Pharmacological interventions targeting the microcirculation following traumatic spinal cord injury

Traumatic spinal cord injury is a devastating disorder chara cterized by sensory,motor,and autonomic dysfunction that seve rely compromises an individual's ability to perform activities of daily living.These adve rse outcomes are closely related to the complex mechanism of spinal cord injury,the limited regenerative capacity of central neurons,and the inhibitory environment fo rmed by traumatic injury.Disruption to the microcirculation is an important pathophysiological mechanism of spinal cord injury.A number of therapeutic agents have been shown to improve the injury environment,mitigate secondary damage,and/or promote regeneration and repair.Among them,the spinal cord microcirculation has become an important target for the treatment of spinal cord injury.Drug inte rventions targeting the microcirculation can improve the microenvironment and promote recovery following spinal cord injury.These drugs target the structure and function of the spinal cord microcirculation and are essential for maintaining the normal function of spinal neuro ns,axons,and glial cells.This review discusses the pathophysiological role of spinal cord microcirculation in spinal cord injury,including its structure and histopathological changes.Further,it summarizes the progress of drug therapies targeting the spinal cord mic rocirc ulation after spinal cord injury.

Hypidone hydrochloride(YL-0919)ameliorates functional deficits after traumatic brain injury in mice by activating the sigma-1 receptor for antioxidation

Traumatic brain injury involves complex pathophysiological mechanisms,among which oxidative stress significantly contributes to the occurrence of secondary injury.In this study,we evaluated hypidone hydrochloride(YL-0919),a self-developed antidepressant with selective sigma-1 receptor agonist properties,and its associated mechanisms and targets in traumatic brain injury.Behavioral experiments to assess functional deficits were followed by assessment of neuronal damage through histological analyses and examination of blood-brain barrier permeability and brain edema.Next,we investigated the antioxidative effects of YL-0919 by assessing the levels of traditional markers of oxidative stress in vivo in mice and in vitro in HT22 cells.Finally,the targeted action of YL-0919 was verified by employing a sigma-1 receptor antagonist(BD-1047).Our findings demonstrated that YL-0919 markedly improved deficits in motor function and spatial cognition on day 3 post traumatic brain injury,while also decreasing neuronal mortality and reversing blood-brain barrier disruption and brain edema.Furthermore,YL-0919 effectively combated oxidative stress both in vivo and in vitro.The protective effects of YL-0919 were partially inhibited by BD-1047.These results indicated that YL-0919 relieved impairments in motor and spatial cognition by restraining oxidative stress,a neuroprotective effect that was partially reversed by the sigma-1 receptor antagonist BD-1047.YL-0919 may have potential as a new treatment for traumatic brain injury.

Drug treatment of functional dyspepsia

Symptomatic improvement of patients with functional dyspepsia after drug therapy is often incomplete and obtained in not more than 60% of patients. This is likely because functional dyspepsia is a heterogeneous disease. Although great advance has been achieved with the consensus definitions of the Rome I and II criteria, there are still some aspects about the definition of functional dyspepsia that require clarification. The Rome criteria explicitly recognise that epigastric pain or discomfort must be the predominant complaint in patients labelled as suffering from functional dyspepsia. However, this strict definition can create problems in the daily primary care clinical practice, where the patient with functional dyspepsia presents with multiple symptoms. Before starting drug therapy it is recommended to provide the patient with an explanation of the disease process and reassurance. A thorough physical examination and judicious use of laboratory data and endoscopy are also indicated. In general, the approach to treat patients with functional dyspepsia based on their main symptom is practical and effective. Generally, patients should be treated with acid suppressive therapy using proton-pump inhibitors if the predominant symptoms are epigastric pain or gastroesophageal reflux symptoms. Although the role of Helicobacter pylori （H pylon） in functional dyspepsia continues to be a matter of debate, recent data indicate that there is modest but clear benefit of eradication of H pylori in patients with functional dyspepsia. In addition, H pylori is a gastric carcinogen and if found it should be eliminated. Although there are no specific diets for patients with FD, it may be helpful to guide the patients on healthy exercise and eating habits.

Amino functionalized chiral mesoporous silica nanoparticles for improved loading and release of poorly water-soluble drug

In the present paper, chiral mesoporous silica nano-cocoon(A-CMSN) functionalized with amino group was synthesized, and its loading and release of indomethacin(IMC), a poorly soluble drug, was studied. Due to the use of chiral anionic surfactants as a template, ACMSN possessed 2D hexagonal nano-cocoon morphology with curled channels on its surface, which was quite different from another 2D hexagonal mesoporous silica nanoparticles(MCM-41) with straightway channels. After being loaded into the two silica carriers by hydrogen bond, crystalline IMC converted to amorphous form, leading to the improved drug dissolution. And IMC loading capacity of A-CMSN was higher than MCM-41 because curled loading process originating from curvature chiral channels can hold more drug molecules. Compared with IMC, IMC loaded A-CMSN presented obviously fast release throughout the in vitro release experiment, while IMC loaded MCM-41 released faster than IMC at the initial 5 h then showed controlled slow release afterwards, which was closely related to the mesoporous silica nanoparticles and different channel mesostructures of these two carriers. A-CMSN possessed nano-cocoon morphology with curled 2D hexagonal channel and its channel length was shorter than MCM-41, therefore IMC molecules can easily get rid of the constraint of A-CMSN then to be surrounded by dissolution medium.

Chronic antiepileptic drug use and functional network efficiency: A functional magnetic resonance imaging study

AIM To increase our insight in the neuronal mechanisms underlying cognitive side-effects of antiepileptic drug(AED) treatment.METHODS The relation between functional magnetic resonance-acquired brain network measures, AED use, and cognitive function was investigated. Three groups of patients with epilepsy with a different risk profile for developing cognitive side effects were included: A "low risk" category(lamotrigine or levetiracetam, n=16), an "intermediate risk" category(carbamazepine, oxcarbazepine, phenytoin, or valproate, n=34) and a "high risk" category(topiramate, n=5). Brain connectivity was assessed using resting state functional magnetic resonance imaging and graph theoretical network analysis. The Computerized Visual Searching Task was used to measure central information processing speed, a common cognitive side effect of AED treatment. RESULTS Central information processing speed was lower in patients taking AEDs from the intermediate and high risk categories, compared with patients from the low risk category. The effect of risk category on global efficiency was significant(P < 0.05, ANCOVA), with a significantly higher global efficiency for patient from the low category compared with the high risk category(P < 0.05, post-hoc test). Risk category had no significant effect on the clustering coefficient(ANCOVA, P > 0.2). Also no significant associations between information processing speed and global efficiency or the clustering coefficient(linear regression analysis, P > 0.15) were observed. CONCLUSION Only the four patients taking topiramate show aberrant network measures, suggesting that alterations in functional brain network organization may be only subtle and measureable in patients with more severe cognitive side effects.

Treatment of Functional Retrograde Ejaculation with Acupuncture and TCM Herbal Drugs

Acupuncture at the Taichong (LR 3), Sanyinjiao (SP 6) and Ciliao (BL 32) points combined with TCM drugs for soothing the liver, replenishing the kidney, freeing the seminal passage, and eliminating the stasis showed effective for functional retrograde ejaculation in 25 cases. The total effective rate of 68.0% was significantly better than imipramine used in the control group (P<0.05).

IN VIVO MAPPING BRAIN MICROCIRCULATION BY LASER SPECKLE CONTRAST IMAGING:A MAGNETIC RESONANCE PERSPECTIVE OF THEORETICAL FRAMEWORK

The fundamental limitations of most vascular-based functional neuroimaging techniques are placed by the fact how fine the brain regulates the blood supply system.In vivo mapping of the cerebral microcirculation with high resolution and sensitivity hence becomes unprecedentedly compelling.This paper reviews the theoretical background of the laser speckle contrast imaging(LSCI)technique and attempts to present a complete framework stemming from a simple biophysical model.Through the sensitivity analysis,more insights into the tool optimization are attained for in vivo applications.Open questions of the technical aspects are discussed within this unified framework.Finally,it concludes with a brief perspective of future research in a way analogous to the magnetic resonance imaging(MRI)technique.Such exploration could catalyze their development and initiate a technological fusion for precise assessment of blood flow across various spatial scales.

The Effect of Several Commonly Used Antipsychotic Drugs on the Renal Function of Patients with Mental Illness

Objective: To understand the effects of several commonly used antipsychotics on the renal function of patients with mental illness. Method: Collected patients with mental illness who were hospitalized in our hospital from January 2020 to June 2021, and selected as the research subjects patients with psychiatric disorders who were treated with 2 kinds of commonly used antipsychotic drugs;and collected 3 ml of venous blood before treatment and one month after treatment for renal function tests;observed the changes of renal function indexes before and after treatment. Results: In the collected 694 patients with mental illness, before using antipsychotic drugs, the renal function indexes were BUN: 4.42 ± 1.92 mmol/l;Cr: 70.97 ± 16.92 μmol/l;CCr: 88.37 ± 21.07 ml/min;β2-MG: 1.67 ± 0.61 mg/L;UA: 359.90 ± 112.82 μmol/l;CYS-C: 0.92 ± 0.24 mg/L. One month after using antipsychotics, BUN: 3.77 ± 1.37 mmol/l;Cr: 70.46 ± 16.71 μmol/l;CCr: 87.78 ± 20.63 ml/min;β2-MG: 1.75 ± 0.64 mg/L;UA: 332.53 ± 91.48 umol/l;CYS-C: 0.92 ± 0.24 mg/L;the renal function indexes of urea nitrogen, β2 microglobulin, uric acid and other items all changed significantly. The differences before and after treatment were statistically significant, P < 0.01. Conclusion: Several commonly used antipsychotic drugs have a greater impact on the renal function of patients with mental illness. During the treatment, the changes in renal function should be monitored regularly, if severe renal damage is found, the treatment plan or dosage should be adjusted in time to avoid endangering life.

Effects of antiplatelet drug combined with magnesium sulfate on platelet function and trophoblast apoptosis in patients with preeclampsia

Objective: To investigate the effects of antiplatelet drug combined with magnesium sulfate on platelet function and trophoblast apoptosis in patients with preeclampsia. Methods: A total of 68 patients with preeclampsia who were treated in this hospital between September 2016 and September 2017 were chosen as the research subjects and divided into the control group (n=34) and the study group (n=34) by the random number table method. Control group received magnesium sulfate spasmolysis, and study group received low-dose aspirin combined with magnesium sulfate therapy. The differences in the levels of platelet function parameters as well as the expression levels of apoptosis-related genes and invasion-related genes in placental tissues were compared between the two groups of patients after treatment. Results:After treatment, the platelet function parameter PLT level in study group was higher than that in control group whereas MPV and PDW levels were lower than those in control group;pro-apoptosis genes Caspase-3, p53 and bax mRNA expression levels in placental tissues were lower than those of control group whereas anti-apoptosis gene bcl-2 mRNA expression level was higher than that of control group;pro-invasion genes MMP-2, MMP-9 and CXCL16 mRNA expression levels in placental tissues were higher than those of control group whereas anti-invasion genes RECK and DPPⅣ mRNA expression levels were lower than those of control group. Conclusion: Low-dose aspirin combined with magnesium sulfate treatment of patients with preeclampsia can effectively optimize the platelet function and inhibit the apoptosis of placental trophoblast cells and promote their invasion function.

Effects of alprostadil combined with nucleoside antiviral drugs on liver function, liver fibrosis markers and serum inflammatory factors in patients with decompensated liver cirrhosis with HBV infection

Objective:To explore the Effects of alprostadil combined with nucleoside antiviral drugs on liver function, liver fibrosis markers and serum inflammatory factors in patients with decompensated liver cirrhosis with HBV infection.Methods: 136 patients with decompensated cirrhosis of HBV infection who were hospitalized in Linxi Hospital of Kailuan General Hospital, Tangshan Infectious Disease Hospital and North China University of Technology Hospital from January to February 2018, 2017 were selected. All patients were divided into control group and case group by random number table method, 68 cases in each group. The control group was treated with routine liver protection and antiviral therapy, while the case group was treated with alprostadil on the basis of the control group. The changes of liver function, liver fibrosis, liver and spleen imaging indexes, anti-virus related indexes and inflammatory factors were observed before and after treatment in the two groups.Results: The total effective rate of the case group was 97.06%, which was significantly higher than that of the control group (85.29%), and the difference was statistically significant. The ALT, AST, TBIL, LN, HA, PCIII, CIV, portal vein diameter, spleen vein diameter, spleen thickness, IL-6, hs-CRP, TNF-α and TGF-β1 were significantly lower in the case group than in the control group. ALB, HBV DNA conversion rate, HBsAg negative rate, and HBeAg negative rate were significantly higher than the control group, the difference was statistically significant. Conclusion: Alprostadil combined with nucleoside antiviral drugs can significantly improve the decompensation of HBV infection Liver function in patients with cirrhosis, reduce the degree of liver fibrosis, inhibit the production of serum inflammatory factors, and can effectively inhibit HBV replication, clinical efficacy is significant, with certain clinical application value.

The immune function injury and its mechanism in drug abuser

Objective To explore the immune function injur y and its mechanism in drug abuser.Methods The immune function changes in50drug abusers were compared with normal healthy populations by detection of the indexes of subgroups of Th cells,transformation rate of lymphocytes,IgA,IgM,IgG,IgE,com pliment C 3 ,C 4 ,IL-1,IL-2,IL-6TNF and NO.Result In peripheral blood the percentage o f Th 1 cell,transformation rate of lymphocyte,IgA,IgM,IgG,IgE content,complime nt C4,C4,IL-1,IL-2,IL-6,and TNF le vels were significantly lower than normal (P <0.01).The value of Th 1 /Th 2 was lower than normal as well(P <0.05).NO content was significantly higher than normal (P <0.001).Conclusion The mechanism of immune function inj ury in drug abuser might be correlative to direct injury of drugs and their inhibition effect on the thymu s-hypothalamus-hypophysis-adren al axis.

Comparison of brain functions between healthy participants and methamphetamine users with various addiction histories:Data analysis based on EEG and fNIRS

The electroencephalogram(EEG)rhythm and functional near-infrared spectroscopy(fNIRS)activation levels have not been compared between a healthy control group(HCG)and methamphetamine user group(MUG)with different addiction histories.This study used 64-electrode EEG and fNIRS to conduct an experiment that analyzed the resting and craving states.The EEG and fNIRS data of 56 participants were collected,including 14 healthy participants,14 methamphetamine users with an addiction history of 0.5–5 years,14 users with an addiction history of 5–10 years,and 14 users with an addiction history of 10–15 years.Isolated effective coherence(iCoh)within the brain network was used to process the EEG data.Statistical analysis was performed to compare differences in iCoh among the delta,theta,alpha,beta,and gamma bands and explore oxyhemoglobin activation levels in the ventrolateral prefrontal cortex,dorsolateral prefrontal cortex,orbitofrontal cortex,and frontopolar prefrontal cortex(FPC)of the control group.Finally,the Kmeans,Gaussian mixed model(GMM),linear discriminant analysis(LDA),support vector machine(SVM),Bayes,and convolutional neural networks(CNN)algorithms were used to classify methamphetamine users based on drug and neutral images.A 3-class accuracy was achieved.Changes in EEG and fNIRS activation levels of HCG and MUG with varied addiction histories were demonstrated.

Functional cure of chronic hepatitis B-hope or hype?

Chronic hepatitis B constitutes a substantial disease burden worldwide.The steps advocated by the World Health Organization in 2016 to eradicate hepatitis B by 2030 has failed to achieve significant progress,especially with respect to immu-nization coverage and linkage to care.The lack of governmental and public awar-eness regarding the long-term implications of hepatitis B burden cause under-funding of developmental projects.The presently approved treatment modalities have limited efficacy in complete viral eradication,hence the need for newer molecules to achieve functional cure(sustained undetectable hepatitis B surface antigen(HBsAg)and hepatitis B virus DNA in peripheral blood after a finite period of therapy).However,preliminary results from trials of novel therapies show their inadequacy to achieve this end by themselves but better performance with a low baseline serum HBsAg with nucleos(t)ide analogues(NA)treatment which need to be combined with/without pegylated interferon as an immu-nomodulator.Such therapy is limited by cost and adverse events and need to show incremental benefit over the standard of care(long-term NA therapy)with respect to efficacy and drug toxicities,making the development process tenuous.Thus,while such therapies continue to be tested,strategies should still focus on prevention of transmission by non-pharmaceutical measures,vaccination and increasing linkage to care.

创伤性脊髓损伤急性期前列腺素E1对血管相关因子的调节和微循环功能的保护

背景:前列腺素E1被证明在血管扩张、炎症、白细胞迁移和黏附中发挥调节作用,但其对创伤性脊髓损伤后脊髓微循环的作用尚缺乏深入的研究。目的:探讨在大鼠创伤性脊髓损伤急性期给予前列腺素E1对血管相关因子的调节和微循环功能的保护作用机制。方法:将72只雌性SD大鼠随机分为3组(n=24),即假手术组、脊髓损伤组、前列腺素E1组。后两组用Allen’s打击法建立脊髓损伤的体内模型,前列腺素E1组大鼠在脊髓损伤后15 min内立即尾静脉注射脂质前列腺素E110μg/kg。分别在损伤后2,24 h测定脊髓微循环血流量和血氧饱和度、脊髓微血管直径和面积、脊髓含水量、血管功能调节因子(血浆血管性血友病因子、血栓素A2、前列环素、内皮素1)和炎症因子(肿瘤坏死因子α、白细胞介素1β)的表达。结果与结论:①脊髓损伤后2 h,前列腺素E1组大鼠的脊髓微血管直径及面积、脊髓微循环血流量和血氧饱和度均高于脊髓损伤组(P<0.05),脊髓含水量低于脊髓损伤组(P<0.05),血浆血管性血友病因子、脊髓组织血栓素A2/前列环素及内皮素1质量浓度均低于脊髓损伤组(P<0.05);②脊髓损伤后24 h,前列腺素E1组大鼠的脊髓微血管面积、血流量和血氧饱和度均高于脊髓损伤组(P<0.05),脊髓含水量低于脊髓损伤组(P<0.05),血浆血管性血友病因子、脊髓组织血栓素A2/前列环素及内皮素1、肿瘤坏死因子α、白细胞介素1β的质量浓度均低于脊髓损伤组(P<0.05);③脊髓损伤组大鼠损伤后24 h的脊髓微血管直径及面积、脊髓微循环血流量和血氧饱和度均高于损伤后2 h(P<0.05),血浆血管性血友病因子、脊髓组织血栓素A2/前列环素、肿瘤坏死因子α、白细胞介素1β的质量浓度均高于损伤后2 h(P<0.05),但是脊髓组织内皮素1质量浓度低于损伤后2 h(P<0.05);④前列腺素E1组大鼠损伤后24 h的脊髓微循环血流量和血氧饱和度低于损伤后2 h(P<0.05),脊髓微血管直径及面积、脊髓含水量高于损伤后2 h(P<0.05);⑤以上结果表明,脊髓损伤大鼠伤后即刻静脉给予前列腺素E1,可调节血管功能调节因子、炎症因子并改善脊髓损伤后脊髓微循环,这为寻找治疗急性脊髓损伤的药物提供了潜在的基础。

MXene基水凝胶在创面修复领域的应用

背景:MXene基水凝胶是一类纳米复合的多功能性水凝胶材料,在慢性创面(如糖尿病足、压疮、癌症及外伤性溃疡等)修复领域有广阔的应用前景。目的:综述MXene基水凝胶的优势及其在创面修复领域的应用和相关作用机制。方法:检索中国知网、维普、PubMed、Science Direct数据库中收录的文章,文献检索时限为2010年1月至2023年10月,中文检索关键词为“MXene,水凝胶,组织工程应用,创面修复”,英文检索关键词为“MXene,Hydrogel,Wound repair”,最终选取符合标准的70篇文献进行综述。结果与结论:MXene基水凝胶在创面组织工程应用中具有优异的力学、导电和光热性能及生物相容性和抗菌性等生物学功效,可以与其他有机物质和无机物质相结合,在水凝胶中产生更大的治疗作用。含有MXene的水凝胶可以结合创面监测、药物递送和缓释以及光热治疗等方式应用于皮肤创面。尽管MXene基水凝胶复合材料的设计和制备已经取得一些良好进展,但仍处于基础研究阶段,缺乏临床验证其功效性和安全性,具有很大发展潜力和应用空间。

活性小分子功能筛选平台M & Function的设计与实现

目的建立一个综合了生物信息学和化学信息学的网络信息平台M&Function,致力于新药筛选和研究。方法通过数据挖掘,整合小分子药物的名称、结构、功能、分类等信息,建立一个小分子药物信息资源库。在此基础上,借助基于最大公共子结构(maximum common substructure,MCS)和Fingerprint的结构比对软件,通过统计分析,建立了功能预测系统,对活性小分子进行生物学功能预测。结果 M&Function平台拥有丰富的数据信息、内嵌的图形显示和数据统计插件人性化的网站设计,具有直观、高效、简便易用、测试数据结果可靠等优点。结论 M&Function平台不仅是一个小分子药物信息资源库,也是一个小分子功能预测平台,可以为高通量先导化合物的筛选提供信息准备和数据支持。网站可以通过http://lifecenter.sgst.cn/mcs/home.do进行访问。

低负荷血流限制和高强度抗阻运动对男性运动青年大腿微循环功能的影响

背景:微循环作为人体物质能量代谢交换的唯一场所,与人体运动能力密切相关。抗阻运动是提高微循环功能的有效方式,但也有研究指出血流限制训练也能提高微循环功能,且具有负荷小和安全性高等优点。目的:比较6周低负荷血流限制运动、高强度抗阻运动对运动型男性青年大腿微循环功能的影响,并从血管内皮功能角度探讨运动改善微循环功能的可能机制。方法:将湖北民族大学60名体育专业男性大学生按照随机数表法分为对照组、高强度抗阻运动组和低负荷血流限制运动组,每组20人。低负荷血流限制运动组进行6周(每周3次、每次90 min、运动强度为30%1RM)的低负荷血流限制运动;高强度抗阻运动组进行6周(每周3次、每次90 min、运动强度为70%1RM强度)的抗阻训练;对照组该时间段不进行任何形式的运动训练。分别在干预开始的前1 d以及6周干预结束后次日的晨起空腹状态下对3组受试者微血管血流灌注量、经皮氧分压、肌氧饱和度、一氧化氮、内皮型一氧化氮合酶、内皮素1、血管内皮细胞生长因子及大腿围、肌力等指标进行测试。结果与结论:①运动干预后,低负荷血流限制运动组和高强度抗阻运动组的微血管血流灌注量加热值、血细胞移动速度加热值与对照组及运动干预前相比有显著差异(P<0.05);低负荷血流限制运动组微血管血流灌注量加热值、血细胞移动速度加热值与高强度抗阻运动组相比有显著差异(P<0.05);经皮氧分压和肌氧饱和度与干预前相比有显著性差异(P<0.05)。②运动干预后,低负荷血流限制运动组和高强度抗阻运动组一氧化氮、内皮型一氧化氮合酶、内皮素1、血管内皮细胞生长因子与对照组及运动干预前相比有显著差异(P<0.05)。③运动干预后,低负荷血流限制运动组和高强度抗阻运动组大腿围和大腿肌肉力量与运动干预前相比有显著差异(P<0.05)。④上述结果证实,6周低负荷血流限制运动和高强度抗阻运动可能通过调节内皮型一氧化氮合酶、内皮素1、血管内皮细胞生长因子等血管因子的分泌,提高体育专业大学生大腿微循环功能,并增加大腿肌肉的收缩力量,且低负荷血流限制运动对微血管血流灌注量、血细胞移动速度的干预效果更佳,因此低负荷血流限制运动较高强度抗阻运动在提高微循环功能方面更具优势。

Effect of clinician-patient communication on compliance with flupentixol-melitracen in functional dyspepsia patients

AIM: To explore whether clinician-patient communication affects adherence to psychoactive drugs in functional dyspepsia(FD) patients with psychological symptoms. METHODS: A total of 262 FD patients with psychological symptoms were randomly assigned to four groups. The patients in Groups 1-3 were given flupentixol-melitracen(FM) plus omeprazole treatment. Those in Group 1 received explanations of both the psychological and gastrointestinal(GI) mechanisms of the generation of FD symptoms and the effects of FM. In Group 2, only the psychological mechanisms were emphasized. The patients in Group 3 were not given an explanation for the prescription of FM. Those in Group 4 were given omeprazole alone. The primary endpoints of this study were compliance rate and compliance index to FM in Groups 1-3. Survival analyses were also conducted. The secondary end points were dyspepsia and psychological symptom improvement in Groups 1-4. The correlations between the compliance indices and the reductions in dyspepsia and psychological symptom scores were also evaluated in Groups 1-3.RESULTS: After 8 wk of treatment, the compliance rates were 67.7% in Group 1, 42.4% in Group 2 and 47.7% in Group 3(Group 1 vs Group 2, P = 0.006; Group 1 vs Group 3, P = 0.033). The compliance index(Group 1 vs Group 2, P = 0.002; Group 1 vs Group 3, P = 0.024) with the FM regimen was significantly higher in Group 1 than in Groups 2 and 3. The survival analysis revealed that the patients in Group 1 exhibited a significantlyhigher compliance rate than Groups 2 and 3(Group 1 vs Group 2, P = 0.002; Group 1 vs Group 3, P = 0.018). The improvement in dyspepsia(Group 1 vs Group 2, P < 0.05; Group 1 vs Group 3, P < 0.05; Group 1 vs Group 4, P < 0.01) and psychological symptom scores(anxiety: Group 1 vs Group 2, P < 0.01; Group 1 vs Group 3, P < 0.05; Group 1 vs Group 4, P < 0.01; depression: Group 1 vs Group 2, P < 0.01; Group 1 vs Group 3, P < 0.01; Group 1 vs Group 4, P < 0.01) in Group 1 were greater than those in Groups 2-4. The compliance indices were positively correlated with the reduction in symptom scores in Groups 1-3. CONCLUSION: Appropriate clinician-patient communication regarding the reasons for prescribing psychoactive drugs that emphasizes both the psychological and GI mechanisms might improve adherence to FM in patients with FD.

Cardiopulmonary bypass induced microcirculatory injury of the small bowel in rats

AIM： To investigate microvascular injury quantitatively in the small bowel with respect to cardiopulmonary bypass （CPB） and related mechanisms. METHODS： In 10 male SD rats, normothermic CPB was established and continued with a flow rate of 100-150 mL/kg per minute for 60 min, while another 10 sham-operated animals served as controls. An approximate 10-cm loop of the terminal ileum was exteriorized for observation by means of intravital fluorescence microscopy. The small bowel microcirculatory network including arterioles, capillaries, and collecting venules was observed prior to CPB, CPB 30 min, CPB 60 min, post-CPB 60 min and post-CPB 120 rain. The intestinal capillary perfusion, microvascular permeability and leukocyte adherence were also measured. RESULTS： The systemic hemodynamics remained stable throughout the experiment in both groups. In CPB animals, significant arteriolar vasoconstriction, blood velocity reduction and functional capillary density diminution were found. As concomitances, exaggerated albumin extravasation and increased leukocyte accumulation were also noted. These changes were more pronounced and there were no signs of restitution at the end of the observation period. CONCLUSION： CPB induces significant microcirculatory injury of the small bowel in rats. The major underlying mechanisms are blood flow redistribution and generalized inflammatory response associated with CPB.

Combination of methylprednisolone and rosiglitazone promotes recovery of neurological function after spinal cord injury

Methylprednisolone exhibits anti-inflammatory antioxidant properties, and rosiglitazone acts as an anti-inflammatory and antioxidant by activating peroxisome proliferator-activated receptor-y in the spinal cord. Methylprednisolone and rosiglitazone have been clinically used during the early stages of secondary spinal cord injury. Because of the complexity and diversity of the inflammatory process after spinal cord injury, a single drug cannot completely inhibit inflammation. Therefore, we assumed that a combination of methylprednisolone and rosiglitazone might promote recovery of neurological function after secondary spinal cord injury. In this study, rats were intraperitoneally rejected with methylprednisolone （30 mg/kg） and rosiglitazone （2 mg/kg） at 1 hour after injury, and methylprednisolone （15 mg/kg） at 24 and 48 hours after injury. Rosiglitazone was then administered once every 12 hours for 7 consecutive days. Our results demonstrated that a combined treatment with methylprednisolone and rosiglitazone had a more pronounced effect on attenuation of inflammation and cell apoptosis, as well as increased functional recovery, compared with either single treatment alone, indicating that a combination better pro- moted recovery of neurological function after injury.