Impact of non-alcoholic fatty liver disease on coronavirus disease 2019: A systematic review

BACKGROUND Many studies have revealed a link between non-alcoholic fatty liver disease(NA-FLD)and coronavirus disease 2019(COVID-19),making understanding the relationship between these two conditions an absolute requirement.AIM To provide a qualitative synthesis on the currently present data evaluating COVID-19 and NAFLD.METHODS This systematic review was conducted in accordance with the guidelines pro-vided by preferred reporting items for systematic reviews and meta-analyses and the questionnaire utilized the population,intervention,comparison,and outcome framework.The search strategy was run on three separate databases,PubMed/MEDLINE,Scopus,and Cochrane Central,which were systematically searched from inception until March 2024 to select all relevant studies.In addition,ClinicalTrials.gov,Medrxiv.org,and Google Scholar were searched to identify grey literature.RESULTS After retrieval of 11 studies,a total of 39282 patients data were pooled.Mortality was found in 11.5%and 9.4%of people in NAFLD and non-NAFLD groups.In all,23.2%of NAFLD patients and 22%of non-NAFLD admissions diagnosed with COVID-19 were admitted to the intensive care unit,with days of stay varying.Ventilatory support ranged from 5%to 40.5%in the NAFLD cohort and from 3.1%to 20%in the non-NAFLD cohort.The incidence of acute liver injury showed significance.Clinical improvement on days 7 and 14 between the two classifications was significant.Hospitalization stay ranged from 9.6 days to 18.8 days and 7.3 days to 16.4 days in the aforementioned cohorts respectively,with 73.3%and 76.3%of patients being discharged.Readmission rates varied.CONCLUSION Clinical outcomes except mortality consistently showed a worsening trend in patients with NAFLD and concomitant COVID-19.Further research in conducting prospective longitudinal studies is essential for a more powerful conclusion.

Diagnostic accuracy of the multi-target stool DNA test in detecting colorectal cancer:A hospital-based study

BACKGROUND The multi-target stool DNA test(MT-sDNA)has potential utility in the detection of colorectal cancer(CRC),but validation of its clinical accuracy has been limited in China.AIM To evaluate the diagnostic performance of MT-sDNA and investigate the combined diagnostic value of alpha-fetoprotein(AFP),carcinoembryonic antigen(CEA),and carbohydrate antigen 199(CA199)with MT-sDNA in CRC and adenomas.METHODS We evaluated the performance of the MT-sDNA kit based on a hospital clinical trial.In this case-control study,135 participants from the Affiliated Hospital of Medical School of Ningbo University,including 51 CRC patients,23 patients with adenomas,and 61 healthy controls were enrolled.We used a risk scoring system to determine the positivity of tests with histological diagnosis or colonoscopy as the reference standard.RESULTS The main indices of sensitivity,specificity and accuracy were evaluated.The sensitivity and specificity for CRC detection were 90.2%and 83.3%,respectively,with an accuracy of 89.8%.For adenoma,the sensitivity and specificity were 56.5%and 68.9%,respectively,with an accuracy of 73.1%.The sensitivity and specificity of MT-sDNA combined with CEA in the diagnosis of adenoma were 78.3%and 60.7%,respectively.CONCLUSION The MT-sDNA test showed better performance in the detection of CRC,which was superior to AFP,CEA,and CA199 separately,but not for predicting adenomas.The combination of MT-sDNA with CEA further improved the sensitivity for adenoma diagnosis.

Effects of Acute Normovolemic Hemodilution on Perioperative Coagulation and Fibrinolysis in Elderly Patients Undergoing Hepatic Carcinectomy

Objective To observe the effects of acute normovolemic hemodilution （ANH） on coagulation function and fibrinolysis in elderly patients undergoing hepatic carcinectomy. Methods Thirty elderly patients （aged 60-70 years） with liver cancer （American Society of Anesthesiologists physical status I-II） scheduled for hepatic carcinectomy from February 2007 to February 2008 were randomly divided into ANH group （n= 15） and control group （n= 15）. After tracheal intubation, patients in ANH group and control group were infused with 6% hydroxyethyl starch （HES） （130/0.4）, and basic liquid containing 6% HES and routine Ringer＇s solution, respectively. In all the studied patients, blood samples were drawn at five different time points： before anesthesia induction （T1）, 30 minutes after ANH （T2）, 1 hour after start of operation （T3）, immediately after operation （T4）, and 24 hours after operation （Ts）. Then co- agulation function, soluble fibrin monomer complex （SFMC）, prothrombin fragment （F1＋2）, and platelet membrane glycoprotein （activated GPIIb/GPIIIa and P-selectin） were measured. Results The perioperative blood loss was not significantly different between the two groups （P〉 0.05）. The volume of allogeneic blood transfusion in ANH group was significantly smaller than that in control group （350.5±70.7 mL vs. 457.8±181.3 mL, P〈0.01）. Compared with the data ofT1, prothrombin time （PT） and activated partial thromboplastin time in both groups prolonged significantly after T3 （P〈0.05）, but still within normal range. There were no significant changes in thrombin time and D-dimer between the two groups and between different time points in each group （all P〉0.05）. SFMC and F1 ＋2 increased in both groups, but without statistical significance. P-selectin expression on the platelet surface of ANH group was significantly lowered atT2 andT3 compared with the level atT1 （P〈 0.05）. Compared with control group, P-selectin was sig-nificantly lower in ANH group atT2-T3 （all P〈0.05）. Conclusions In elderly patients undergoing resection of liver cancer, ANH may not hamper fibri- nolvsis and coagulation function. It coukt therefore be safe to largely reduce allogeneic blood transfusion.

Long non-coding RNAs involved in metastasis of gastric cancer

Gastric cancer(GC) is one of the most frequently diagnosed malignant diseases. The molecular mechanisms of metastasis remain unclear. Recently, studies have shown that long non-coding RNAs(lncRNAs) play critical roles in metastasis. Therefore, deeper understanding of this mechanism could provide potential diagnostic tools and therapeutic targets for metastatic GC. This review focuses on dysregulated lncRNAs in GC metastases. Due to the identification of multiple diverse mechanisms involved in GC metastasis, we classified them into seven categories, including lncRNAs related to epithelialmesenchymal transition, regulation of degradation of extracellular matrix, angiopoiesis, vasculogenic mimicry, and immunologic escape. As the TNM stage is pivotal for evaluating the severity and prognosis of GC patients, we summarize the lncRNAs relevant to lymphatic metastasis, distant metastasis and TNM classification. This review summarizes the lncRNAs related to metastasis, which may provide insight into the mechanisms, and provide potential markers for prognostic prediction and monitoring the relapse of GC.

Leukocyte cell-derived chemotaxin 2 inhibits development of atherosclerosis in mice

Leukocyte cell-derived chemotaxin 2 (LECT2), a multifunctional hepatokine, is involved in many pathological conditi ons. However, its role in atherosclerosis remains undefined. In this study, we admimistered vehicle or LECT2 to male Apoe^-/- mice fed a Western diet for 15 weeks. Atherosclerotic lesions were visualized and quantified with Oil-red O and hematoxylin staining. The mRNA expression levels of MCP-1, MMP-1, IL-8 IL-1β, and TNF-a were analyzed by quantitative real-time polymerase chain reaction. Serum TNF-a, IL-1β, IL-8, MCP-1, and MMP-1 concentrations were measured by en zyme-li nked immuno sorbent assay. CD68, CD31, and a-SMA, markers of macrophages, endothelial cells, and smooth muscle cells, respectively, were detected by immuno staining. Results showed that LECT2 reduced total cholesterol and low-density lipoprotein concentrations in serum and inhibited the development of atherosclerotic lesions, accompanied by reductions in inflammatory cytokines and lower MCP-1, MMP-1, TNF-a, IL-8, and IL-1β mRNA abundanee. Furthermore, LECT2 decreased CD68, but in creased cr SMA in atherosclerotic lesi ons, suggesting an in crease in smooth muscle cells and reduction in macrophages. In summary, LECT2 inhibited the development of atherosclerosis in mice, accompanied by reduced serum total cholesterol concentration and lower inflammatory responses.

Effect of dopamine on bone morphogenesis protein-2 expression in human retinal pigment epithelium

AIM：To investigate the effect of dopamine on bone morphogenesis protein-2（BMP-2）expression in retinal pigment epithelium（RPE）cells in vitro.METHODS：ARPE-19 cells as a human RPE cell line were cultured with dopamine for different times（2,4,6,8,12,16and 24h）or with different concentrations（0.1,1,2,5,10,20,and 100μg/m L）in vitro.BMP-2 m RNA expression level in ARPE-19 cells was analyzed with real-time polymerase chain reaction（PCR）analysis and BMP-2 protein level was measured with Western blot analysis.The active form of BMP-2 in the culture medium was measured with enzymelinked immunosorbent assay（ELISA）.RESULTS：The expression level of BMP-2 increased significantly cultured with 20μg/m L dopamine,at different time points（P〈0.05）.BMP-2 m RNA level peaked 2h and the protein level peaked at 6 and 8h after treatment.The concentrations of secreted BMP-2 elevated at 12h and peaked at 24h（P〈0.05）in a time-dependent manner.Treated with 100μg/m L dopamine for 6h,the expression levels of BMP-2 m RNA and protein in ARPE-19 cells were enhanced significantly compared to that in the untreated cells（P〈0.05）.And secreted BMP-2 protein in the cell culture supernatant was also increased（P〈0.05）.CONCLUSION：Dopamine up-regulate BMP-2 expression in RPE cells,and this may be associated with its inhibitive effect on myopia development.

Biological roles and potential clinical values of circular RNAs in gastrointestinal malignancies

Circular RNAs(circ RNAs),a class of endogenous RNA molecules,are produced by alternative splicing of precursor RNA and are covalently linked at the 5′and 3′ends.Recent studies have revealed that dysregulated circ RNAs are closely related to the occurrence and progression of gastrointestinal malignancies.Accumulating evidence indicates that circ RNAs,including circ PVT1,circ LARP4,circ-SFMBT2,cir-ITCH,circ RNA_100782,circ_100395,circ-DONSON,hsa_circ_0001368,circ NRIP1,circ FAT1(e2),circ CCDC66,circ SMARCA5,circ-ZNF652,and circ_0030235 play important roles in the proliferation,differentiation,invasion,and metastasis of cancer cells through a variety of mechanisms,such as acting as micro RNA sponges,interacting with RNA-binding proteins,regulating gene transcription and alternative splicing,and being translated into proteins.With the characteristics of high abundance,high stability,extensive functions,and certain tissue-,time-and diseasespecific expressions,circ RNAs are expected to provide novel perspectives for the diagnoses and treatments of gastrointestinal malignancies.

Infective severe acute pancreatitis:A comparison of ^(99m)Tc-ciprofloxacin scintigraphy and computed tomography

AIM:To evaluate 99mTc-ciprofloxacin scintigraphy compared with computed tomography(CT)for detecting secondary infections associated with severe acute pancreatitis(SAP)in swine.METHODS:Six healthy swine were assigned to a normal control group(group A,n = 6).SAP was induced in group B(n = 9)and C(n = 18),followed by inoculation of the resulting pancreatic necroses with inactive Escherichia coli(E.coli)(group B)and active E.coli(group C),respectively.At 7 d after inoculation,a CT scan and a series of analyses using infecton imaging(at 0.5,1,2,3,4 and 6 h after the administration of 370 MBq of intravenous infecton)were performed.The scintigrams were visually evaluated and semi-quantitatively analyzed using region of interest assignments.The differences in infecton uptake and changes in the lesion-background radioactive count ratios(L/B)in the 3 groups were recorded and compared.After imaging detection,histopathology and bacterial examinations were performed,and infected SAP was regarded as positive.The imaging findings were compared with histopathological and bacteriological results.RESULTS:In group A,6 animals survived without infection in the pancreas.In group B,7/9 swine survived and one suffered from infection.In group C,15/18 animals survived with infection.Hence,the number of normal,non-infected and infected SAP swine was 6,6 and 16,respectively.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of the infecton method were 93.8%(15/16),91.7%(11/12),92.9%(26/28),93.8%(15/16)and 91.7%(11/12),whereas these values for CT were 12.5%(2/16),100.0%(12/12),50.0%(14/28),100.0%(2/2)and 46.2%(12/26),respectively.The changes in L/B for the infected SAP were significantly different from those of the non-infected and normal swine(P < 0.001).The mean L/B of the infectious foci at 0.5,1,2,3,4 and 6 h was 1.17 ± 0.10,1.71 ± 0.30,2.46 ± 0.45,3.36 ± 0.33,2.04 ± 0.37 and 1.1988 ± 0.09,respectively.At 3 h,the radioactive counts(2350.25 ± 602.35 k)and the mean L/B of the infectious foci were significantly higher than that at 0.5 h(P = 0.000),1 h(P = 0.000),2 h(P = 0.04),4 h(P = 0.000)and 6 h(P = 0.000).CONCLUSION:99m Tc-ciprofloxacin scintigraphy may be an effective procedure for detecting SAP secondary infections with higher sensitivity and accuracy than CT.

Port-site metastasis of unsuspected gallbladder carcinoma with ossification after laparoscopic cholecystectomy:A case report

BACKGROUND Unsuspected gallbladder carcinoma(UGC)refers to cholecystectomy due to benign gallbladder disease,which is pathologically confirmed as gallbladder cancer during or after surgery.Port-site metastasis(PSM)of UGC following laparoscopic cholecystectomy is rare,especially after several years.CASE SUMMARY A 55-year-old man presenting with acute cholecystitis and gallstones was treated by laparoscopic cholecystectomy in July 2008.Histological analysis revealed unexpected papillary adenocarcinoma of the gallbladder with gallstones,which indicated that the tumor had spread to the muscular space(pT1b).Radical resection of gallbladder carcinoma was performed 10 d later.In January 2018,the patient was admitted to our hospital for a mass in the upper abdominal wall after surgery for gallbladder cancer 10 years ago.Laparoscopic exploration and complete resection of the abdominal wall tumor were successfully performed.Pathological diagnosis showed metastatic or invasive,moderately differentiated adenocarcinoma in fibrous tissue with massive ossification.Immunohistochemistry and medical history were consistent with invasion or metastasis of gallbladder carcinoma.His general condition was well at follow-up of 31 mo.No recurrence was found by ultrasound and epigastric enhanced computed tomography.CONCLUSION PSM of gallbladder cancer is often accompanied by peritoneal metastasis,which indicates poor prognosis.Once PSM occurs after surgery,laparoscopic exploration is recommended to rule out abdominal metastasis to avoid unnecessary surgery.

Effects of electroacupuncture versus nimodipine on long-term potentiation and synaptophysin expression in a rat model of vascular dementia

The present study stimulated Baihui （DU 20） and Dazhui （DU 14） acupoints in a rat model of vascular dementia with electroacupuncture to investigate changes in long-term potentiation and synaptophysin expression in the hippocampus. The results revealed that synaptophysin expression in brain tissues was increased after electroacupuncture. After high4requency stimulation, the population spike latency was shortened and the excitatory postsynaptic potential slope and population spike amplitude were increased. In addition, cognitive function was enhanced, similar to the effects of intragastric perfusion of nimodipine. The results indicated that electroacupuncture at Baihui and Dazhui acupoints can improve learning and memory functions of a rat model of vascular dementia by promoting synaptophysin expression, enhancing hippocampal synaptic plasticity and accelerating synaptic transmission.

Effect of early psychedelic use on social func⁃tion in adulthood

Psychedelic is one of psychoac⁃tive drug substances which leads to abnormali⁃ties in thinking,mood and sensory perception via the subtype of 5-HT receptor(5-HT2A receptor).Psychedelic is known to cause schizophrenia-like symptoms or worsen schizophrenia.Mean⁃while it causes abnormalities in neural synchroni⁃zation and oscillations.In recent years,with the prevalence of various new psychedelic drugs and the rising population of young addicts,the clinical effects of psychedelic have been highly concerned.Adolescence is an important period for the formation of neuroplasticity,and it is an important stage in the functional development and maturation of the central nervous system.However,it is currently unclear about the endur⁃ing effects of juvenile exposure to psychedelic on social behavior,and neural network function.OBJECTIVE The chronic exposure model of psy⁃chedelic(2CC-NBOMe,2CC)in rats was used to reveal the enduring effects on social behavior and neural network function in adulthood,which is intended to provide important reference infor⁃mation about the potential enduring effects and clinical applicability of psychedelic.METHODS Repeated exposure of normal saline in adoles⁃cence group(0.1 mL·kg-1,for 14 d),repeated exposure of 2CC group(0.1 mg·kg-1,for 14 d).The duration of adolescent administration was 35-48 d after birth.Adulthood means 9 weeks after birth.Behavioral and somatic neuroelectro⁃physiological experiments were performed 9-12 weeks after birth in the adolescent drug exposure group.RESULTS Psychedelic-exposed animals during adolescence showed a significant decline in social rank and an increase in social willingness.Coherence of theta waves(6-10 Hz)from the hippocampal CA1 to the orbital frontal cortex(Orb)was significantly reduced in the psy⁃chedelic-exposed animals compared to the con⁃trol animals.During the social task,the coher⁃ence of theta waves between CA1 and Orb was significantly reduced in the control animals,but not in the psychedelic-exposed animals.CON⁃CLUSION The altered social function caused by chronic psychedelic exposure during adoles⁃cence is associated with abnormal CA1-Orb theta wave coherence.

IgE Reactivity of Potential Allergens from the Swimming Crab Portunus trituberculatus and the Research of ELISA Reagent for Detecting Crab Food Anaphylaxis

Crustacean is one of the major allergic foods.It is of great significance to identify more crab allergens and research the detection methods for crab food anaphylaxis.In this study,IgE reactivity to three recombinant proteins from Portunus trituberculatus,including tropomyosin(rPtTM),myosin light chain(rPtMLC),and pancreatic lipase(rPtPL),were detected by enzyme-linked im-munosorbent assay(ELISA).The expressions of tropomyosin(TM)in various tissues of P.trituberculatus were detected by Western blot(WB).Furthermore,microplates were coated with rPtTM and the ELISA conditions were optimized.The cut-off value was deter-mined by the receiver operating characteristic(ROC)curve.Among 51 crab-allergic sera,21(41.2%)showed positive IgE to rPtTM.Other 70 crab-allergic sera more frequently recognized rPtPL(9/70;12.9%),followed by rPtMLC(1/70;1.4%).WB results showed that TM was mainly expressed in the muscle,followed by the heart and a small amount in gills and the testis.The optimal results showed that the coating condition of rPtTM was 50 ng per well with coating for 3 h at 37℃.The optimal blocking condition was 1.2%BSA with blocking for 3 h at 37℃,and the optimal dilution of the second antibody was 1:1500.The ROC curve showed that the ELISA reagent had high sensitivity(83.52%)and specificity(98.00%)when the cut-off value was 0.45.All results indicated that tropomyosin is the major allergen of P.trituberculatus,and myosin light chain and pancreatic lipase are the potential allergens.Addi-tionally,the ELISA reagent developed with the rPtTM was feasible for laboratory detection of crab anaphylaxis.

Cross-modality PET/CT and contrast-enhanced CT imaging for pancreatic cancer

AIM:To explore the diagnostic value of the crossmodality fusion images provided by positron emission tomography/computed tomography(PET/CT) and contrast-enhanced CT(CECT) for pancreatic cancer(PC).METHODS:Data from 70 patients with pancreatic lesions who underwent CECT and PET/CT examinations at our hospital from August 2010 to October 2012were analyzed.PET/CECT for the cross-modality image fusion was obtained using Ture D software.The diagnostic efficiencies of PET/CT,CECT and PET/CECT were calculated and compared with each other using aχ2 test.P<0.05 was considered to indicate statistical significance.RESULTS:Of the total 70 patients,50 had PC and 20had benign lesions.The differences in the sensitivity,negative predictive value(NPV),and accuracy between CECT and PET/CECT in detecting PC were statistically significant(P<0.05 for each).In 15 of the 31patients with PC who underwent a surgical operation,peripancreatic vessel invasion was verified.The differences in the sensitivity,positive predictive value,NPV,and accuracy of CECT vs PET/CT and PET/CECT vs PET/CT in diagnosing peripancreatic vessel invasionwere statistically significant(P<0.05 for each).In 19of the 31 patients with PC who underwent a surgical operation,regional lymph node metastasis was verified by postsurgical histology.There was no statistically significant difference among the three methods in detecting regional lymph node metastasis(P>0.05for each).In 17 of the 50 patients with PC confirmed by histology or clinical follow-up,distant metastasis was confirmed.The differences in the sensitivity and NPV between CECT and PET/CECT in detecting distant metastasis were statistically significant(P<0.05 for each).CONCLUSION:Cross-modality image fusion of PET/CT and CECT is a convenient and effective method that can be used to diagnose and stage PC,compensating for the defects of PET/CT and CECT when they are conducted individually.

Dietary Patterns Associated Metabolic Syndrome in Chinese Adults

Dietary pattern has been revealed to be associated with metabolic syndrome. However, the association was not well documented in Chinese due to the complexity of Chinese foods. We mainly assessed the dietary patterns and examined their effects on metabolic syndrome among Chinese adults. Four dietary patterns including ＇Refined Grains ＆ Vegetables＂ Pattern, ＇Dairy ＆ Eggs＇ Pattern, ＇Organ Meat ＆ Poultry＇ Pattern, and ＇Coarse Grains ＆ Beans＇ Pattern were extracted. ＇Dairy ＆ Eggs＇ Pattern was associated with a decreased odds of metabolic syndrome in women, and ＇Coarse Grains ＆ Beans＇ Pattern was associated with a decreased odds of hypertension in men. These results provided a scientific basis for future research and dietarv euideline Perfection.

Signet ring cell carcinoma hidden beneath large pedunculated colorectal polyp:A case report

BACKGROUND Large pedunculated colorectal polyps are not frequent among colonic polyps.We present a clinical case of a large pedunculated colorectal polyp with signet ring cell cancer infiltrating the submucosa and lymph node invasion in a patient who ultimately underwent additional surgery.Clinicians should attach importance to pedunculated colorectal polyps and choose the most appropriate therapy.CASE SUMMARY A 52-year-old female farmer underwent routine screening colonoscopy and denied constipation,diarrhea,hematochezia,or other gastrointestinal symptoms.Her past medical history and general biochemical examination results were unremarkable.During the colonoscopy,a 25-mm pedunculated polyp in the sigmoid colon was identified.The superficial epithelium was macroscopically congestive,rough,and granular,showing characteristic features of adenoma.We first ligated the root of the pedunculated polyp using nylon loops as well as a titanium clip.Histopathological examination revealed high-grade intraepithelial neoplasia of the tumor surface and a negative margin with signet ring cell adenocarcinoma infiltrating the submucosal layer.The deepest infiltration was approximately 0.9 cm from the tumor surface and 0.55 cm from the stratum basale.We performed radical resection of the left colon with lymph node dissection after two weeks.The lesion was completely resected,and pathological assessment revealed signet ring cell adenocarcinoma infiltrating the submucosal layer as well as lymph node invasion(stage PT1N1M0 and grade IIIA in pathological grading,NRAS-,BRAF V600E-,KRAS-).CONCLUSION This case highlights the importance of paying attention to the malignancy of large pedunculated polyps.Polyps or adenomas removed via endoscopy must be evaluated histologically.Even if adenomas may be fragile,endoscopy doctors should still remove polyps as completely as possible and choose perpendicular sections through the stalk and base to fix by formaldehyde solution.

A novel CRX mutation by whole-exome sequencing in an autosomal dominant cone-rod dystrophy pedigree

AIMTo identify the disease-causing gene mutation in a Chinese pedigree with autosomal dominant cone-rod dystrophy (adCORD).METHODSA southern Chinese adCORD pedigree including 9 affected individuals was studied. Whole-exome sequencing (WES), coupling the Agilent whole-exome capture system to the Illumina HiSeq 2000 DNA sequencing platform was used to search the specific gene mutation in 3 affected family members and 1 unaffected member. After a suggested variant was found through the data analysis, the putative mutation was validated by Sanger DNA sequencing of samples from all available family members.RESULTSThe results of both WES and Sanger sequencing revealed a novel nonsense mutation c.C766T (p.Q256X) within exon 5 of CRX gene which was pathogenic for adCORD in this family. The mutation could affect photoreceptor-specific gene expression with a dominant-negative effect and resulted in loss of the OTX tail, thus the mutant protein occupies the CRX-binding site in target promoters without establishing an interaction and, consequently, may block transactivation.CONCLUSIONAll modes of Mendelian inheritance in CORD have been observed, and genetic heterogeneity is a hallmark of CORD. Therefore, conventional genetic diagnosis of CORD would be time-consuming and labor-intensive. Our study indicated the robustness and cost-effectiveness of WES in the genetic diagnosis of CORD.

Triptolide for cerebral ischemia/reperfusion injury

BACKGROUND： Studies have demonstrated that triptolide has good anti-inflammatory and immunosuppressive effects. However, the effect of triptolide on cerebral ischemia/reperfusion injury is still unclear. OBJECTIVE： To observe the effects of triptolide on neurologic function, infarct volume, water content of brain tissue, neutrophil number in microvascular wall and interleukin-1β （IL-1β ） expression in rat models of local ischemia/reperfusion, and analyze the mechanism of triptolide for protecting brain. DESIGN： Randomized controlled experiment. SETTING： Department of Pathology, Medical School of Ningbo University; Department of Forensic Medicine, Tongji Medical College of Huazhong University of Science and Technology. MATERIALS： Sixty Wistar rats of either gender, aged 4 months old, weighing from 200 to 250 g, were provided by the Experimental Animal Center, Tongji Medical College, Huazhong University of Science and Technology. Triptolide was purchased from Fujian Institute for Medical Science （purity 99.98%; Batch No. 2000215）. It was dissolved in 20 g/L propanediol, and filtered with 200-mesh filter for later use. METHODS： This experiment was carded out in the laboratory of Forensic Medicine, Tongji Medical College of Huazhong University of Science and Technology, Department of Pathology, Medical School of Ningbo University between January 2001 and September 2004. ① Sixty Wistar rats were randomized into 4 groups： sham-operation group, model group, low-dose triptolide group and high-dose triptolide group. Rats in each group, except for sham-operation group, were developed into rat models of cerebral ischemia/reperfusion according to the method of Longa et al. In the first 3 days of modeling, rats in the lowand high-dose triptolide groups were intraperitoneally injected with 0.2 and 0.4 mg/kg triptolide respectively, once a day, 3 days in total. ② At ischemia 1 hour and reperfusion 24 hours, infarct volume, neurologic deficit （five-point scale, higher scores indicated poor neurologic function）, water content of brain tissue, neutrophil number in microvascular wall in the middle cerebral artery occlusive side of rats were detected, meanwhile, brain tissue injury degree and IL-1β immunohistochemical staining changes in brain-derived nerve ceils were observed under the optical microscope. MAIN OUTCOME MEASURES： Neurologic deficit, infarct volume percentage, water content of brain tissue, neutrophil number in microvascular wall and positive rate of IL-1β immunoreaction. RESULTS： Sixty rats were all involved in the final analysis. ①Neurologic deficit scores of rats in the lowand high-dose triptolide groups were （ 1.96 ± 0.14 ） and （ 1.75 ± 0.16）points respectively, which were both significantly lower than those in model group [ （2.58±0.11） points, P 〈 0.05, 0.01].②Infarct volume percentages of rats in low- and high-dose triptolide groups were significantly lower than that in model group separately （P 〈 0.05, 0.01）. ③Water content of brain tissue of rats in model group was significantly higher than that in the sham-operation group [ （82.35±1.26） % vs. （76.65±1.17） %, P 〈 0.01]; Water content of brain tissue of rats in the low- and high-dose triptolide groups was respectively （80.15± 1.43） %, （78.23 ± 1.15） %, which was significantly lower than that in the model group （P 〈 0.05, 0.01）. ④Pathological changes of brain tissue of rats： Under the optical microscope, infarct focus was not found in the brain tissue of rats in the sham-operation group, while clear infarct focus could be found in the brain tissue of rats in the model group; Although infarct focus was found in the brain tissue of rats in the low- and high-dose triptolide groups, the whole infarct area was contracted as compared as that in the model group. ⑤Neutrophil number in microvascular wall of brain tissue of rats in the low- and high dose triptolide groups was 10.60± 2.12, 8.11 ±1.21 respectively, which was significantly less than that in model group （ 16.25 ±1.96, P 〈 0.05, 0.01） . ⑥Positive rate of IL-1β immunoreaction in the brain tissue of rats in model group was significantly higher than that in the sham-operation group （P 〈 0.01）; and positive rate of IL-1β immunoreaction in the brain tissue of rats in low- and high-dose triptolide groups was significantly lower than that in the model group （P 〈 0.05, 0.01）, but higher than that in the sham-operation group, without significant difference （P 〉 0.05）. CONCLUSION： Triptolide protects against cerebral ischemia/reperfusion injury of rats that may be related with anti-inflammations. Triptolide inhibits IL-1β expression in brain tissue and reduces the attachment and aggregation of neutrophils in blood capillary, and further inhibits the infiltration of blood white cells, thus, it will lessen cerebral injury, contract cerebral infarct and improve cerebral function.

Simple cholangitis induces extremely and recurrently elevated serum carbohydrate antigen 19-9 level

To the Editor: The carbohydrate antigen 19-9 (CA19-9) is a tumor maker which is usually used in biliary and pancreatic malignancies [1]. However, the specificity of CA19-9 can be reduced by biliary inflammation and other benign diseases [2].

S4A-4 Cognitive Enhancers as A Treatment for Heroin Relapse

Rationale:Heroin addiction is a disorder that stems from maladaptive plasticity within neural circuits and produces broad cognitive deficits.Despite considerable advances in psychotherapy and pharmacotherapy for heroin addiction,but there are a few treatments for the heroin relapse after long term abstinence.Preclinical and clinical evidence indicates that the cognitive deficit during the addiction and withdrawal process,thus,cognitive enhancers may be used to treatment for heroin addiction.Objectives:The purpose of this study was to evaluate whether the cognitive enhancers would reduce the heroin relapse induced by cues which was associated with heroin reward or heroin priming in rat.Methods:Rats were trained to self-administer heroin under fixed ratio 1 schedule for two weeks and extinguished for 10 days,then the reinstatement of drug seeking induced by conditioned cues or heroin priming(250μg·kg-1,sc)was used.Results:We evaluated systemically the effects of acetylcholinase inhibitor,PDE4 inhibitor,mGlu2/3 agonist or mGlu1/5 antagonist,etc on heroin relapse.The data showed that pretreatment with acetylcholinase inhibitor,PDE4 inhibitor,mGlu2/3 agonist or mGlu1/5 antagonist could inhibit the heroin relapse induced by cues or heroin priming in a dose-dependent manner.Meanwhile,we also illustrated the circuits and signal pathway of these compounds.Conclusion:The data demonstrated that Cognitive enhancers could be used as the pharmacological treatments for heroin relapse or addiction.

Comparison of a minimally invasive osteosynthesis technique with conventional open surgery for transverse patellar fractures

Parpose:The study aims to compare the efficacy and safety of a new minimally invasive osteosynthesis technique with those of conventional open surgery for transverse patellar fractures.Methods:It was a retrospective study.Adult patients with closed transverse patellar fracture were included,and with open comminuted patellar fracture were excluded.These patients were divided into minimally invasive osteosynthesis technique(MIOT)group and open reduction and internal fixation(ORIF)group.Surgical time,frequency of intraoperative fluoroscopy,visual analogue scale score,flexion,extension,Lysholm knee score,infection,malreduction,implant migration and implant irritation in two groups were recorded and compared.Statistical analysis was performed by the SPsS software package(version 19).A p<0.05 indicated statistical significance.Results:A total of 55 patients with transverse patellar fractures enrolled in this study,the minimally invasive technique was performed in 27 cases,and open reduction was performed in 28 cases.The surgical time in the ORIF group was shorter than that in the MIOT group(p=0.033).The visual analogue scale scores in the MIOT group were significantly lower than those in the ORIF group only in the first month after surgery(p=0.015).Flexion was restored faster in the MIOT group than that in the ORIF group at one month(p=0.001)and three months(p=0.015).Extension was recovered faster in the MIOT group than that in the ORIF group at one month(p=0.031)and three months(p=0.023).The recorded Lysholm knee scores in the MIOT group were always greater than those in the ORIF group.Complications,such as infection,malreduction,implant migration,and implant irritation,occurred more frequently in the ORIF group.Conclusion:Compared with the ORIF group,the MIOT group reduced postoperative pain and had less complications and better exercise rehabilitation.Although it requires a long operation time,MIOT may be a wise choice for transverse patellar fractures.