Objective: To explore the neurophysiological properties of hereditary neuropathy with liability to pressure palsies (HNPP), so as to provide evidence for the diagnosis of HNPP. Methods: Three families (8 individuals) with clinically affected and asymptomatic HNPP patients underwent routine electrodiagnostic tests, including median, ulnar, radial, tibial and proneal motor and sensory nerve conduction, and the results: were compared with those of 30 healthy subjects. Results (1) Prolongation of the distal nerve conduction latencies was the most seen abnormality (92.1%), mainly found in the median and common peroneal nerves, including those with and without symptoms. (2) The rate of motor nerve conduction slowing was 63.2%, mostly seen in the median and common peroneal nerves. (3)The rate of sensory nerve conduction slowing was 89.6%, mostly affecting the sural and median nerves. (4)The conduction block of the ulnar nerve at the elbow was more commonly seen than that of the proneal nerve at the fibular head. Conclusion: Neurophysiological examination is a noninvasive, fast, simple and accurate diagnosis way for clinically suspected HNPP patients, and it can be used for screening the family members of HNPP patients and for prevention of HNPP.

As an important component of the “neurovascular unit”,astrocytes provide protective effect for nervous through intaking excessive excitatory amino acids,providing energy substances,maintaining extracellular K + and water balance,scavenging oxygen free radicals and secreting neurotrophic factor during ischemic stroke.This article elaborates the mechanisms of astrocytes participating in ischemic stroke in recent years.

Objective To investigate the effects of phosphocreatine on apoptosis following myocardial ischemia-reperfusion (I/R) in diabetic rats. Methods Male SD rats weighing 150-170 g were used in this study.Diabetes mellitus was induced by high fat diet and intraperitoneal streptozotocin. Twenty-seven rats in which diabetes mellitus was successfully induced were randomly divided into 3 groups ( n = 9 each): sham operation group (group S);myocardial I/R group(group I/R )and phosphocreatine group (group PP). Myocardial I/R was induced by 30 min occlusion of left anterior descending branch of coronary artery followed by 2 h reperfusion in I/R and PP groups. In group PP phosphocreatine 1 g/kg was given intraperitoneally 30 min before myocardial I/R. Blood samples were collected at the end of 2 h reperfusion for determination of plasma concentration of calcium troponin T (cTnT). The animals were then sacrificed and iscbemic myocardial specimens were isolated. The expression of Bcl-2, Bax and Caspase-3 in isehemic myocarcdium was determined and Bcl-2/Bax ratio was calculated. Myocardial apoptosis was detected by TUNEL and apoptotic index was calculated. The ultrastructure of cardiomyocytes was examined with electron microscope. Results Myocardial I/R significantly increased plasma cTnT concentration and Bcl-2, Bax and Caspase-3 expression in myocardium and apoptosis index and decreased Bcl-2/Bax ratio. Phosphocreatine significantly attenuated I/R-induced above-mentioned changes and myocardial damage. Conclusion Phosphocreatine can reduce myocardial I/R injury in diabetic mellitus rats by reducing myocardial apoptosis through up-regulation of Bcl-2 expression and down-regulation of Bax and Caspase-3 expression.

Objective To evaluate the value in following up the patients with clipped aneurysms with the subtraction CT angiography technique.Methods 30 consecutive patients with clipped aneurysms were followed up with 64-slice spiral CT angiography (CTA) and DS angiography 10 d later postoperatively.CT images were reconstructed with volume rendering (VR) and maximum intensity projection(MIP) techniques to display the vessels.The site of the clip and patency of the parent vessel on both CT and DSA were studies independently by two radiologists.Results The clips in 27 patients were showed clearly by the subtraction CTA.Subtraction CTA demonstrated a partial remnant of aneurysm in 2,28 cases were complete occlusion.The loading vessels were free in passing in 28 cases,occlusion and narrowing of a parent vessel were seen in one respectively.The sensitivity and specificity in detecting neck remnants on MSCT angiography were 67% and 100%,and the sensitivity and specificity in evaluating vessel patency were 100% and 100%,Inter-observer agreements were 0.78 and 1.00,respectively.Conclusion Subtraction CT angiography can be used as the mainly method in following up the patients with clipped aneurysms.

Objective:To research the clinical effect of abdominal total hysterectomy on the patients with uterine fibroids and the serum vascular endothelial growth factor (VEGF) and interleukin 6 (IL-6),interleukin 8 (IL-8) levels.Methods:106 cases of patients with uterine fibroids from February 2014 to February 2016 were divided into the control group and the research group according to the lottery method,the control group was treated with total abdominal hysterectomy,while the research group was given abdominal total hysterectomy treatment,the operation time,blood loss,anal exhaust time,length of hospital stay,changes of serum VEGF,IL-6,IL-8,Follicle stimulating hormone (FSH),estradiol (E2) levels,resistance to seedling le tube hormone (AMH) before and after the surgery as well as the occurrence of complications were compared between two groups.Results:The operation time,blood loss,length of hospital stay,anal exhaust time of research group were significantly shorter than those of the control group (P＜0.05).Before surgery,the serum levels of VEGF,IL-6,IL-8,FSH,E2,AMH showed no difference between two groups (P＞0.05).After the operation,the serum levels of IL-6,IL-8,E2,AMH of research group were lower than those of the control group (P＜0.05),the serum level of FSH in research group was higher than that of the control group (P＜0.05).The serum level of VEGF showed no difference between the two groups (P＞0.05).The incidence rate of complications in research group was lower than that of the control group (P＜0.05).Conclusion:Abdominal total hysterectomy showed similar effect with the abdominal hysterectomy in the treatment of uterine fibroids patients,but the abdominal full hysterectomy induced less trauma,promoted the recovery of ovarian function after surgery,which might be related to the decrease of serum IL-6,IL-8 and VEGF levels.

Objective To assess whether the plaque volume of carotid artery evaluated by three-dimensional ultrasound can predict the risk of cardiovascular events earlier in patients with coronary heart disease, in comparison with plaque thickness.Methods A total of 99 patients were enrolled, including 66 patients with asymptomatic carotid plaque and 33 patients with coronary heart disease (CHD) and carotid plaque.Three-dimensional ultrasound was performed in all the patients.Coronary angiography was performed in all the patients in CHD group.Coronary artery Gensini score was calculated.Plaque thickness, plaque area and plaque volume were compared between the two groups.We analyzed the relationship of plaque volume with Gensini score and other cardiovascular risk factors.Results Plaque volume was significantly higher in CHD group [(1312.38±513.70)mm3] than in asymptomatic group [(947.54±321.41)mm3] (P=0.023).However, plaque thickness and plaque area were not significantly different between the two groups (P>0.05).Plaque volume was positively correlated with Gensini score (r=0.519, P=0.002), homocysteine (r=0.569, P=0.002), and cardiovascular risk factors such as diabetes, blood glucose and glycosylated hemoglobin.There was a negative correlation between plaque volume and high-density lipoprotein (HDL), a factor protecting against cardiovascular events (r=-0.387, P=0.038).Conclusion Compared with plaque thickness, the volume of carotid plaques assessed by three-dimensional imaging technique may be a better predictor of the risk of cardiovascular events in patients with coronary heart disease.

Objective To investigate the effects of propofol on the changes in myocardial Toll-like receptor 4 (TLR-4)and TNF-αand NF-κb protein expressions in ischemia-reperfusion injury (I/R).Methods Thirty healthy male SD rats weighing 250-320 g were randomly divided into 3 groups (n=10 for each):Group A,sham operation;Group B,I/R;and Group C,propofol + I/R.In Groups B and C myocardial I/R was induced by occlusion of the left anterior descending artery (LAD)for 30 min,followed by 120 min reperfusion.In Group C propofol was given intravenously 1 0 min before myocardial ischemia,followed by continuous infusion of propofol at 5 mg/(kg·h)until the end of 120 min reperfusion.In Groups A and B normal saline instead of propofol was given. The myocardial tissues were taken at the end of 120 min;ultrastructural changes of myocardial cells were observed under X-ray electron microscope and the expressions of TLR-4 mRNA as well as TNF-αand NF-κb protein were determined.Results Ultrastructural observation under electron microscope showed significantly worsened damage in myocardial tissue structure and mitochondria in Groups B and C compared with Group A.The myocardial expressions of TLR-4 and TNF-αand NF-κb protein were significantly higher in Groups B and C than in control Group A.The myocardial expressions of TLR-4 and TNF-αand NF-κb protein were down-regulated in Group C compared with Group B.Conclusion Intravenous injection of propofol can protect against myocardial damage.Propofol can suppress the increase in myocardial TLR-4 and TNF-αand NF-κb protein expressions induced by I/R.

Objective To study the changes and significance of sCD14 in inflammatory response of patients with gouty arthritis.Methods CD14 mRNA was measured using quantitative real-time PCR in peripheral blood mononuclear cells (PBMCs).The expression of CD14 mRNA in PBMCs was compared between patients with acute gouty arthritis (AGA)(n =31)and non-acute gouty arthritis (NAGA)(n =23)and healthy controls (HC)(n =20).β-actin was selected as the internal control.The protein expressions of sCD14,IL-1βand TNF-αwere measured using enzyme linked immunosorbent assay (ELISA) in patients’ plasma.The protein expression of CRP was measured using immunoturbidimetry in patients’ plasma. Routine blood and blood biochemistry indexes were measured by routine blood analyzer and blood biochemistry analyzer of patients with AGA,NAGA and HC.We analyzed the correlation between CD14 mRNA,sCD14 protein expression and each clinical indicator.Results When compared with that in AGA group,the mRNA expression of CD14 increased significantly in PBMCs of HC patients (P < 0.05 ).When compared with that in HC and NAGA patients,the protein expression of sCD14 increased significantly in the plasma of AGA patients (P <0.01).The protein expression of sCD14 was significantly lower in the plasma of NAGA than in HC (P <0.05).The protein expression of sCD14 increased significantly in the plasma of AGA compared with HC and NAGA (P < 0.01 ).When compared with those in HC,the protein expressions of IL-1β and TNF-α increased significantly in the plasma of AGA and NAGA (P < 0.01 ).When compared with that in NAGA,the protein expression of IL-1βincreased significantly in plasma of AGA (P <0.01). The indexes of WBC increased significantly in AGA compared with HC (P <0.01),and WBC increased significantly in NAGA compared with HC (P <0.05).The indexes of GR and MO increased significantly in AGA compared with HC (P <0.05),and MO increased significantly in AGA compared with NAGA (P < 0.05 ).The indexes of UA increased significantly in AGA and NAGA compared with HC (P <0.01).There was a positive correlation between CD14 mRNA expression and IL-1β in PBMCs in AGA group (r s =0.362,P =0.045).A positive correlation was found between GR and the protein expression of sCD14 in NAGA patients’plasma (r s = 0.397,P = 0.030 ). Conclusion The dysregulated expressions of CD14 mRNA in PBMCs and sCD14 protein in GA show that sCD14 may play a significantly regulatory role in inflammatory reaction.

Virus infection is a serious threat to human health and social development. The increase in pandemics caused by emerging and re-emerging viruses highlights the urgent need for broad-spectrum antivirals. In this perspective, we highlight recent case studies and summarize the universal strategies and methodologies in broad-spectrum antiviral drug discovery from common targets, common steps in viral life cycle, universal strategies, and broad-spectrum molecules, hoping to provide valuable guidance for the current and future development of antiviral drugs.

New drug research and development is a technology-intensive industry with high investment, high cycle and high risk. In recent years, with the rapid development of modern disciplines such as omics technology, bioinformatics, high-throughput and high-content screening, and artificial intelligence, the research and development of small-molecule drugs has presented a new paradigm characterized by "integrated medicinal chemistry". This review summarizes new enabling drug discovery technologies, the emergence of new subfields formed through integration innovations and practical chemistry toolbox in the field of medicinal chemistry.