Palmitoleic acid on top of HFD ameliorates insulin resistance independent of diacylglycerols and alters gut microbiota in C57BL/6J mice

With the prevalence of obesity and obesity-related metabolic syndrome,such as insulin resistance in recent years,it is urgent to explore effective interventions to prevent the progression of obesity-related metabolic syndrome.Palmitoleic acid is a monounsaturated fatty acid that is available from dietary sources,mainly derived from marine products.P almitoleic acid plays a positive role in maintaining glucose homeostasis and reducing inflammation.However,it is still unknow the mechanism of palmitoleic acid in ameliorating insulin resistance.Here,we investigated the effects of palmitoleic acid on chow diet(CD)-fed and high-fat diet(HFD)-fed mice,which were fed CD or HFD for 12 weeks before administration.We administrated mice with BSA(control),oleic acid,or palmitoleic acid for 6 weeks on top of CD or HFD feeding.We found that palmitoleic acid only improved glucose homeostasis in HFD-fed obese mice by increasing glucose clearance and reducing HOMA-IR.Further study explored that palmitoleic acid changed the composition of gut microbiota by decreasing Firmicutes population and increasing Bacteroidetes population.In colon,palmitoleic acid increased intestinal tight junction integrity and reduced inflammation.Moreover,palmitoleic acid decreased macrophage infiltration in liver and adipose tissue and increase glucose uptake in adipose tissue.Diacylglycerol(DAG)in tissue(for example,liver)is found to positively correlated with HOMA-IR.HFD enhanced the levels of DAGs in liver but not in adipose tissue in this study.Palmitoleic acid did not reverse the high DAG levels induced by HFD in liver.Therefore,in HFD-fed mice,palmitoleic acid reduced insulin resistance by an independent-manner of DAGs.It might be associated with the beneficial effects of palmitoleic acid on altering the gut microbiota composition,improving of intestinal barrier function,and downregulating the inflammation in colon,liver,and adipose tissue.

Advances in targeted therapy for human epidermal growth factor receptor 2 positive in advanced gastric cancer

Emerging therapeutic methods represented by targeted therapy are effective supplements to traditional first-line chemoradiotherapy resistance.Human epidermal growth factor receptor 2(HER2)is one of the most important targets in targeted therapy for gastric cancer.Trastuzumab combined with chemotherapy has been used as the first-line treatment for advanced gastric cancer.The safety and efficacy of pertuzumab and margetuximab in the treatment of gastric cancer have been verified.However,monoclonal antibodies,due to their large molecular weight,inability to penetrate the blood-brain barrier,and drug resistance,lead to decreased therapeutic efficacy,so it is necessary to explore the efficacy of other HER2-targeting therapies in gastric cancer.Small-molecule tyrosine kinase inhibitors,such as lapatinib and pyrrotinib,have the advantages of small molecular weight,penetrating the blood-brain barrier and high oral bioavailability,and are expected to become the drugs of choice for perioperative treatment and neoadjuvant therapy of gastric cancer after validation by large-scale clinical trials in the future.Antibo-drug conjugate,such as T-DM1 and T-DXd,can overcome the resistance of monoclonal antibodies despite their different mechanisms of tumor killing,and are a supplement for the treatment of patients who have failed the treatment of monoclonal antibodies such as trastuzumab.Therefore,after more detailed stratification of gastric cancer patients,various gastric cancer drugs targeting HER2 are expected to play a more significant role.

Ferroptosis regulating lipid peroxidation metabolism in the occurrence and development of gastric cancer

BACKGROUND Gastric cancer is one of the most common malignant tumors in the world,and its occurrence and development involve complex biological processes.Iron death,as a new cell death mode,has attracted wide attention in recent years.However,the regulatory mechanism of iron death in gastric cancer and its effect on lipid peroxidation metabolism remain unclear.AIM To explore the role of iron death in the development of gastric cancer,reveal its relationship with lipid peroxidation,and provide a new theoretical basis for revealing the molecular mechanism of the occurrence and development of gastric cancer.METHODS The process of iron death in gastric cancer cells was simulated by cell culture model,and the occurrence of iron death was detected by fluorescence microscopy and flow cytometry.The changes of gene expression related to iron death and lipid peroxidation metabolism were analyzed by high-throughput sequencing technology.In addition,a mouse model of gastric cancer was established,and the role of iron death in vivo was studied by histology and immunohistochemistry,and the level of lipid peroxidation was detected.These methods comprehensively and deeply reveal the regulatory mechanism of iron death on lipid peroxidation metabolism in the occurrence and development of gastric cancer.RESULTS Iron death was significantly activated in gastric cancer cells,and at the same time,associated lipid peroxidation levels increased significantly.Through high-throughput sequencing analysis,it was found that iron death regulated the expression of several genes related to lipid metabolism.In vivo experiments demonstrated that increased iron death in gastric cancer mice was accompanied by a significant increase in lipid peroxidation.CONCLUSION This study confirmed the important role of iron death in regulating lipid peroxidation metabolism in the occurrence and development of gastric cancer.The activation of iron death significantly increased lipid peroxidation levels,revealing its regulatory mechanism inside the cell.

Alterations in gut microbiota are related to metabolite profiles in spinal cord injury

Studies have shown that gut microbiota metabolites can enter the central nervous system via the blood-spinal cord barrier and cause neuroinflammation, thus constituting secondary injury after spinal cord injury. To investigate the correlation between gut microbiota and metabolites and the possible mechanism underlying the effects of gut microbiota on secondary injury after spinal cord injury, in this study, we established mouse models of T8–T10 traumatic spinal cord injury. We used 16 S rRNA gene amplicon sequencing and metabolomics to reveal the changes in gut microbiota and metabolites in fecal samples from the mouse model. Results showed a severe gut microbiota disturbance after spinal cord injury, which included marked increases in pro-inflammatory bacteria, such as Shigella, Bacteroides, Rikenella, Staphylococcus, and Mucispirillum and decreases in anti-inflammatory bacteria, such as Lactobacillus, Allobaculum, and Sutterella. Meanwhile, we identified 27 metabolites that decreased and 320 metabolites that increased in the injured spinal cord. Combined with pathway enrichment analysis, five markedly differential amino acids(L-leucine, L-methionine, L-phenylalanine, L-isoleucine and L-valine) were screened out, which play a pivotal role in activating oxidative stress and inflammatory responses following spinal cord injury. Integrated correlation analysis indicated that the alteration of gut microbiota was related to the differences in amino acids, which suggests that disturbances in gut microbiota might participate in the secondary injury through the accumulation of partial metabolites that activate oxidative stress and inflammatory responses. Findings from this study provide a new theoretical basis for improving the secondary injury after spinal cord injury through fecal microbial transplantation.

LOXL3 Inhibits Autophagy of Chondrocytes by Activating Rheb in Osteoarthritis

Objective This study aimed to investigate the potential mechanisms by which lysyl oxidase like 3(LOXL3)affects the autophagy in chondrocytes in osteoarthritis(OA),specifically through the activation of mammalian target of rapamycin complex 1(mTORC1).Methods To establish an OA model,rats underwent anterior cruciate ligament transection(ACLT).Chondrocytes were isolated from cartilage tissues and cultured.Western blotting was performed to assess the expression of LOXL3,Rheb,phosphorylation of p70S6K(p-p70S6K,a downstream marker of mTORC1),and autophagy markers.The autophagy of chondrocytes was observed using an immunofluorescence assay.Results The expression levels of both LOXL3 and Rheb proteins were upregulated in chondrocytes isolated from the OA model cartilage,in comparison to those from the normal cartilage.The silencing of LOXL3 resulted in a decrease in the protein levels of Rheb and p-p70S6K,as well as an increase in the expression of autophagy-related proteins.Additionally,the effect of LOXL3 could be reversed through the silencing of Rheb.The results of the immunofluorescence assay confirmed the impact of LOXL3 and Rheb on chondrocyte autophagy.Conclusion LOXL3 inhibits chondrocyte autophagy by activating the Rheb and mTORC1 signaling pathways.

Clinical experience sharing on gastric microneuroendocrine tumors: A case report

BACKGROUND The majority of gastric neuroendocrine tumors(G-NENs)are present in various lesions under endoscopy,and they can be polypoid uplifts,submucosal tumors or papules,erosions,and ulcers.The lesions are mostly confined to the mucosal or submucosal layer,usually less than 2 cm,and exclusively localized to the gastric body or fundus.In type 1 G-NENs,about 22%of cases have no visible lesions under an endoscope,and such lesions can only be detected via biopsies(microcar-cinoids).CONCLUSION In the case under study,the patient did not have any visible raised lesions under a gastroscope,and the lesions were found only after a random biopsy.This article combines the endoscopic manifestations and clinical features of the lesions in this case to improve the diagnosis of G-NENs.

Down-regulating Circular RNA Prkcsh suppresses the inflammatory response after spinal cord injury

Circular RNAs(circRNAs)are a class of conserved,endogenous non-coding RNAs that are involved in transcriptional and post-transcriptional gene regulation and are highly enriched in the nervous system.They participate in the survival and differentiation of multiple nerve cells,and may even promote the recovery of neurological function after stroke.However,their role in the inflammatory response after spinal cord injury remains unclear.In the present study,we established a mouse model of T9 spinal cord injury using the modified Allen’s impact method,and identified 16,013 circRNAs and 960 miRNAs that were differentially expressed after spinal cord injury.Of these,the expression levels of circPrkcsh were significantly different between injured and sham-treated mice.We then treated astrocytes with tumor necrosis factor-αin vitro to simulate the inflammatory response after spinal cord injury.Our results revealed an elevated expression of circPrkcsh with a concurrent decrease in miR-488 expression in injured cells.We also found that circPrkcsh regulated the expression of the inflammationrelated gene Ccl2.Furthermore,in tumor necrosis factor-α-treated astrocytes,circPrkcsh knockdown decreased the expression of Ccl2 by upregulating miR-488 expression,and reduced the secretion of inflammatory cytokines in vitro.These findings suggest that differentially expressed circRNAs participate in the inflammatory response after spinal cord injury and act as the regulators of certain microRNAs.Furthermore,circPrkcsh may be used as an miR-488 sponge to regulate Ccl2 expression,which might provide a new potential therapy for SCI.The study was approved by the Animal Ethics Committee of Shandong University of China(approval No.KYLL-20170303)on March 3,2017.

Concurrent alcoholic cirrhosis and malignant peritoneal mesothelioma in a patient:A case report

BACKGROUND Malignant peritoneal mesothelioma(MPM)originates from the mesothelial and subcutaneous cells of the abdominal cavity.Its diagnose is difficult due to its nonspecific and vague symptoms,and it should be differentiated from alcoholic cirrhosis and liver and pancreatic cancers.Misdiagnosis and missed diagnosis can easily occur when MPM presents with other diseases.To the best of our knowledge,no case of MPM concurrent with alcoholic cirrhosis has been reported.CASE SUMMARY A 63-year-old man presented to our hospital with abdominal distension for 20days.He had a history of alcohol consumption for nearly 30 years and no history of special drug use or toxic exposure.After treatment for alcoholic cirrhosis in a community hospital,his symptoms did not improve significantly.The patient underwent exploratory laparotomy and surgical resection.Pathologic examination showed an epithelioid MPM.He was treated with chemotherapy and intraperitoneal hyperthermic perfusion after surgery.Currently,he is in a stable condition and tumor recurrence has not occurred.CONCLUSION Misdiagnosis and missed diagnosis of MPM can easily occur because of its insidious onset.Therefore,there is a need to understand.MPM in clinical practice,make the correct diagnosis,and provide timely and effective treatment.

Submucosal hematoma with a wide range of lesions, severe condition and atypical clinical symptoms: A case report

BACKGROUND Submucosal hematoma(SH)is one of the rare causes of upper gastrointestinal bleeding.As a rare and critical disease in clinical practice,it should be paid more attention to by clinicians to avoid missed diagnosis and misdiagnosis.Most of the esophageal submucosal hematomas have clear causes,including retrosternal pain,dysphagia,etc.Here,we report a rare case of SH extending from the hypopharynx to the lower esophagus caused by oral administration of hirudin and panax notoginseng powder,with atypical clinical manifestation.Such a long submucosal hematoma has rarely been reported.CASE SUMMARY The patient was a 60-year-old male with a history of gastritis,hypertension,coronary heart disease,and coronary stent implantation.The patient developed chest tiredness and heartburn after taking 10 capsules of a homemade mixture of hirudin and notoginseng powder in the previous 2 d.He did not have hematemesis or black stool.Gastroscopy and chest computed tomography confirmed the diagnosis of SH,which ranged from the pharynx to the lower esophagus and was 35-40 cm in length.After the diagnosis was confirmed,we performed active conservative treatment on the patient,and the patient recovered well and remained asymptomatic during the 26-mo follow-up.CONCLUSION SH is rare,and cases with atypical clinical symptoms may lead to misdiagnosis and missed diagnosis.Ignorance of this disease can lead to serious clinical consequences.Conservative therapy is effective and the prognosis is good.

Research on the Related Factors of the Second Molar Dislocation and Orthodontic Erect Method

The second molar dislocation is more common clinically.To investigate the related factors of the second permanent molar dislocation,and provide reference for the clinical diagnosis and treatment of orthodontics.From the current clinical research,the clinical methods of orthodontic erect secondary molars are also diverse and clinical.The narrower first molar alveolar arch width,smaller ANB angle,and crowded maxillary posterior segment arch are the factors that cause the maxillary second permanent molar dislocation.The narrow alveolar arch width,the smaller SNB angle,the larger ANB angle,and the crowded lower mandibular arch are the factors leading to the dislocation of the mandibular second permanent molar.In addition,for the second mandibular molar malposition,it is particularly important to select the corrective treatment plan.It is especially important to improve the treatment.

Safety of butylphthalide and edaravone in patients with ischemic stroke:a multicenter real-world study

BACKGROUND Butylphthalide(NBP)and edaravone(EDV)injection are common acute ischemic stroke medications in China,but there is a lack of large real-world safety studies on them.This study aimed to determine the incidence of adverse events,detect relevant safety signals,and assess the risk factors associated with these medications in real-world populations.METHODS In this study,data of acute ischemic stroke patients were extracted from the electronic medical record database of six tertiary hospitals between January 2019 and August 2021.Baseline confounders were eliminated using propensity score matching.The drugs’safety was estimated by comparing the results of 24 laboratory tests standards on liver function,kidney function,lipid level,and coagulation function.The drugs’relative risk was estimated by logistic regression.A third group with patients who did not receive NBP or EDV was constructed as a reference.Prescription sequence symmetry analysis was used to evaluate the associations between adverse events and NBP and EDV,respectively.RESULTS 81,292 patients were included in this study.After propensity score matching,the NBP,EDV,and third groups with 727patients in each group.Among the 15 test items,the incidence of adverse events was lower in the NBP group than in the EDV group,and the differences were statistically significant.The multivariate logistic regression equation revealed that NBP injection was not a promoting factor for abnormal laboratory test results,whereas EDV had statistically significant effects on aspartate transaminase,low-density lipoprotein cholesterol and total cholesterol.Prescription sequence symmetry analysis showed that NBP had a weak correlation with abnormal platelet count.EDV had a positive signal associated with abnormal results in gamma-glutamyl transferase,alanine aminotransferase,aspartate aminotransferase,prothrombin time,and platelet count.CONCLUSIONS In a large real-world population,NBP has a lower incidence of adverse events and a better safety profile than EDV or other usual medications.

Bilateral thigh pyomyositis in an otherwise healthy middle-aged woman:A case report

BACKGROUND Pyomyositis generally occurs in otherwise healthy young men.Because this condition is unusual among otherwise healthy women in temperate climates,we present the following case.CASE SUMMARY An otherwise healthy 43-year-old woman presented with bilateral pain in her lower extremities and fever.Magnetic resonance imaging(MRI)findings were indicative of myositis with a possible abscess.We initiated empirical antibiotic therapy with ceftriaxone.However,the swelling and pain in her legs persisted even after 7 d of treatment.Contrast MRI revealed multiple pockets of pus in the vastus lateralis and gluteal muscles.We performed needle aspiration of these abscesses with ultrasound guidance and local anesthesia.Upon culturing,the purulent material was positive for Staphylococcus aureus.We diagnosed her with S.aureus-induced pyomyositis of the vastus lateralis muscle and gluteus region.Based on the antibiotic sensitivity report,ceftriaxone was administered for an additional 7 d.By day 15 post-drainage,the patient was able to start walking.Oral antibiotic therapy was continued for 1 wk following her discharge from hospital,after which her symptoms resolved completely.CONCLUSION Pyomyositis may present with muscle pain,swelling,and fever.Ultrasoundguided percutaneous puncture and drainage may enable timely diagnosis and treatment.

Stent-assisted coiling of intracranial carotid ophthalmic segment aneurysm segment aneurysms:Long-term follow-up from a single center

Background:To evaluate the efficacy of stent-assisted coiling(SAC)for the treatment of carotid ophthalmic segment aneurysm segment aneurysms(OSAs)of the internal carotid artery(ICA)through detailed long-term follow-up of a large patient cohort.Methods:We retrospectively analyzed 88 consecutive patients with OSAs between January 2009 and January 2020 at our center.Angiographic results were evaluated using the modified Raymond grading system and clinical outcomes were evaluated using the mRS scale.The primary endpoints were major aneurysm recurrence and poor clinical outcomes for at least 18 months of follow-up.The patients were asked to attend clinical follow-up assessments and possibly undergo DSA or MR via telephone.Results:We enrolled 88 patients with 99 OSAs treated with coiling,of whom 76 were treated with SAC.The coiling procedures were successful in all 88 patients.Overall,complications occurred in 8 patients(9.1%).No procedure-related mortality was observed.67(76.1%)experienced immediate aneurysm occlusion at the end of the procedure.Long-term angiographic follow-up(18 months)was available in 45/88 aneurysms(51%)(average 18.7±5.2 months).Four patients continued their follow-up for 5 years after initial aneurysm treatment.After a clinical follow-up time of 28.7 months(range,12-51 months),85 patients(95.5%)achieved favorable clinical outcomes(mRS scores of 0-2).Conclusions:This study indicates that SAC treatment is a safe and effective therapeutic alternative for ruptured and unruptured OSAs.The procedural risks are low with relatively long-term effectiveness.

Bibliometric analysis of the global research status and trends of mechanotransduction in cancer

BACKGROUND The development of cancer is thought to involve the dynamic crosstalk between the tumor cells and the microenvironment they inhabit.Such crosstalk is thought to involve mechanotransduction,a process whereby the cells sense mechanical cues such as stiffness,and translate these into biochemical signals,which have an impact on the subsequent cellular activities.Bibliometric analysis is a statistical method that involves investigating different aspects(including authors’names and affiliations,article keywords,journals and citations)of large volumes of literature.Despite an increase in mechanotransduction-related research in recent years,there are currently no bibliometric studies that describe the global status and trends of mechanotransduction-related research in the cancer field.AIM To investigate the global research status and trends of mechanotransduction in cancer from a bibliometric viewpoint.METHODS Literature on mechanotransduction in cancer published from January 1,1900 to December 31,2022 was retrieved from the Web of Science Core Collection.Excel and GraphPad software carried out the statistical analysis of the relevant author,journal,organization,and country information.The co-authorship,keyword cooccurrence,and keyword burst analysis were visualized with VOSviewer and CiteSpace.RESULTS Of 597 publications from 745 institutions in 45 countries were published in 268 journals with 35510 citation times.With 270 articles,the United States is a well-established global leader in this field,and the University of California system,the most productive(n=36)and influential institution(n=4705 citations),is the most highly active in collaborating with other organizations.Cancers was the most frequent publisher with the highest H-index.The most productive researcher was Valerie M.Weaver,with 10 publications.The combined analysis of concurrent and burst keywords revealed that the future research hotspots of mechanotransduction in cancer were related to the plasma membrane,autophagy,piezo1/2,heterogeneity,cancer diagnosis,and post-transcriptional modifications.CONCLUSION Mechanotransduction-related cancer research remains a hot topic.The United States is in the leading position of global research on mechano-oncology after almost 30 years of investigations.Research group cooperations exist but remain largely domestic,lacking cross-national communications.The next big topic in this field is to explore how the plasma membrane and its localized mechanosensor can transduce mechanical force through post-transcriptional modifications and thereby participate in cellular activity regulations and cancer development.

A computed tomography-based radiomic model for the prediction of strangulation risk in patients with acute intestinal obstruction

Background We created and validated a computed tomography(CT)-based radiomic model using both clinical factors and the radiomic signature for assessing the strangulation risk of acute intestinal obstruction.This would assist surgeons in accurately predicting intestinal ischemia and strangulation in patients with intestinal obstruction.Methods We recruited 289 patients with acute intestinal obstruction admitted in the Affiliated Hospital of Qingdao University from January 2019 to February 2022.The patients were allocated to a training(n=226)and validation cohort(n=63).Radiomic features were collected from CT images,and the radiomic signature was extracted and used to calculate a radiomic score(Rad-score).A nomogram was constructed using the clinical features and the Rad-score,and the performance of the clinical,radiomics,and nomogram models was assessed in the two cohorts.Results Six robust features were used to construct the radiomic signature.The nomogram incorporating hemoglobin levels,C-reactive protein levels,American Society of Anesthesiologists score,time of obstruction,CT image of mesenteric fluid(P<0.05),and the signature demonstrated good predictive ability for intestinal ischemia in patients with acute intestinal obstruction,with areas under the curve of 0.892(95%confidence interval,0.837–0.947)and 0.781(95%confidence interval,0.619–0.944)for the training and validation sets,respectively.The decision curve analysis showed that this model outperformed the clinical and radiomic signature models.Conclusion The radiomic nomogram may effectively predict intestinal ischemia in patients with acute intestinal disease and may assist clinical decision-making。

Peripheral blood transcriptome analysis of patients with ovarian hyperstimulation syndrome through high-throughput sequencing

Objective:Ovarian hyperstimulation syndrome(OHSS)is a frequent iatrogenic complication that arises during assisted reproduction and accounts for approximately 30%of all in vitro fertilization cycles.Using high-throughput sequencing,we investigated the peripheral blood transcriptome of patients with OHSS.Methods:Peripheral blood samples were obtained from 15 patients in each of the OHSS high-risk and low-risk groups on the ovum pick-up day.Subsequently,high-throughput sequencing was used to obtain the peripheral blood transcriptomes of five patients each from the high-and low-risk groups.Bioinformatic tools were used for mRNA expression profile mapping and screening of differentially expressed genes(DEGs).Bioinformatics techniques were also implemented in the Kyoto Encyclopedia of Genes Genomes(KEGG)signal pathway,Gene Ontology(GO)function,and protein-protein interaction(PPI)network analyses of DEGs.Results:A total of 20,031 genes were identified and 148 were found to be differentially expressed(P<0.05,|log_(2)FC|>0.58),with 52 upregulated and 96 downregulated genes.GO and KEGG analyses indicated that these genes were involved in extracellular corpuscles(GO:0070062),plasma membrane(GO:0005886),extracellular regions(GO:0005576),immune system response(GO:0006955),PI3K-Akt signaling pathways(hsa04151),cell adhesion molecules(CAMs,hsa04514),focal adhesion(hsa04510),and complement and coagulation cascades(hsa04610).The PPI network and realtime fluorescence quantitative polymerase chain reaction(qPCR)verification predicted that complement C3,von Willebrand factor,and vascular cell adhesion protein 1 proteins are highly implicated in OHSS and may serve as potential biomarkers for future OHSS studies.Conclusion:Transcriptome analysis revealed several DEGs related to OHSS risk factors in the peripheral blood,indicating that these DEGs may be novel players in OHSS development.

Recurrent perimesencephalic nonaneurysmal subarachnoid hemorrhage within a short period of time: A case report

BACKGROUND Spontaneous subarachnoid hemorrhage(SAH)is primarily caused by a ruptured intracranial aneurysm.Perimesencephalic nonaneurysmal SAH(PNSAH)accounts for approximately 5%of all spontaneous SAH.PNSAH displays favorable prognosis.The risk of hemorrhage recurrence is low.We report a case of PNSAH recurrence,occurring within a short time after the initial episode in a patient not receiving antithrombotic or antiplatelet drugs.CASE SUMMARY A 66-year-old male,without any history of recent trauma or antithrombotic/antiplatelet medication,suffered two similar episodes of sudden onset of severe headache,nausea,and vomiting.A plain head computed tomography(CT)scan showed subarachnoid blood confined to the anterior part of the brainstem.Platelet count and coagulation function were normal.PNSAH was diagnosed by repeated head CT,magnetic resonance imaging,and cerebral angiography,none of which revealed the source of SAH.The patient was discharged without focal neurological deficits.At 6-mo follow-up,the patient had experienced no sudden onset of severe headache and presented favorable clinical outcome.Studies have reported a few patients with recurrent PNSAH,originating frequently from venous hemorrhage and conventionally associated with venous abnormalities.PNSAH recurs within a short time following the initial onset of symptoms,although the possibility of re-hemorrhage is extremely rare.CONCLUSION PNSAH recurrence should arouse vigilance;however,the definite source of idiopathic SAH in this case report deserves further attention.

Modified Gant procedure for treatment of internal rectal prolapse in elderly women

BACKGROUND Although rectal prolapse is not a life-threatening condition,it can cause defecation disorders,anal incontinence,sensory abnormalities,and other problems that can seriously affect quality of life.AIM To study the efficacy of the modified Gant procedure for elderly women with internal rectal prolapse.METHODS Sixty-three elderly female patients with internal rectal prolapse underwent the modified Gant procedure.The preoperative and postoperative anal symptoms,Patient Assessment of Constipation Quality of Life(PAC-QOL),Wexner incontinence score,incontinence quality of life score,and complications(massive hemorrhage,infection,anorectal stenosis,and anorectal fistula)were compared.RESULTS The improvement rates of postoperative symptoms were defecation disorders(84.5%),anal distention(69.6%),defecation sensation(81.4%),frequent defecation(88.7%),and anal incontinence(42.9%)(P<0.05).All dimensions and total scores of the PAC-QOL after the procedure were lower than those before the operation(P<0.05).The postoperative anal incontinence score and Wexner score were significantly lower than those before the procedure(P<0.05).The quality of life and total scores of postoperative anal incontinence were significantly higher than those before the procedure(P<0.05).There were no serious complications and no deaths.CONCLUSION The modified Gant procedure has significant advantages in the treatment of elderly women with internal rectal prolapse.

NPRC deletion mitigated atherosclerosis by inhibiting oxidative stress, inflammation and apoptosis in ApoE knockout mice

Previous studies suggested a beneficial effect of natriuretic peptides in animal models of cardiovascular disease,but the role of natriuretic peptide receptor C(NPRC)in the pathogenesis of atherosclerosis(AS)remains unknown.This study was designed to test the hypothesis that NPRC may promote AS lesion formation and instability by enhancing oxidative stress,inflammation,and apoptosis via protein kinase A(PKA)signaling.ApoE^(−/−)mice were fed chow or Western diet for 12 weeks and NPRC expression was significantly increased in the aortic tissues of Western diet-fed mice.Systemic NPRC knockout mice were crossed with ApoE^(−/−)mice to generate ApoE^(−/−)NPRC^(−/−)mice,and NPRC deletion resulted in a significant decrease in the size and instability of aortic atherosclerotic lesions in ApoE^(−/−)NPRC^(−/−)versus ApoE^(−/−)mice.In addition,endothelial cell-specific NPRC knockout attenuated atherosclerotic lesions in mice.In contrast,endothelial cell overexpression of NPRC aggravated the size and instability of atherosclerotic aortic lesions in mice.Experiments in vitro showed that NPRC knockdown in human aortic endothelial cells(HAECs)inhibited ROS production,pro-inflammatory cytokine expression and endothelial cell apoptosis,and increased eNOS expression.Furthermore,NPRC knockdown in HAECs suppressed macrophage migration,cytokine expression,and phagocytosis via its effects on endothelial cells.On the contrary,NPRC overexpression in endothelial cells resulted in opposite effects.Mechanistically,the anti-inflammation and anti-atherosclerosis effects of NPRC deletion involved activation of cAMP/PKA pathway,leading to downstream upregulated AKT1 pathway and downregulated NF-κB pathway.In conclusion,NPRC deletion reduced the size and instability of atherosclerotic lesions in ApoE^(−/−)mice via attenuating inflammation and endothelial cell apoptosis and increasing eNOS expression by modulating cAMP/PKA-AKT1 and NF-κB pathways.Thus,targeting NPRC may provide a promising approach to the prevention and treatment of atherosclerosis.

Chinese consensus on the diagnosis and treatment of immunoglobulin light-chain cardiac amyloidosis

Epidemiology of Amyloid Light-Chain Cardiac Amyloidosis(AL-CA)The annual incidence of amyloid light-chain(AL)amyloidosis is 3-5/million,and the incidence in men is slightly higher than that in women.Approximately,70%of patients with newly diagnosed AL amyloidosis have cardiac involvement.