stem cell group was highest and significantly higher than that in the other two groups. In conclusion, use of U251 stem cells to establish transplanted tumor model in nude mice is an excellent method and the model is more likely and malignant than the one established by cancer cells, which showed a new animal model to research glioma.

To assess the anti-tumor immune response of cryoablation for prostate cancer.Mouse model of prostate cancer was established. And the tumor-bearing mice were divided into three groups: control group (Group A), surgery group (Group B) and cryoablation group (Group C). Blood samples were withdrawn before and at Days 7, 14, 21 post-treatment. IFN-gamma and IL-4 were analyzed by enzyme-linked immunosorbent assay (ELISA). Th1/Th2 ratio was estimated from the IFN-gamma/IL-4 ratio. Lymphocytes of draining lymph node (DLN) and spleen were isolated. And the post-therapeutical number of tumor-specific IFN-gamma+CD4+ Th cells was measured by the method of enzyme link immunological spot (ELISPOT). And tumor-specific cytolytic activity of CD8+ cytotoxic T lymphocyte (CTL) was measured by LDH assay. The rate of metastasis was assessed.At Day 7 post-treatment in Groups A, B and C, Th1/Th2 ratio was 4.97+/-0.31, 10.07+/-0.62 and 13.71+/-0.57 respectively (P0.05); the number of IFN-gamma+ cells every 10(6) CD4+ Th cells in DLN 22.3+/-1.0, 24.0+/-1.2 and 243.4+/-46.2 respectively; cytolytic activity of cytotoxic T lymphocyte against prostate cancer cells (14.6+/-1.1)%, (15.2+/-0.8)% and (62.6+/-2.3)% respectively (P0.05). But for T cells derived from spleen, there were no difference in IFN-gamma+CD4+ Th cells or cytolytic activity of CTL among the groups. At Day 28 post-treatment, the rate of DLN metastasis was 100%, 80% and 40% respectively. And the rates of lung metastasis were all 100%.Cryoablation for prostate cancer can induce the Th1 advantage of anti-tumor immunity and generate the tumor-specific immune response in DLN. But the response remains limited. Further studies are warranted.

To explore the methods of evidence-based medicine to determine objectives and evaluate the efficacy of interventional therapy for advanced hepatocellular carcinoma.Clinical questions were raised after a thorough evaluation of the status of interventional therapy. The term of evidence based medicine methods was searched in EBSCO, Cochrane library, Medline (January 1990-January 2007), ACP Journal Club (January 1991-January 2007) and Sumsearch. The searching subjects were hepatocellular carcinoma, interventional therapy, systematic review and meta-analysis etc. Based upon an analysis of the searching results, rational evidence based interventional therapy regimes were made. The survival benefit was studied by comparing with the empirical counterpart of the same period and with the same inclusion criteria. Data and Kaplan-Meier survival analyses were conducted by SPSS version 16.0 software.Nine randomized controlled clinical trials related to clinical questions and three systematic reviews were retrieved. A total of 119 cases of hepatocellular carcinoma were included. The evidence-based interventional therapy was performed in 59 cases and empirical interventional therapy in other 60 cases. The 2-year follow-up results confirmed that the evidence-based regimes were more appropriate for advanced hepatocellular carcinoma. The 1 and 2-year overall survival rates in evidence-based interventional therapy group and empirical group were 79.7% vs 68.3% and 50.8% vs 31.7% respectively. And the difference was significant (P0.05).Choosing the therapeutic regimes according to evidence-based medicine methods can increase the clinical efficacy of interventional therapy and achieve survival benefits.