Efficacy of tibial transverse transport combined with platelet-rich plasma versus platelet-rich plasma alone in the treatment of diabetic foot ulcers:A meta-analysis

Background:Diabetic foot ulcers(DBFU)are one of the main complications of diabetes.Platelet-rich plasma(PRP)treatment is a commonly used treatment option.Tibial transverse transport(TTT)also has a therapeutic effect on DBFU.Some studies have found that the TTT combined with PRP(TTT&PRP)has a significant effect on DBFU.Methods:PubMed,Cochrane Library,Web of Science,EMBASE,Chinese Biomedical Literature,CNKI,VIP,and Wanfang databases were used to find literature on the treatment of DBFUs using the TTT and PRP treatment according to the inclusion criteria.The specific inclusion criteria are as follows:(1)research type:clinical controlled trials,including retrospective cohort and randomized controlled studies;(2)diagnosis of DBFUs that does not include a definitively diagnosed traumatic ulcer;(3)original materials of Chinese and English literature published in full text.The exclusion criteria are:(1)the research group was not defined or grouped;(2)nonrandomized controlled trials,non-cohort studies,non-case-control studies,retrospective studies,and case reports;(3)repetitive research and animal experimentation;(4)ulcers caused by other diseases;(5)conservative treatment or no use of invasive treatment methods.Review Manager software(version 5.3)was used to conduct a meta-analysis of the included results.Result:The literature included 6 randomized controlled studies,including 508 patients,254 patients in the PRP treatment group,and 254 patients in the TTT&PRP group.The meta-analysis results showed that in terms of treatment efficacy,the TTT&PRP combined treatment group had a higher efficacy than the PRP group.After treatment,the TTT&PRP group had better treatment effects in psychological function,physiological function,and social function compared to the PRP group.After treatment,the TTT&PRP group showed a significant increase in serum epidermal growth factor(EGF),vascular endothelial growth factor(VEGF),basic fibroblast growth factor(bFGF),and platelet-derived growth factor(PDGF)levels compared to the PRP group.In terms of wound healing after treatment,the TTT&PRP group performed better than the PRP group in terms of postoperative wound reduction rate,bacterial clearance rate,granulation tissue coverage rate,and granulation tissue growth thickness.Conclusion:TTT combined with PRP was more effective than PRP alone in treating DBFUs.

气动升力协同列车升力翼优化设计研究

气动升力协同列车是一种新型高速列车的概念模型,旨在提高运行速度的同时兼顾列车整体耗能与寿命周期成本。其通过加装升力翼,提高列车的气动升力,从而减少列车轮毂磨损。为设计出适合现有高铁限界约束的升力翼,本文采用Hicks-Henne翼型参数化方法和遗传算法,建立了考虑列车外型与高铁限界约束的气动优化方法,并利用此方法开展了翼型优化设计,以优化翼型为基础设计了加装翼梢小翼的三维升力翼模型。研究表明:采用本文优化设计方法得到的优化翼型,相比基础翼型,升力系数提升13%,阻力系数几乎不变。加装翼梢小翼可以有效的减小升力翼的气动阻力,通过对比不同外倾角和后掠角的小翼气动特性,设计出了一种外倾角为15°、后掠角为30°的较优升力翼模型,其最大升力系数可达到1.8247。

Two stages power generation test of the hot dry rock exploration and production demonstration project in the Gonghe Basin,northeastern Qinghai-Tibet plateau,China

The Hot Dry Rock(HDR)is considered as a clean and renewable energy,poised to significantly contribute to the global energy decarbonization agenda.Many HDR projects worldwide have accumulated valuable experience in efficient drilling and completion,reservoir construction,and fracture simulation.In 2019,China Geological Survey(CGS)initiated a demonstration project of HDR exploration and production in the Gonghe Basin,aiming to overcome the setbacks faced by HDR projects.Over the ensuing four years,the Gonghe HDR project achieved the first power generation in 2021,followed by the second power generation test in 2022.After establishing the primary well group in the initial phase,two directional wells and one branch well were drilled.Noteworthy progress was made in successfully constructing the targeted reservoir,realizing inter-well connectivity,power generation and grid connection,implementing of the real-time micro-seismic monitoring.A closed-loop technical validation of the HDR exploration and production was completed.However,many technical challenges remain in the process of HDR industrialization,such as reservoir fracture network characterization,efficient drilling and completion,multiple fracturing treatment,continuous injection and production,as well as mitigation of induced seismicity and numerical simulation technology.

Optimization of water-urban-agricultural-ecological land use pattern:A case study of Guanzhong Basin in the southern Loess Plateau of Shaanxi Province,China

Extensive land use will cause many environmental problems.It is an urgent task to improve land use efficiency and optimize land use patterns.In recent years,due to the flow decrease,the Guanzhong Basin in Shaanxi Province is confronted with the problem of insufficient water resources reserve.Based on the Coupled Ground-Water and Surface-Water Flow Model(GSFLOW),this paper evaluates the response of water resources in the basin to changes in land use patterns,optimizes the land use pattern,improves the ecological and economic benefits,and the efficiency of various spatial development,providing a reference for ecological protection and high-quality development of the Yellow River Basin.The research shows that the land use pattern in the Guanzhong Basin should be further optimized.Under the condition of considering ecological and economic development,the percentage change of the optimum area of farmland,forest,grassland,water area,and urban area compared with the current land use area ratio is+2.3,+2.4,-6.1,+0.2,and+1.6,respectively.The economic and ecological value of land increases by14.1%and 3.1%,respectively,and the number of water resources can increase by 2.5%.

Dynamic in situ reconstruction of NiSe_(2) promoted by interfacial Ce_(2)(CO_(3))_(2)O for enhanced water oxidation

Understanding and manipulating the structural evolution of water oxidation electrocatalysts lays the foundation to finetune their catalytic activity.Herein,we present a synthesis of NiSe_(2)-Ce_(2)(CO_(3))_(2)O heterostructure and demonstrate the efficacy of interfacial Ce_(2)(CO_(3))2O in promoting the formation of catalytically active centers to improve oxygen evolution activity.In-situ Raman spectroscopy shows that incorporation of Ce_(2)(CO_(3))2O into NiSe_(2) causes a cathodic shift of the Ni^(2+)→Ni~(3+) transition potential.Operando electrochemical impedance spectroscopy reveals that strong electronic coupling at heterogeneous interface accelerates charge transfer process.Furthermore,density functional theory calculations suggest that actual catalytic active species of NiOOH transformed from NiSe_(2),which is coupled with Ce_(2)(CO_(3))_(2)O,can optimize electronic structure and decrease the free energy barriers toward fast oxygen evolution reaction(OER) kinetics.Consequently,the resultant NiSe_(2)-Ce_(2)(CO_(3))_(2)O electrode exhibits remarkable electrocatalytic performance with low overpotentials(268/304 mV@50/100 mA cm^(-2)) and excellent stability(50 mA cm^(-2) for 120 h) in the alkaline electrolyte.This work emphasizes the significance of modulating the dynamic changes in developing efficient electrocatalyst.

Pan-immune-inflammation value as a prognostic biomarker for colon cancer and its variation by primary tumor location

BACKGROUND A growing body of research indicates significant differences between left-sided colon cancers(LCC)and right-sided colon cancers(RCC).Pan-immune-inflammation value(PIV)is a systemic immune response marker that can predict the prognosis of patients with colon cancer.However,the specific distinction between PIV of LCC and RCC remains unclear.AIM To investigate the prognostic and clinical significance of PIV in LCC and RCC patients.METHODS This multicenter retrospective cohort study included 1510 patients with colon cancer,comprising 801 with LCC and 709 with RCC.We used generalized lifting regression analysis to evaluate the relative impact of PIV on disease-free survival(DFS)in these patients.Kaplan-Meier analysis,as well as univariate and multivariate analyses,were used to examine the risk factors for DFS.The correlation between PIV and the clinical characteristics was statistically analyzed in these patients.RESULTS A total of 1510 patients{872 female patients(58%);median age 63 years[interquartile ranges(IQR):54-71];patients with LCC 801(53%);median follow-up 44.17 months(IQR 29.67-62.32)}were identified.PIV was significantly higher in patients with RCC[median(IQR):214.34(121.78-386.72)vs 175.87(111.92-286.84),P<0.001].After propensity score matching,no difference in PIV was observed between patients with LCC and RCC[median(IQR):182.42(111.88-297.65)vs 189.45(109.44-316.02);P=0.987].PIV thresholds for DFS were 227.84 in LCC and 145.99 in RCC.High PIV(>227.84)was associated with worse DFS in LCC[PIV-high:Adjusted hazard ratio(aHR)=2.39;95%confidence interval:1.70-3.38;P<0.001]but not in RCC(PIV-high:aHR=0.72;95%confidence interval:0.48-1.08;P=0.114).CONCLUSION These findings suggest that PIV may predict recurrence in patients with LCC but not RCC,underscoring the importance of tumor location when using PIV as a colon cancer biomarker.

A feedback control method for phase signal demodulation in fber-optic hydrophones

In the realm of acoustic signal detection,the identification of weak signals,particularly in the presence of negative signal-to-noise ratios,poses a significant challenge.This challenge is further heightened when signals are acquired through fiber-optic hydrophones,as these signals often lack physical significance and resist clear systematic modeling.Conventional processing methods,e.g.,low-pass filter(LPF),require a thorough understanding of the effective signal bandwidth for noise reduction,and may introduce undesirable time lags.This paper introduces an innovative feedback control method with dual Kalman filters for the demodulation of phase signals with noises in fiber-optic hydrophones.A mathematical model of the closed-loop system is established to guide the design of the feedback control,aiming to achieve a balance with the input phase signal.The dual Kalman filters are instrumental in mitigating the effects of signal noise,observation noise,and control execution noise,thereby enabling precise estimation for the input phase signals.The effectiveness of this feedback control method is demonstrated through examples,showcasing the restoration of low-noise signals,negative signal-to-noise ratio signals,and multi-frequency signals.This research contributes to the technical advancement of high-performance devices,including fiber-optic hydrophones and phase-locked amplifiers.

OCTA characteristics in non-arteritic central retinal artery occlusion and correlation with visual acuity

AIM:To observe the retinal and choroidal circulations in patients with non-arteritic permanent central retinal artery occlusion(NA-CRAO)via optical coherence tomography angiography(OCTA)and analyze their correlation with visual acuity.METHODS:Sixty-two eyes with clinically confirmed acute NA-CRAO were included in the study and divided into:A type(mild n=29),B type(moderate n=27)and C type(severe n=6)based on the degree of visual loss,retinal edema,and arterial blood flow delay in fundus fluorescence angiography(FFA).Contralateral healthy eyes were used as the control group.Best-corrected visual acuity(BCVA),slit lamp microscopy,indirect ophthalmoscopy,fundus color photography,OCTA,and FFA were performed.Spearman’s correlation analysis was used to determine the correlations between retinal and choroidal vessels and visual acuity.RESULTS:There were no statistically significant differences in age,gender,and intraocular pressure among the three types and the control group(P>0.05).Vessel density in deep capillary plexus(VD-DCP)significantly decreased(P<0.05)in all three types of NA-CRAO patients compared to the control group.Vessel density in superficial vascular plexus(VD-SVP)significantly decreased(P<0.05)in type A patients and choriocapillaris flow area significantly decreased(P<0.05)in type B and type C patients compared to the control group;while outer retinal flow areas significantly increased in the type A(P<0.05)and decreased in type C patients(P<0.05).The retinal thickness significantly increased in type C group(P<0.05).The VD-SVP at fovea in the type A was significantly lower than both of type B and C.The VD-SVP at nasal parafovea in type A and B was significantly lower than type C(P<0.05).The logMAR BCVA of type A was significantly better than that of type B and C groups(P<0.05).Spearman’s correlation analysis showed that the logMAR BCVA was positively correlated with VD-SVP at fovea(r=0.679,P=0.031)and nasal parafovea(r=0.826,P=0.013).CONCLUSION:OCTA is valuable for assessing retinal ischemia,and evaluating visual impairment.Deep retinal vasculature is commonly affected in all NA-CRAO types.VDSVPs at fovea and nasal parafovea can serve as reliable markers of visual impairment in NA-CRAO.

Privacy-Preserving Multi-Keyword Fuzzy Adjacency Search Strategy for Encrypted Graph in Cloud Environment

In a cloud environment,outsourced graph data is widely used in companies,enterprises,medical institutions,and so on.Data owners and users can save costs and improve efficiency by storing large amounts of graph data on cloud servers.Servers on cloud platforms usually have some subjective or objective attacks,which make the outsourced graph data in an insecure state.The issue of privacy data protection has become an important obstacle to data sharing and usage.How to query outsourcing graph data safely and effectively has become the focus of research.Adjacency query is a basic and frequently used operation in graph,and it will effectively promote the query range and query ability if multi-keyword fuzzy search can be supported at the same time.This work proposes to protect the privacy information of outsourcing graph data by encryption,mainly studies the problem of multi-keyword fuzzy adjacency query,and puts forward a solution.In our scheme,we use the Bloom filter and encryption mechanism to build a secure index and query token,and adjacency queries are implemented through indexes and query tokens on the cloud server.Our proposed scheme is proved by formal analysis,and the performance and effectiveness of the scheme are illustrated by experimental analysis.The research results of this work will provide solid theoretical and technical support for the further popularization and application of encrypted graph data processing technology.

Efficient User Identity Linkage Based on Aligned Multimodal Features and Temporal Correlation

User identity linkage(UIL)refers to identifying user accounts belonging to the same identity across different social media platforms.Most of the current research is based on text analysis,which fails to fully explore the rich image resources generated by users,and the existing attempts touch on the multimodal domain,but still face the challenge of semantic differences between text and images.Given this,we investigate the UIL task across different social media platforms based on multimodal user-generated contents(UGCs).We innovatively introduce the efficient user identity linkage via aligned multi-modal features and temporal correlation(EUIL)approach.The method first generates captions for user-posted images with the BLIP model,alleviating the problem of missing textual information.Subsequently,we extract aligned text and image features with the CLIP model,which closely aligns the two modalities and significantly reduces the semantic gap.Accordingly,we construct a set of adapter modules to integrate the multimodal features.Furthermore,we design a temporal weight assignment mechanism to incorporate the temporal dimension of user behavior.We evaluate the proposed scheme on the real-world social dataset TWIN,and the results show that our method reaches 86.39%accuracy,which demonstrates the excellence in handling multimodal data,and provides strong algorithmic support for UIL.

Contrastive Consistency and Attentive Complementarity for Deep Multi-View Subspace Clustering

Deep multi-view subspace clustering (DMVSC) based on self-expression has attracted increasing attention dueto its outstanding performance and nonlinear application. However, most existing methods neglect that viewprivatemeaningless information or noise may interfere with the learning of self-expression, which may lead to thedegeneration of clustering performance. In this paper, we propose a novel framework of Contrastive Consistencyand Attentive Complementarity (CCAC) for DMVsSC. CCAC aligns all the self-expressions of multiple viewsand fuses them based on their discrimination, so that it can effectively explore consistent and complementaryinformation for achieving precise clustering. Specifically, the view-specific self-expression is learned by a selfexpressionlayer embedded into the auto-encoder network for each view. To guarantee consistency across views andreduce the effect of view-private information or noise, we align all the view-specific self-expressions by contrastivelearning. The aligned self-expressions are assigned adaptive weights by channel attention mechanism according totheir discrimination. Then they are fused by convolution kernel to obtain consensus self-expression withmaximumcomplementarity ofmultiple views. Extensive experimental results on four benchmark datasets and one large-scaledataset of the CCAC method outperformother state-of-the-artmethods, demonstrating its clustering effectiveness.

Design and commissioning of a wideband RF system for CSNS-Ⅱ rapid-cycling synchrotron

The China Spallation Neutron Source(CSNS) upgrade project(CSNS-Ⅱ) aims to enhance the beam power from 100 to 500 kW. A dual-harmonic accelerating method has been adopted to alleviate the stronger space-charge effect in rapid-cycling synchrotrons owing to the increased beam intensity. To satisfy the requirements of dual-harmonic acceleration, a new radiofrequency(RF) system based on a magnetic alloy-loaded cavity is proposed. This paper presents design considerations and experimental results regarding the performance evaluation of the proposed RF system through high-power tests and beam commissioning. The test results demonstrate that the RF system satisfies the desired specifications and affords significant benefits for CSNS-Ⅱ.

Low level of hepatitis B viremia is associated with increased risk of hepatocellular carcinoma in compensated cirrhotic patients

BACKGROUND Whether patients with compensated cirrhosis and low-level viremia(LLV)of hepatitis B should receive antiviral therapy(AVT)is still controversial,and published results are inconsistent.AIM To investigate the link between LLV in compensated cirrhosis and prognosis concerning hepatocellular carcinoma(HCC),decompensation,and liver-related events.METHODS The PubMed,EMBASE,and Cochrane Library databases were searched up to March 5,2023.Outcomes of interest were assessed by pooled hazard ratios(HRs).The study was registered with PROSPERO(CRD42023405345).RESULTS Six cohort studies representing 3155 patients were included.Compared with patients with undetectable HBV DNA,patients with LLV was associated with increased risk of HCC(HR:2.06,95%CI:1.36-3.13;Q-statistic-P=0.07,I^(2)=51%)regardless of receiving AVT or not(AVT group:HR:3.14;95%CI:1.73-5.69;Qstatistic-P=0.60,I2=0%;un-AVT group:HR:1.73,95%CI:1.09-2.76;Q-statistic-P=0.11,I2=50%).The pooled results showed no statistical association between LLV and decompensation of cirrhosis(HR:2.06,95%CI:0.89-4.76;Q-statistic-P=0.04,I2=69%),and liver-related events(HR:1.84,95%CI:0.92-3.67;Q-statistic-P=0.03,I2=72%),respectively.Grading of Recommendations Assessment,Development and Evaluation assessment indicated moderate certainty for HCC,very low certainty for decompensation of cirrhosis and liver-related clinical events.CONCLUSION LLV in compensated cirrhotic patients is associated with increased risk of HCC,higher tendency for hepatic decompensation and liver-related events.Closer screening of HCC should be conducted in this population.

Innovative integration of lung ultrasound and wearable monitoring for predicting pulmonary complications in colorectal surgery:A prospective study

BACKGROUND Postoperative pulmonary complications(PPCs)are common in patients who undergo colorectal surgery.Studies have focused on how to accurately diagnose and reduce the incidence of PPCs.Lung ultrasound has been proven to be useful in preoperative monitoring and postoperative care after cardiopulmonary surgery.However,lung ultrasound has not been studied in abdominal surgeries and has not been used with wearable devices to evaluate the influence of postoperative ambulation on the incidence of PPCs.AIM To investigate the relationship between lung ultrasound scores,PPCs,and postoperative physical activity levels in patients who underwent colorectal surgery.METHODS In this prospective observational study conducted from November 1,2019 to August 1,2020,patients who underwent colorectal surgery underwent daily bedside ultrasonography from the day before surgery to postoperative day(POD)5.Lung ultrasound scores and PPCs were recorded and analyzed to investigate their relationship.Pedometer bracelets measured the daily movement distance for 5 days post-surgery,and the correlation between postoperative activity levels and lung ultrasound scores was examined.RESULTS Thirteen cases of PPCs was observed in the cohort of 101 patients.The mean(standard deviation)peak lung ultrasound score was 5.32(2.52).Patients with a lung ultrasound score of≥6 constituted the high-risk group.High-risk lung ultrasound scores were associated with an increased incidence of PPCs after colorectal surgery(logistic regression coefficient,1.715;odds ratio,5.556).Postoperative movement distance was negatively associated with the lung ultrasound scores[Spearman’s rank correlation coefficient(r),-0.356,P<0.05].CONCLUSION Lung ultrasound effectively evaluates pulmonary condition post-colorectal surgery.Early ambulation and respiratory exercises in the initial two PODs will reduce PPCs and optimize postoperative care in patients undergoing colorectal surgery.

Who can benefit more from its twelve-week treatment:A prospective cohort study of blonanserin for patients with schizophrenia

BACKGROUND Blonanserin(BNS)is a well-tolerated and effective drug for treating schizophrenia.AIM To investigate which types of patients would obtain the most benefit from BNS treatment.METHODS A total of 3306 participants were evaluated in a 12-week,prospective,multicenter,open-label post-marketing surveillance study of BNS.Brief psychiatric rating scale(BPRS)scores were calculated to evaluate the effectiveness of BNS,and its safety was assessed with the incidence of adverse drug reactions.Linear regression was used to screen the influencing factors for the reduction of BPRS total score,and logistic regression was used to identify patients with a better response to BNS.RESULTS The baseline BPRS total score(48.8±15.03)decreased to 27.7±10.08 at 12 weeks(P<0.001).Extrapyramidal symptoms(14.6%)were found to be the most frequent adverse drug reactions.The acute phase,baseline BPRS total score,current episode duration,number of previous episodes,dose of concomitant antipsychotics,and number of types of sedative-hypnotic agents were found to be independent factors affecting the reduction of BPRS total score after treatment initiation.Specifically,patients in the acute phase with baseline BPRS total score≥45,current episode duration<3 months,and≤3 previous episodes derived greater benefit from 12-week treatment with BNS.CONCLUSION Patients in the acute phase with more severe symptoms,shorter current episode duration,fewer previous episodes,and a lower psychotropic drug load derived the greatest benefit from treatment with BNS.

Clinical characteristics and risk factors of post-operative intestinal flora disorder following laparoscopic colonic surgery:A propensityscore-matching analysis

BACKGROUND Intestinal flora disorder(IFD)poses a significant challenge after laparoscopic colonic surgery,and no standard criteria exists for its diagnosis and treatment.AIM To analyze the clinical features and risk factors of IFD.METHODS Patients with colon cancer receiving laparoscopic surgery were included using propensity-score-matching(PSM)methods.Based on the occurrence of IFD,patients were categorized into IFD and non-IFD groups.The clinical characteristics and treatment approaches for patients with IFD were analyzed.Multivariate regression analysis was performed to identify the risk factors of IFD.RESULTS The IFD incidence after laparoscopic surgery was 9.0%(97 of 1073 patients).After PSM,97 and 194 patients were identified in the IFD and non-IFD groups,respectively.The most common symptoms of IFD were diarrhea and abdominal,typically occurring on post-operative days 3 and 4.All patients were managed conservatively,including modulation of the intestinal flora(90.7%),oral/intravenous application of vancomycin(74.2%),and insertion of a gastric/ileus tube for decompression(23.7%).Multivariate regression analysis identified that preoperative intestinal obstruction[odds ratio(OR)=2.79,95%CI:1.04–7.47,P=0.041]and post-operative antibiotics(OR=8.57,95%CI:3.31–23.49,P<0.001)were independent risk factors for IFD,whereas pre-operative parenteral nutrition(OR=0.12,95%CI:0.06–0.26,P<0.001)emerged as a protective factor.CONCLUSION A stepwise approach of probiotics,vancomycin,and decompression could be an alternative treatment for IFD.Special attention is warranted post-operatively for patients with pre-operative obstruction or early use of antibiotics.

Inhibition of autophagy significantly enhances combination therapy with sorafenib and HDAC inhibitors for human hepatoma cells

AIM: To clarify whether histone deacetylase inhibitors histone deacetylase inhibitors (HDACIs) can sensitize hepatocellular carcinoma (HCC) cells to sorafenib treatment. METHODS: Bax, Bcl-2, ATG5-ATG12, p21, and p27 protein levels in Hep3B, HepG2, and PLC/PRF/5 cells were examined by Western blot. CCK8 and a fluoro-metric caspase-3 assay were used to examine cellular viability and apoptosis levels. The effect of Beclin-1 on sensitization of HCC cells to sorafenib was examined by transfecting Beclin-1 siRNA into Hep3B, HepG2, and PLC/PRF/5 cells. RESULTS: Autophagy inhibition enhances the inhibitory effects of vorinostat and sorafenib alone or in combination on HCC cell growth. Vorinostat and sorafenib synergistically induced apoptosis and cell cycle alterations. Western blot data indicated that HDACIs and Beclin- 1 knockdown increased the p53 acetylation level. The knockdown of Beclin-1 enhanced the synergistic effect of the combination of vorinostat with sorafenib. CONCLUSION: HDACIs can sensitize HCC cells to sorafenib treatment by regulating the acetylation level of Beclin-1. (C) 2014 Baishideng Publishing Group Co., Limited. All rights reserved.

Protective effects of combined Astragalus membranaceus and magnesium ions on global brain ischemia

The traditional Chinese herb Astragalus membranaceus is a well-known treatment for neurological diseases and is considered to exhibit anti-dementia properties.This study investigated the synergistic effects of magnesium ions and Astragalus membranaceus on global brain ischemia in rats.4＇-6-diamidino-2-phenylindole staining demonstrated that the number of living neurons was significantly greater in the rat hippocampus after administration of a combination of Astragalus membranaceus and magnesium,compared with a vehicle group,an Astragalus membranaceus alone group,and a magnesium alone group.Western blot assay revealed that cleaved Caspase-3 protein expression was significantly reduced in the rat hippocampus in the combined Astragalus membranaceus and magnesium group compared with the Astragalus membranaceus alone group and the magnesium alone group.The results suggested that the combination of Astragalus membranaceus and magnesium exhibits a stronger neuroprotective effect on global brain ischemia in rats compared with Astragalus membranaceus or magnesium alone.This effect was associated with decreased Caspase-3 expression.

Sevoflurane effects on cyclic adenosine monophosphate response element binding protein,phosphorylated cyclic adenosine monophosphate response element binding protein,and Livin expression in the cortex and hippocampus of a vascular cognitive impairment rat

BACKGROUND： Neuronal necrosis and apoptosis play important roles in the pathophysiology of cerebral ischemia and resulting cognitive impairment. However, inhibition of neuronal necrosis and apoptosis has been shown to attenuate cognitive impairment following cerebral ischemia. OBJECTIVE： To investigate the effects of sevoflurane on cyclic adenosine monophosphate response element binding protein （CREB）, phosphorylated CREB （pCREB）, and Livin expression in the cortex and hippocampus of a rat model of vascular cognitive impairment.DESIGN, TIME AND SETTING： A randomized, controlled experiment was performed in the Chongqing Key Laboratory of Neurology between June 2007 and July 2008.MATERIALS： Sevoflurane was provided by Abbott Laboratory, UK; Morris water maze was provided by Chinese Academy of Medical Sciences, China; goat anti-rat CREB, goat anti-rat pCREB and goat anti-rat Livin antibodies were provided by Biosource International, USA. METHODS： A total of 42 female, Wistar rats were randomly assigned to the following groups： sham operation, vascular cognitive impairment, and sevoflurane treatment. The vascular cognitive impairment rat model was established by permanent bilateral occlusion of both common carotid arteries, and 1.0 MAC sevoflurane was immediately administered by inhalation for 2 hours. MAIN OUTCOME MEASURES： CREB, pCREB, and Livin expression was measured in the cortex and hippocampus by Western blot and reverse transcription-polymerase chain reaction. Behavior was evaluated with Morris water maze. RESULTS： CREB, pCREB, and Livin expression in the sevoflurane treatment group was significantly greater than the vascular cognitive impairment group （P 〈 0.01）. However, expression of CREB and pCREB was significantly less in the sevoflurane treatment and vascular cognitive impairment groups, compared with the sham operation group （P 〈 0.01）. Livin expression in the sevoflurane treatment and vascular cognitive impairment groups was significantly greater than the sham operation group （P 〈 0.01）. Learning, memory, and behavior disorders were observed in the vascular cognitive impairment group. Sevoflurane treatment significantly improved these observed disorders. CONCLUSION： Sevoflurane improved cognitive impairment due to permanent bilateral occlusion of both common carotid arteries. Improved function was associated with increased CREB, pCREB, and Livin expression in the cortex and hippocampus.

Role of Hiraoka's transurethral detachment of the prostate combined with biopsy of the peripheral zone during the same session in patients with repeated negative biopsies in the diagnosis of prostate cancer

BACKGROUND Persistent suspicion of prostate cancer(PCa)due to a rising prostate-specific antigen(PSA)level after repeated negative biopsies is a serious challenge in clinical practice.AIM To determine the role of Hiraoka’s transurethral detachment of the prostate(TUDP)combined with biopsy of the peripheral zone during the same session in patients with repeated negative biopsies in the diagnosis of PCa.METHODS We retrospectively evaluated the records of 10 patients who were eligible for inclusion in our hospital between December 2012 and August 2017.Patient demographics,a family history of PCa,the number of biopsies,prostate volume,pathological examination,and perioperative PSA level were obtained.RESULTS Two of 10 patients were pathologically diagnosed with PCa after surgery;the Gleason scores were 4+4 and 4+3,respectively.Both patients subsequently underwent laparoscopic radical prostatectomy.The median PSA levels preoperatively,and 3 mo and 1 year postoperatively in the other eight patients who were diagnosed with benign prostate hyperplasia after surgery were 19.10 ng/mL,1.10 ng/mL,and 1.15 ng/mL,respectively.The adjusted P values of the 3-mo and 1-year post-operative PSA level vs pre-operative PSA level were 0.003 and 0.026,respectively.None of the patients had increased PSA levels or PCa detected after a median 35 mo of follow-up.CONCLUSION TUDP combined with peripheral zone biopsy may improve the detection rate of PCa in patients with repeated negative biopsies.The PSA level declined rapidly in patients who had negative pathological examinations after TUDP,which remained stable 1 year after surgery.