Objective To investigate the effect of ketamine injected into the ventral posteromedial nucleus (VPM) of the thalamus on sensory processing of thalamocortical circuits in rats.Methods Twenty-four SpragueDawley rats in which the neurophysiological model was successfully established,aged 2 months,weighing 280-350g,were randomly divided into 4 groups (n=6 each):control group (group C),specific inhibitor of NMDA receptors AP-5 group (group A) and two different concentrations of ketamine groups (K1 and K2 groups).Normal saline 1 μl,AP-5 5 μg/μl and ketamine 12.5 and 25.0 μg/μl were injected into the VPM in A,AP-5,K1 and K2groups,respectively.Somatosensory-evoked potentials (SEPs) in the primary somatosensory cortex (S1) of the rat was recoded at 4 time periods:300 s before administration-immediately after administration (baseline,T0),immediately after administration-300 s after administration (T1),300-600 s after administration (T2),600-900 s after administration (T3).Results Compared with the baseline value at T0,there was no significant difference in the peak amplitude of SEPs at T1-3 in group C (P ＞ 0.05),and the peak amplitude of SEPs was significantly decreased at T1-3 in A,K1 and K2 groups (P ＜ 0.05).Compared with group C,the peak amplitude of SEPs was significantly decreased at T1-3 in A,K1 and K2 groups (P ＜ 0.05).Compared with group A,the peak amplitude of SEPs was significantly increased at T3 in group K1 (P ＜ 0.05).There was no significant difference in the peak amplitude of SEPs between A and K2 groups,K1 and K2 groups (P ＞ 0.05).Conclusion Ketamine results in damage to the integrity of sensory processing of thalamocortical circuits and reduction of incoming sensory information,and the mechanism may be related to blockade of NMDA receptors in VPM of the thalamus.

Objective To study the effect of Shengmai injection on the platelet parameters and CD4+CD25+cells in peripheral blood of patients with chronic lymphocytic leukemia,and to explore the optimal regimen for patients with chronic lymphocytic leukemia.Methods One hundred and twenty patients with chronic lymphocytic leukemia were enrolled in this study from January 2012 to December 2014.(D1),vincristine 4mg(d1),prednisone 60 mg/d(d1-5)were given to the CHOP regimen in the control group: cyclophosphamide 600 mg/m2(d1),doxorubicin 25 mg/m2(d12)28d a course of treatment,a total of 4 courses,the observation group of patients in the control group of patients treated on the basis of Shengmai injection,compared the two groups of patients with chemotherapy,platelet parameters and serum CD4+CD25+T cells and Th17 cells.Results After treatment,the PLT,MPV and PDW of the observation group were(215.4± 31.7),(9.5±2.5)and(16.9±2.4),respectively,which were significantly higher than those of the control group.The CD4+CD25+T cells in the observation group were(1.5±0.8)The total effective rate of the control group was 35.0％,the total effective rate was 35.0％,and the total effective rate of the control group was 35.0％.There were significant difference between the control group and the control group(P<0.05),The difference was statistically significant.Conclusion Shengmai injection combined with CHOP regimen in chronic lymphocytic leukemia patients can improve immune function,promote platelet growth,improve platelet clinical parameters,and help improve the efficiency of chemotherapy,compared with CHOP alone Program treatment is better,worthy of clinical application.

Objective To analyse the influence of esmolol on plasma N terminal pro-brain natriuretic peptide ( NT-proBNP) , heart-type fatty acid binding protein ( H-FABP) and cardiac function in acute cerebral infarction patients with myocardial enzyme abnormalities.Methods 86 acute cerebral infarction patients with myocardial enzyme abnormalities from September 2010 to July 2014 in our hospital were selected and divided into experimental group and control group randomly (43 cases in each group).All patients were accompanied by myocardial enzyme abnormalities, patients in control group were given basic treatment, while patients in experimental group were given esmolol hydrochloride intravenous injection on the basis of control group.Plasma NT-proBNP, H-FABP levels and cardiac function were analyzed in two groups.Results Myocardial enzyme levels had no significant difference between two groups on admission.Plasma NT-proBNP levels also had no statistical differences after admission hospital of 6 h, 15 h and 3 d , and experimental group was significantly lower than control group ( P<0.05 ) after admission hospital of 5 day and 7 days.H-FABP levels had no statistical differences after admission hospital of 6 h, 15 h, and the experimental group was significantly lower than the control group (P<0.05) after admission hospital of 3, 5, 7 days.Cardiac function with Killip classification showed no significant difference when on admission and after admission hospital of 3 days, and the experimental group was significantly better than control group (P<0.05) after admission hospital of 5, 7 days.Conclusion Acute cerebral infarction patients with myocardial enzyme abnormalities given esmolol on the basic treatments significantly reduce NT-proBNP and HAFBP levels, and improve cardiac function, which is worthy of promotion in clinical applications.

Objective: To analyze relationships between levels of 24 hour movement (physical activity, screen time and sleep) and childhood obesity in students aged 7-18 years. Methods: This study used data from students aged 7-18 years in the 2015 China health and nutrition survey, and assessed levels of physical activity, screen time and sleep based on the Canadian 24 hour Movement Guidelines for Children and Youth. Associations between levels of 24 hour movement and childhood obesity were assessed using multivariable Logistic regression models. Results: The overall rate of overweight and obesity was 21.56%. Proportions of students meeting the guidelines for physical activity, screen time, sleep and three behaviors combined were 24.84%, 38.69%, 57.08%, and 6.77%, respectively. After adjusting for age, sex, location of residence and nationality, students meeting the sleep guideline were less likely to be overweight and obese than those who did not(OR=0.73)， students meeting both sleep and screen time guidelines had a lower risk in overweight and obesity than those met neither guidelines(OR=0.58)(P<0.05). However, other behaviors and behavior combinations showed no significant associations with overweight and obesity. Conclusion Only a small proportion of students met all three 24 hour movement guidelines. Ensuring adequate sleep and limiting excessive screen time may be an important strategy for childhood obesity prevention and management.

OBJECTIVETo study the clinicopathologic characteristics of extrarenal malignant rhabdoid tumor (E-MRT) with emphasis on diagnosis and differential diagnosis.

METHODSThe clinical and pathologic data of 8 E-MRT cases were reviewed. The outcome was analyzed.

RESULTSThere were four males and four females. The age at presentation ranged from 3 days to 8 years (mean, 2.6 years; median, 3 years). The tumors were located in the extremities (n = 1), head and neck (n = 2), trunk (n = 2), cervical cord (n = 1), liver (n = 1) and retroperitoneum (n = 1). Histologically, the tumors were composed of a diffuse proliferation of rounded or polygonal cells with eccentric nuclei, prominent nucleoli, and glassy eosinophilic cytoplasm containing hyaline-like inclusion bodies, arranged in sheets and nests. Cellular atypia was easily observed and mitotic activity was high. Necrotic and hemorrhagic areas were abundant. On immunohistochemistry, the tumor cells expressed vimentin and epithelial marker such as EMA, AE1/AE3, and CAM5.2. The absence of INI1 protein expression was a distinctive feature. Follow-up of all eight cases revealed five deaths in one year and the other three were disease-free at last follow-up of one month, three months and seven months.

CONCLUSIONSE-MRT is a rare and highly aggressive tumor of infancy and childhood. Recurrence and distant metastasis was common and the 5-year survival rate is low. Increased awareness of the clinocopathologic features and immunophenotypes of E-MRT is helpful for correct diagnosis and effective treatment.

Child ; Child, Preschool ; Diagnosis, Differential ; Extremities ; Female ; Head and Neck Neoplasms ; metabolism ; pathology ; Humans ; Immunohistochemistry ; Infant ; Infant, Newborn ; Male ; Neoplasm Recurrence, Local ; Retroperitoneal Neoplasms ; metabolism ; pathology ; Rhabdoid Tumor ; metabolism ; pathology ; Treatment Outcome ; Vimentin ; metabolism

Objective To observe the effect of pretreatment with Rhizoma Alismatis extract on cardiac function and cysteinyl aspartate specific protease-3 (caspase-3)in ischemia-reperfusion injury of rats.Methods Male Sprague-Dawley(SD)rats were randomized into a sham-operated group (S group),an ischemia-reperfusion group(IR group),Rhizoma Alismatis water extract group(S1 group),Rhizoma Alismatis alcohol extract group(S2 group)and Rhizoma Alismatis polysaccharide group(S3 group).At the end of 14-day of intragastric gavages,rats were subjected to 40 min(T1)of LAD(left anterior descending)coronary artery ligation (ischemia)and 120 min (T2)of ligation loosening (reperfusion),called as myocardial ischemia-reperfusion(IR)models.Then,at the end of T1 and T2,the left ventricular end diastolic pressure (LVEDP),left ventricular systolic pressure (LVSP),and maximum rise/fall rate of left intraventricular pressure(± dp/dtmax)were recorded respectively.The level of creatine kinase(CK)and lactate dehydrogenase(LDH)were determined.The area of myocardial infarction and the expression level of caspase-3 protein were tested.Results At end of T2,compared with the index values of IR group as a non-treatment control[LVEDP(6.70 ±0.22)mmHg,LVSP (86.16±15.11)mmHg,+dp/dtmax(997.99±151.03)mmHg,-dp/dtmax(663.71±68.55)mmHg,CK(10.54±2.04)U/L,LDH(296.51±7.00)U/L,the size of myocardial infarction(39.82±11.80)％and expression level of caspase-3(123.42±14.77)],the treatment groups of S1,S2,and S3 showed a lower levels of LVEDP [(5.89 ± 0.47) mmHg,(5.89 ± 0.67) mmHg,(6.07 ±0.51) mmHg],of activity of CK[(8.60± 1.67)U/L(8.90±1.27)U/L,(9.39±0.83) U/L],of LDH[(239.33±30.81) U/L,(223.63 ± 20.26) U/L,(241.19 ± 45.56) U/L],of size of myocardial infarction[(30.39 ± 5.44) ％,(32.18±5.90)％,(33.12±8.16)％],and of expression level of caspase3 protein[(73.44± 15.28),(65.47±12.53),(65.05± 10.45)],(all P＜0.01 or＜0.05);but showed a higher levels of LVSP[(99.24±12.00)mmHg,(97.05±12.45)mmHg,(97.06±7.61) mmHg],and of ±dp/dtmax [(1 137.33±85.70)mmHg,(1 147.24±118.07)mmHg,(1 124.50±141.47)mmHg];[(604.77± 68.37)mmHg,(616.61±46.73)mmHg,(708.76±81.44)mmHg],(all P＜0.01 or＜0.05).Conclusions Pretreatment with Rhizoma Alismatis extract can effectively improve the cardiac function of ischemic repeffusion injury in vivo in rats,and reduce myocardial infarction size and myocardial enzyme release.The mechanism may be related to the down-regulation of apoptotic protein caspase-3 in myocardial tissue.

Objective:To examine the effects of transcutaneous electrical acupoint stimulation(TEAS)on pain and rapid recovery in elderly patients undergoing thoracoscopic surgery.Methods:A total of 60 elderly patients undergoing thoracoscopic surgery were randomly divided into the TEAS group and the control group.Patients in the TEAS group received TEAS in bilateral acupoints of Hegu, Neiguan, Houxi and Zhigou at a frequency of 2/100 Hz for 30 min before anesthesia induction.The electrical stimulation intensity went from weak to strong, and gradually adjusted to the patient's maximum tolerance(10 to 15 mA)continuously for 30 min; TEAS continued during intraoperative anesthesia with a stimulation intensity of 30 mA and a frequency of 2/100 Hz until the end of surgery.Patients in the control group were given electrode pads at the same acupoints without electrical stimulation.Results:Compared with the control group, patients in the TEAS group were associated with significantly decreased doses of Sufentanil[(57.93±5.54)μg vs (44.30±4.03 )μg, t=-10.903, P=0.000)], Remifentanil[(1.56±0.26)μg vs (1.08±0.18)μg, t=-8.3043, P=0.000)], Propofol[(763.23±62.04)mg vs (559.20±46.44) mg, t=-14.420, P=0.000)]and Dexmedetomidine[(545.07±53.36) vs (301.67±43.27) μg, t=-19.405, P=0.000)], reduced frequency of analgesic pump pressing(9.9±2.0 vs 2.9±1.3, t=-10.903, P=0.000), decreased VAS scores 24 h(3.53±1.07 vs 1.90±0.66, t=-7.090, P=0.000)and 48 h(1.37±0.61 vs 0.93±0.37, t=-4.660, P=0.000)postoperatively.Time to regaining consciousness, extubation and detachment were also markedly shortened in the TEAS group.In addition, time to postoperative feeding and time to postoperative ambulation were also reduced.Postoperative hospitalization days( P<0.05)and anesthesia cost( P<0.01)both significantly decreased in the TEAS group compared with those in the control group.Patients in the TEAS group had lower rates of nausea, vomiting, decreased oxygen saturation, dyspnea, dizziness, agitation and lethargy, and increased heart rate and decreased mean arterial pressure after the opening of the pleura(H1)compared with those in the control group(all P<0.05). Bispectral indexes were maintained between 40 and 60 after anesthesia in both groups(all P<0.01). Conclusions:TEAS-assisted anesthesia can effectively alleviate pain in elderly patients undergoing thoracoscopic surgery and promote rapid recovery after operation.

Objective:To explore the critical value of different blood group antibody titration in ABO blood group incompatible kidney transplant(ABOi-KT)recipients by tube and gel methods to provide rationales for selecting the threshold value of antibody titration before ABOi-KT.Methods:From January 2019 to April 2021, 681 blood group antibody titrations were performed for 214 ABOi-KT recipients.There were type A( n=135), type B( n=168)and type O( n=378). The difference, correlation and consistency of two methods were statistically analyzed. Results:Tube method was 2 gradients lower than gel method(4-fold dilution)and the results were significantly different( P<0.000 1). Spearman's test indicated that the results of two methods were significantly correlated( P<0.000 1). The results of intraclass correlation coefficient showed that the consistency of two methods was general for type A recipients(ICC=0.640), decent for type B recipients(ICC=0.751)and poor for type O recipients(ICC<0.4). When the critical value of tube method was set, titration of type A anti-B was 16, titration of type B anti-A 8 and titration of type O anti-A/B 8.And the corresponding critical values of gel was type A anti-B 32, type B anti-A 16 and type O anti-A/B 16. Conclusions:The results of ABO blood group IgM antibody titration by gel and tube methods are correlative.And gel method is recommended for more stable and reproducible results.

Background: Diabetic macrovascular and microvascular complications often coexist and may share similar risk factors and pathological pathways. We aimed to investigate whether 10-year atherosclerotic cardiovascular disease (ASCVD) risk, which is commonly assessed in diabetes management, can predict incident diabetic nephropathy (DN) and retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM). Methods: This prospective cohort study enrolled 2,891 patients with clinically diagnosed T2DM who were free of ASCVD, nephropathy, or retinopathy at baseline in the Guangzhou (2017–2022) and Shaoguan (2019–2021) Diabetic Eye Study in southern China. The 10-year ASCVD risk was calculated by the Prediction for ASCVD Risk in China (China-PAR) equations. Multivariable- adjusted Cox proportional hazard models were developed to estimate hazard ratios (HRs) with 95% confidence intervals (CIs). The area under the receiver operating characteristic curve (AUC) was used to evaluate predictive capability. Results: During follow-up, a total of 171 cases of DN and 532 cases of DR were documented. Each 1% increment in 10-year ASCVD risk was associated with increased risk of DN (pooled HR, 1.122; 95% CI, 1.094 to 1.150) but not DR (pooled HR, 0.996; 95% CI, 0.979 to 1.013). The model demonstrated acceptable performance in predicting new-onset DN (pooled AUC, 0.670; 95% CI, 0.628 to 0.715). These results were consistent across cohorts and subgroups, with the association appearing to be more pronounced in women. Conclusion Ten-year ASCVD risk predicts incident DN but not DR in our study population with T2DM. Regular monitoring of ASCVD risk in routine diabetes practice may add to the ability to enhance population-based prevention for both macrovascular and microvascular diseases, particularly among women.

Background: Diabetic macrovascular and microvascular complications often coexist and may share similar risk factors and pathological pathways. We aimed to investigate whether 10-year atherosclerotic cardiovascular disease (ASCVD) risk, which is commonly assessed in diabetes management, can predict incident diabetic nephropathy (DN) and retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM). Methods: This prospective cohort study enrolled 2,891 patients with clinically diagnosed T2DM who were free of ASCVD, nephropathy, or retinopathy at baseline in the Guangzhou (2017–2022) and Shaoguan (2019–2021) Diabetic Eye Study in southern China. The 10-year ASCVD risk was calculated by the Prediction for ASCVD Risk in China (China-PAR) equations. Multivariable- adjusted Cox proportional hazard models were developed to estimate hazard ratios (HRs) with 95% confidence intervals (CIs). The area under the receiver operating characteristic curve (AUC) was used to evaluate predictive capability. Results: During follow-up, a total of 171 cases of DN and 532 cases of DR were documented. Each 1% increment in 10-year ASCVD risk was associated with increased risk of DN (pooled HR, 1.122; 95% CI, 1.094 to 1.150) but not DR (pooled HR, 0.996; 95% CI, 0.979 to 1.013). The model demonstrated acceptable performance in predicting new-onset DN (pooled AUC, 0.670; 95% CI, 0.628 to 0.715). These results were consistent across cohorts and subgroups, with the association appearing to be more pronounced in women. Conclusion Ten-year ASCVD risk predicts incident DN but not DR in our study population with T2DM. Regular monitoring of ASCVD risk in routine diabetes practice may add to the ability to enhance population-based prevention for both macrovascular and microvascular diseases, particularly among women.